Triple Vessel disease

Question

Let me explain my problem clearly..
My mom aged 56 yrs. She got a chest pain last week and it was there for 5-10 mins. And before she is taken to the near by doctor she became alright. But the doctor advised to take ECG. And in the report it showed some variation. Then she was admitted to the hospital and underwent angiogram. I'll publish the report exactly.

She is diabetic patient and under control from 1998 onwards. Regular monthly checkup as per the doctors advice by taking frequent tests.

------------------- Result of angio -------------------------------------------------------------------------------------------------------------------------------
PRE CATH DIAGNOSIS : Coronary artery disease - recent acute coronary syndrome
INDICATION : Evaluation of Coronary  anatomy
PRE MEDICATION : Inj.Pethidine + Inj.Phenergan
CATHETERS USED : 5F TIG

AO SYS/DIA : 150/100 M 120                     CONTRAST USED : Xenetic 350mg 100ml

LMCA : Normal

LAD : Type III LAD has 50% proximal stenosis followed by eccentric 95% stenosis before D1 and 90% - 95% long segment stenosis astride D2. Distal LAD exhibits TIMI - III flow D2 has 90% ostial stenosis

LCX : Non-dominant LCX has 70% proximal stenosis followed by 90% stenosis after OM1. Major OM1 is normal.

RCA : Dominant RCA has mid luminal irregularities in the proximal and mid segment. Distal segment at bifurcation has 70% stenosis involving the origin of PDA & PLB

LEFT SUBCLAVIAN ARTERY : Normal                     RENAL ARTERIES : Normal

DIAGNOSIS : 
                    CORONARY ARTERY DISEASE
                    TRIPLE VESSEL DISEASE
                    NORMAL RENAL ARTERIES

RECOMMENDATION :
                                  CAB SURGERY WITH GRAFT TO LAD, D2, OM1, LAST OM, PDA & PLB
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Kindly help me how do i proceed further. I am more concerned about my mom's health. Can we cure this through medicines or do we need to go ahead with surgery. Please advice.

Nana18 · Answer

Thanks for the detailed report. To some extent i can understand that my mom is under greater risk. Is there a way that we can resolve this by giving medicines. Or there is no other way than bypass.. As i am from a middle class, i am not able to get money immediately to do the bypass. I got an appointment with the cardialogist tomorrow. But before that can you give me some hope that my mom will be ok soon.

Jack54 · Answer

Your Mother has many very, very serious blockages in 3 major coronary arteries that need bypassing soon. The recommendation at the bottom of the cath report states that she needs a 5x CABG (Coronary Artery Bypass Graft).

 RECOMMENDATION :
 CAB SURGERY WITH GRAFT TO LAD, D2, OM1, LAST OM, PDA & PLB

The pre cath diagnoses means that your Mother may have had a recent heart attack, which is not at all surprising.
Coronary artery disease - recent acute coronary syndrome.

Some info from an un-copyrighted source:

Heart Attack: an Acute Coronary Syndrome

Types of Acute Coronary Syndromes - or heart attacks

Acute Coronary Syndrome is a name given to three types of coronary artery disease that are associated with sudden rupture of plaque inside the coronary artery: unstable angina, Non-ST segment elevation myocardial infarction or heart attack (NSTEMI), or ST segment elevation myocardial infarction or heart attack (STEMI).

A Type III LAD (Left Anterior Descending) coronary artery, means that the heart muscle/tissue territory affected by, due to the location of her blockages, is her SEPTUM. The septum divides the left and right side of the heart. I have a type III LAD blockage myself.
=======================================
Your Mothers renal arteries than run through each of her kidneys are fine and the subclavian artery is also. This is great news!

From my dictionary:

Subclavian Artery
The proximal (beginning) part of the main artery of the arm that arises on the right side from the brachiocephalic artery and on the left side from the arch of the aorta, that extends from its point of origin to the outer border of the first rib where it becomes the axillary artery and passes through the axilla and into the arm to become the brachial artery, and that supplies or gives off branches supplying the brain, neck, anterior wall of the thorax, and shoulder.

Most importantly your Mom's Left Main Coronary Artery (LMCA) is normal.

Your Mother is at great risk for a lethal heart attack without bypass surgery soon. If you would like, I can pinpoint and explain the blockages and which arteries are affected, but you would need some understanding of the anatomy of the coronary arteries.

Your Mom's heart is what cardiologist call Right Dominant, because it supplies the PDA and PLB coronary arteries. I am Left Dominant which is kind of rare (10% of all folks).

I wish your Mother the very best with the outcome of her CABG X5 surgery (5 arteries bypassed). Diabetes tends to "help" cause coronary artery disease or CAD.

Keep your chin up :) She will be fine after the surgery,

Jack


P.S. Please keep us posted. Your Mom will need a good recliner to sleep in after she leaves the hospital, I have read this many times. I myself am waiting on bypass surgery. Give you Mom lots of TLC after she comes home!