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Treatment for a triple vessel disease with severe LV systolic dysfunction
Adhoc PTCA + Stent to LAD has been done. Could you advise what should the next step be. Patient condition as follows:
Pre cath diagnosis: CAD - ACS, Anterior wall MI, Acute LVF, HTN, DM Type-2, Severe LV Systolic Dysfunction
LMCA: Normal
LAD: Type 3 vessel, mid total cut off with retrograde filling, Diagonal - 60% disease
LCX: Non-dominant, distal 70% stenosis. OM1 - Mild disease, OM2 - 70% Disease
RCA: Dominant system, mid 70% stenosis. PDA/PLVB - Normal
Pre cath diagnosis: CAD - ACS, Anterior wall MI, Acute LVF, HTN, DM Type-2, Severe LV Systolic Dysfunction
LMCA: Normal
LAD: Type 3 vessel, mid total cut off with retrograde filling, Diagonal - 60% disease
LCX: Non-dominant, distal 70% stenosis. OM1 - Mild disease, OM2 - 70% Disease
RCA: Dominant system, mid 70% stenosis. PDA/PLVB - Normal
I am no cardiologist, but even if, it would be impossible to advice with this limited information.
Did the stent in the LAD open up the complete blockage?
If so and if the stenoses of 70% in the LCX and RCA are considered as being non critical, the blood supply to the heart is restored for the moment.
How long has it been since the MI?
If the duration of the infarction was not too long, the damage to the heart muscle may be limited and the LV Systolic function could increase in the weeks/months after the MI.
Did the stent in the LAD open up the complete blockage?
If so and if the stenoses of 70% in the LCX and RCA are considered as being non critical, the blood supply to the heart is restored for the moment.
How long has it been since the MI?
If the duration of the infarction was not too long, the damage to the heart muscle may be limited and the LV Systolic function could increase in the weeks/months after the MI.
5 Comments
The doctors said that the heart Is working at 35%EF. The report said that the angio revealed a well deployed stent with TIMI - 3 Flow. No dissection/ residual lesion. Does the LV Systolic function get better? His age is 62. I am unaware of the duration of the MI
Dysfunction can occur from a prolonged period (months) of ischemia (not enough oxygen rich blood through the coronary arteries to the heart muscle). If that is the cause for the dysfunction, improvement may be seen in the coming weeks/months.
If the dysfunction is a direct result from the MI (loss of heart muscle tissue and forming of scar tissue), chances for improvement are less.
The months after the MI will show if his heart function will improve.
If the dysfunction is a direct result from the MI (loss of heart muscle tissue and forming of scar tissue), chances for improvement are less.
The months after the MI will show if his heart function will improve.
What about the two blocks? Are those very dangerous?
70% normally does not cause direct problems.
Healthy coronary arteries have quite some reserve capacity. 30% of that is normally still enough, at least for light to moderate physical activity.
Problems often start when the blockages are >80%.
Healthy coronary arteries have quite some reserve capacity. 30% of that is normally still enough, at least for light to moderate physical activity.
Problems often start when the blockages are >80%.
Thanks!
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