I am a 58 year old male in pretty good shape except for my high cholesterol ,triglycerides and high blood pressure. Recently I was diagnosed as a diabetic, my sugars are under control by diet. I went to my cardiologist for a base line check up. He order various tests. They found a problem on the stress test. Had a cardiac cath last week, he did not put any stents in but was told that I have 3 main arteries blocked 75%,75% and 50%. I was told that stent would not help me or avoid a heart attack since I am not symptomatic as far as I know. I was lifting weights (light lifting) using the olyptical nightly with out issues. Now I feel every little twinge or gas pain and think this is it! What do you recommend for a patient like myself for treatment? I am on 25 mg of statin, 25 mg metoporlol, 10 mg lisinopril. My diet is pretty good. What is your recommendation as far as exercise? I feel good but know I'm a walking time bomb 24 -7. Thanks.
It is always difficult to answer questions via the internet, but I'll give you some thoughts. I'm not sure why you had the stress test ordered, but we don't routinely perform them as just a "screening" test. Meaning, even if you have all the risk factors for heart disease (hypertension, diabetes, cholesterol issues), we don't usually order a stress test unless you are having symptoms. That is mainly because studies have reinforced that in patients without symptoms, medicines are just as good as stents.
That all being said, I can't comment on what I would have recommended in your case given I can't see your heart catheterization films and would need to know which vessels were blocked and a host of other details. You could always get a second opinion from another cardiologist if that would make you more comfortable. You are on a good medical regimen, although you should also be on a baby aspirin unless there is a reason you can't take it. Make sure you talk to your cardiologist before starting it.
You are obviously a high risk patient given all your medical problems. It is very understandable that you would have a lot of anxiety associated with that. Unfortunately, genetics play a greater role in some patients than others. That seems to be the case for you given you seem to lead a healthy lifestyle. I would focus on having your blood pressure, cholesterol, and triglycerides monitored closely. If you haven't already, you should reduce your fat intake (important for triglycerides) and carbs (important for your LDL or "bad" cholesterol). Stop smoking if you're a smoker.
In terms of exercise, this is a very important part of staying healthy (both mentally and physically). You may qualify for "cardiac rehab" which develops an exercise plan for you with the supervision of individuals trained to work with heart patients. You should discuss this and a safe exercise regimen with your doctor. Make sure you voice the concerns you have. If you are not having any symptoms, I think that is reassuring in terms of how much activity you can tolerate. Again, I would definitely discuss this first with your cardiologist as he/she knows you and your history.
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