Finally had meeting with him yesterday and I have to say that I'm very confused, perhaps it's a good thing I have a meeting in two weeks with another cardiologist in a different hospital. This is how the meeting went.
Cardiologist : It's really good to see you, it was considered by many cardiologists that the procedure would not work or wouldn't last very long, but seeing you sitting here is proof it did. How are you feeling?
Me : Disappointed. My angina has not improved at all, I expected to be running around. The only difference I've noticed is that I can comfortably breath cold air. Throat discomfort, aching jaw, chest pains, shortness of breath are the same on exertion.
Cardiologist : Well, your heart is now in excellent shape, your LAD has a better supply than most people of your age. Whatever is going on is not the heart.
Me : Well I beg to differ. I've lived with angina for years and I do know the symptoms. What else could give these problems upon exertion if not angina.
Cardiologist : Well it is possible that a smaller vessel was overlooked and this could cause angina. I will have a re-study of your angio and see what I can find. Your arteries do tend to spasm also, we noticed a lot of this during the procedure, they were actually quite wild.
Me : Well with the amount of work performed wouldn't this be expected. It doesn't mean they spasm without a catheter moving around inside or balloons being inflated. Besides, isn't a spasm spontaneous? are you saying my
LAD goes into spasm with exertion only?
Cardiologist : No you are correct, I will look at your angio and see what I can find. I will write to your GP and suggest you wear a Nitro patch which should help. Whatever is going on, I still don't think it's your heart.
Me : Well, I was here two days ago and had a stress echo. They were able to reproduce my throat discomfort and chest pains with a 10 out of 10 extremity of pain. I'm sure you would have seen the results and surely this points to the heart and nothing else.
Cardiologist : I didn't know you was referred for a stress test. I have no results and I will find out and access them. You are right, it does seem to point to the heart. I will have to have another good look at your case.
Me : I had a lung function test last week also, and the results were very good, above average. However, this test did not look at oxygen concentration in the blood, it simply checked the physical ability and volume of the lungs. I take it you remember doing my procedure?
Cardiologist : Oh yes, I remember your procedure very well, just like it was yesterday. It was very challenging to say the least.
Me : So can you please explain to me what happened in recovery when my HR went to 220 + and I was knocked out with medication.
Cardiologist : When I was initially removing the first section of plaque in the 100% blockage (chipping away at it), the catheter broke through the artery wall. It didn't seem to be posing a problem at the time, there was no bleeding. I continued to remove the blockage and put in a long stent. I then proceeded all the way down the LAD because it was completely lined with Plaque, but not very thick, probably 20% in the worst part. I ballooned and stented with 4 more long stents. In recovery, the LAD split slightly where the catheter broke through the wall, causing your heart rate to increase. Your oxygen level reduced and we quickly got you back into the angio suite where I repaired the vessel and
put in a small stent. So, you had 5 long stents and one small one in total.
What medication are you currently taking?
Me : Aspirin/Plavix/Atorvastatin/Ezetimibe
Cardiologist : So no beta blockers?
Me : No, I hate those things
Cardiologist : That's great, you can stay off them. I will do the letter to your GP, re-study your case. I want to see you again in 6 months, but if I see anything obvious then I will certainly be getting you back in.
So as you can see, yet again there is a lot of confusion over what can be causing my Angina. I will be writing a letter to my GP outlining all the events so there is a record of it. According to him, with my LAD so wide, I should be running around with no problems but I really wish that was the case. I feel like they believe I am imagining the symptoms and I wish we could swap bodys for half an hour so they can see/feel exactly what it feels like.