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TVD with CAD
My father, aging 61, gets episodes of sweating quite often. Non-smoker, Non alcoholic or any other addiction. Mild pain in chest. He has diabetes since 1.5 yrs on Rx. Recently spotted high BP (150/80). He underwent ECG-NORMAL, CXR-Normal. Lipid profile - Normal.
2D Echo - Moderate concentric LVH; LVEF 60-65%;
ANGIOGRAPHY shows-
LMCA - calcified
LAD - calcified proximally, shows 50-60%lesion after D1 & 30-40% lesion in mid segment. Distal LAD after D2 shows 70% lesion. D1 shows 60% ostial stenosis. D2 shows 70% ostial stenosis.
LCx - calcified proximally & shows no significant disease. OM1 is a small vessel & shows 80-90% ostial lesion. OM2 is a large vessel and shows 70%long segmental lesion starting from its origin. A small branch of OM2 shows 80% ostial lesion.
RCA - is a dominant vessel, calcified proximally with a small saccular aneurysm. Mid RCA shows plaque. PD shows 60% lesion proximally starting from its ostium. PLV shows 50% lesion in the mid segment.
LIMA/RIMA - Normal
LV Angio - Not done
Conclusion - Triple Vessel Disease with moderate Coronary Artery Disease
2D Echo - Moderate concentric LVH; LVEF 60-65%;
ANGIOGRAPHY shows-
LMCA - calcified
LAD - calcified proximally, shows 50-60%lesion after D1 & 30-40% lesion in mid segment. Distal LAD after D2 shows 70% lesion. D1 shows 60% ostial stenosis. D2 shows 70% ostial stenosis.
LCx - calcified proximally & shows no significant disease. OM1 is a small vessel & shows 80-90% ostial lesion. OM2 is a large vessel and shows 70%long segmental lesion starting from its origin. A small branch of OM2 shows 80% ostial lesion.
RCA - is a dominant vessel, calcified proximally with a small saccular aneurysm. Mid RCA shows plaque. PD shows 60% lesion proximally starting from its ostium. PLV shows 50% lesion in the mid segment.
LIMA/RIMA - Normal
LV Angio - Not done
Conclusion - Triple Vessel Disease with moderate Coronary Artery Disease
Best Answer
Please guide me the further course of treatment - Angioplasty/ bypass/alternative medicine/any other? How sever and serious it is?
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Hopefully he is controlling his diabetes, his cholesterol numbers, and has adopted a healthy cardiac diet. If he is over weight, hopefully he is trying to lose it and is exercising. Also, I'm trusting that he is taking all the good pharma drugs that help control CAD, and mixing in fish oil tablets. His situation sounds like it should be monitored closely. Hopefully he will have his cholesterol level checked at least every three months, and any change in chest pain should be reported. I'm sure he is carrying Nitro tablets, if not, he should. Exercise is simply vital. It's the only way he will be able to self-monitor how his heart is doing. If the same exercise regimine suddenly get's difficult, it's time to get another angiogram and see what is causing the problem.
His situation is much like mine twelve years ago, but I had eight stents inserted, then a pacemaker, and finally bypass surgery. However, I'm still standing. If I were to do it over again, however, I'd had a bypass procedure. Keep us informed.