stints and heart blocage issue

[kcrandy]

i just had a heart cath today at va hosp and was told that i have a couple of arteries
50% blocked and one that is 70% blockage and was scheduled for another cath the
following thur for an extra test that measures the pressure readings on either side of
the blockages to determine my need for stints.  is this soc or does anyone know
what this pressure test is in laymans term.

i am 51 and and in fairly good health but as you can see my heart is giving me fits so
i have to keep going to the repair shop.  :O)

thanks!

[kenkeith]

Quote: "Our Mom had bypass surgery about 10 years ago and she had a heart attack 3 weeks ago and another small one last weekend while in ICU.  She's still hanging on.   The doctor said the only part of her heart that's working is the by-passes.  Can a person survive a long time with only their by-passes working in the heart???  Thanks".
________________________________________________

To give some insight, a prior heart attack damaged heart muscle medically referred to as myocardium infarction (MI).  The damage could be stunned cells that recover with blood perfusion (bypass) and/or the cells are necrotic (dead).  It may be this situation the doctor is referring.

To know with some certainy, requires an echocardiogram.  The echo can view heart wall movement or lack thereof, and the percentage EF, (ejection fractiontion) of blood out of chamber with each heartbeat.  Apparently, the doctor did some testing to have made the comments you have posted.  The part of the heart that is not working would identified as impaired wall movement (hypokinesis) and/or akinesis (necrotic heart cells)  Also, an ejection fraction would be included with the test.  Your mom is entitled to have a copy of the report. People can live many years with dead, scared heart cells. Hope this helps and gives you some visibiliy to your mom's condition.






family is entitled

[ed34]

It isn't how many vessels that are open, it is the area of heart muscle being supplied which is the key. The statement "The doctor said the only part of her heart that's working is the by-passes" can be interpreted in many different ways and the Cardiologist needs to be more specific. For example, it could mean the native coronary arteries are so blocked that the blood isn't able to get from the bypass vessels into them, but the bypass vessels themselves are fine.
While in ICU, what type of scan did they perform to establish the condition of the blood vessels?

[ourmom]

Our Mom had bypass surgery about 10 years ago and she had a heart attack 3 weeks ago and another small one last weekend while in ICU.  She's still hanging on.   The doctor said the only part of her heart that's working is the by-passes.  Can a person survive a long time with only their by-passes working in the heart???  Thanks.

[kenkeith]

If a vessel is totally blocked, often there are collateral vessel development that will feed into the the blood/oxygen deficit location.  It is unlikely a blockade can open up without intervention, but if part of the blockage breaks away due to pulsating pressures that particle that breaks away could cause blockage in another area with harmful results. Also, if there is total blockage, the heart cells downsream would have been damaged  (necrotic) and a return of blood flow to the area would be of no benefit. (no evidence, just creative thinking of possibilities).

If  there is good blood flow through the new opening with intervention or without, blood will flow through the vessel(s) that have the least resistance, and if that is the freshly opened blockage, blood may not any longer flow through the collaterals and that may or may not be a problem. Also, whether or not other arteries are supplying the area that the blocked artery is supposed to supply is an important factor. Thus, the decision to open an old blocked artery is not always an easy one.

[ed34]

This is unlikely. If you imagine a 70-90% blockage, there is still a gap for blood to get through and this extra pressure exerted on the blood is the major cause of an eruption of the plaque. A 100% blockage is all the way across the artery, with no gaps and no blood flowing through it.

[bobcat315]

I was just wondering if anyone has ever heard of a 100% blockage opening back up after a year, and wondering how dangerous this is?

[kcrandy]

thanks everyone for your responses.  very helpful info.  i was told in the ask a doctor side to also ask for a corodid artery ultra sound to make sure there not any blockage developing there as well,  and that the pressure check is used to determine if a stint is needed or would be practical in my case.  

i look so forward to another needle poke on thursday.  oh well the price we pay for our indiscretions of earlier days.  dang before i know it im gonna have to go onto craigs list to find spare parts, lol  :O)

[erijon]

Flycaster is correct, most blockages come from an eruption in areas of vulnerable plaques which breaks free and starts to form a new blockage in another location or a clot forms where the plaque erupts to seal it and a larger blockage appears, so they can develop very quickly.

I hope this helps and good luck.

jon

[Flycaster305]

I'm wondering if they are going to test for left ventricular ejection fraction and pressures.  Just a guess based on my experiences.  How did you get so lucky to keep your leg still only six hours?  Where I have had eight stents, they require eight hours.  You are right on, staying still that long is really tough.  Blockages come on very quickly, at least in my case.  Keep in mind that a blood clot is probably the problem caused by an eruption of the cholesterol in the artery, and that can happen in the blink of an eye, so to speak.
Sorry about your hep c experience.  Hang in there.  

[kcrandy]

ditto! :O)

i also forgot to mention that i am taking avandia for the last 18 mths and just went thru hep c  tx ( without success ) and was wondering if anyone has heard of heart blockages developing from using avandia or interferon/ribaviran tx.  this 70% blockage seems to have come rather quickly.  i say that because while i was on tx for hep c this new blockage was not there ( heart cath jan 2007 ) and one year later it is.  

oh well i guess its the price i pay for fun in my early days and now im paying for it now.lol :O)

p.s.  the drugs werent bad but keeping my leg still for six hour s*&%ed  :O)

[jim62]

I've had 4 caths, and as far as I know, I've never had the pressure test you're referring to.  I'm thinking that it's probably pretty much what it sounds like at face value, and will determine how effectively the blood is  passing through the blockage.  70% is usually the point at which a stent or some other treatment is done.  Maybe they're just trying to decide what that treatment should be??

Happy trails !  Gotta love them drugs they give you for a cath........:-)

[kcrandy]

:O)