So I first came on this forum with my Afib diagnosis and was terrified and depressed about the diagnosis and medications. I had good news from my echocardiogram as I had no damage at all. The last hurdle was a CT angiogram sadly I’ve not made it so well past this hurdle. I’m absolutely gutted to be honest.
From my report.
The scan demonstrated moderate burden of the coronary artery atheroma. There is a short moderate stenosis in the mid left anterior descending artery as well as mild stenoses in the distal part of this vessel and circumflex artery. They say because I have mostly no symptoms they’ve suggested high dose Artorvastrin 80mg daily and not aspirin as I’m already on Apixiban my CHADvasc is now 1 so anticoagulants for life. And Ramipril 1.25mg od.
I’m terrified and feel like once again I’m potentially going to drop dead at any minute. i was hoping to have a mini maze procedure for my AF and get off anticoagulants. This now seems unlikely or maybe I can just be on aspirin after this surgery or I can’t have this surgery or maybe I will need stents before surgery. I have no idea. I had a good chat with a heart foundation nurse I feel terrified. I feel like I have now got many surgery’s and medications and side affects. I’m 47 on Friday and have a ten year old son.Any advise would be gratefully received
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Dadtoalad23
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I can’t give any advice apart from ‘do what your doctors tell you and don’t do anything stupid like signing up for any kind of extreme fitness regime’. Oh, and visit the British Heart Foundation website where you will find plenty of info and advice, can call a nurse, and can join the BHF forum, though be aware some of the posters believe in telling it like it is! One piece of info, aspirin is absolutely not an improvement on anticoagulants as it can have dangerous effects, no antidote and takes a long time to wear off, speaking from experience.
I know it is no use telling you not to worry so just sending sympathy and positive thoughts ❤️🩹
thanks. I’m already a runner and running 25k plus weekly. The BHF nurse said this was fine, but maybe I should call it down a bit. I have no real problems with the running, I’d hoped that was a good indicator to not get this CT result. Thanks again
There are implications between your CAD and Afib. You need a strict rate control during your afib episodes. On a non CAD heart, high heart rate is tolerable but on a CAD heart, when the heart is not well oxygenated because the heart does not have time to pump the blood into the coronary arteries, other ventricular arrythmias might happen. Also drugs such as Flecainide or other drugs in the same class are not recommended. Sotalol or drugs in its class is recommended.
Stenosis of your coronary arteries are plaques of fat and statins can dissolve it so keep hope and work on your life style changes to stop the plaques from growing and let the statins dissolve it. If you have the following comorbidities, you need to manage them strictly: High blood pressure, dyslipidemia, overweight, diabetes or prediabetes, smoking and alcohol. It requires strong will and discipline to manage them. Easy said than done. Western diet is full of salt and carbs. A small portion of French fries from fast food is full of salt and can bring your blood pressure to an unacceptable level for your heart. Food full of carbs is so cheap and so tasty. Excess carbs will become fat in the blood. For high cholesterol, I would go with the most potent statins, which is rosuvastatin. The last thing is exercise. Ask your medics if you can walk or even brisk walk. The walk/brisk walk is so critical for CAD. It helps developing a small collateral network of vessels which bypasses the blockages/stenosis. The day the plaque might detach from the wall of the artery and blood clot is formed and a heart attack is about to happen, this small network of vessels allows your heart to survive and allows your medics team to intervene with stents, angioplasty or bypass on time before your heart got damaged. Keep hope and work on your life style changes. Hope it helps.
I’m already 12 stone and 6’3. I certainly have eaten badly in the past alongside a good diet but to much sugar and snack food. I recently reduced all of those to almost nothing so diet in check. I gave up alcohol although I wasn’t big drinker anyways. But I’ve gone back to a couple of glasses of wine or beer at the weekend. I’m actually very fit I have surfed for 35 years and in the last few years taken up running I average about 25-35Km weekly. I’m worried if I’m doing to much in this regard ? The heart nurse says that the running is good but to be aware for any changes. My AF is mainly at a low rate but it is persistent AF. I’m already scared about taking Apixiban and it’s side affects and now I’m going on the the highest dose of Artovstatin 80mg (Lipitor?). Again terrified of how Ill this is all going to make me feel. Will it destroy my liver ? Kidneys ? Make me diabetic ? Destroy my overall fitness. It’s a lot to deal with. As you say they’ve ruled out Flec and other Rhythm control drugs. My Af is persistent but well controlled and was and is often asymptomatic even before being diagnosed. Basically feeling a bit over whelmed.
No the high dose will not destroy your liver ,it will get rid of crap in your ateries.I had a score of 13.5 cholesterol...yup! Dr tried to keep straight face when he pulled up my results on screen but failed. Popped down the corridor and came back with a box of 80mg atorvastatin.
After a while,cant recall timeline,gradually reduced down to 20mg.
All good with liver etc
MyAF generally was low rate but erratic.
Flutter was much worse.
Diagnosed at 53 but sure had IT 5 years before.
Are you under an EP? Far better than cardiologist.
I have an EP and will be speaking with a cardiologist as well for the CAD. I suppose they will try and reduce my cholesterol and hopefully slow down the progress of my artery disease. I have moderate blockages which I think means over 50%. They want to do a cardioversion and then will be talking about different options. I would like to have the mini maze but obviously all my parameters and hopes to come off medications have significantly changed. I will be on some sort of anti platelets or blood thinners for life. This is quite a big disappointment to me. Although I still might be a candidate for the mini maze or other maze procedures. A heart foundation nurse did mention that before the mini maze they might want to do an angiogram and stent first. Anyways it was a hard road to feeling like I was dealing mentally with the Afib and I feel like I’ve been knocked back down again. Ramipril and the statin don’t sound fun. Appreciate your response though, just need to readjust take some deep breaths and catch on with it all.
What are your concerns about side effects of anticoagulants? BobD did an interesting post about this recently. Have a look by clicking on his profile. Perhaps change your goal to 'physical wellness' rather than 'Fitness'. For many, Fitness is about physical prowess or achievement but that's not really a health goal - and right now you need to look.after yourself and be there for your family. Not saying you shouldn't exercise- it's essential for your BP and probably for your mental health too. But maybe explore different levels of exercise? Shorter runs or interval training? The latter is thought to be excellent for both heart and BP.
main concern is I’ve had stop my life long pursuit of surfing. Been surfing since I was ten years old and now the injury risk of bangs on the head and twisted knees whilst on anticoagulants has curtailed that for me for now. So I hoped to be able to get the mini maze and come off them. But now I will be on anti platelet drugs for life with my coronary artery disease. Maybe in the future I can surf some small waves.
Oh I do sympathise. The loss is real, and surfing such joyous full body experience! There IS a procedure where they can close up the atrial appendage. I've forgotten the name of it but if you look for Dr Tim Betts on YouTube you might find the video about it. It's only available in the UK for certain candidates at present but it might be worth looking into.
I would replace Lipitor with Crestor(Rosuvastatin) which is more potent to dissolve plaques. It is potent and you dont need I guess more than 20 to 25 mg of Crestor. Anyway see with your medics. The key point with statins is to take it at bedtime since cholesterol formation is most active during sleep/night time. The other point I need to point out is when you run please keep your heart rate under 120 or 125 bpm. With persistent Afib, heart rate is not accurate but you see what I meant. The last point is to control the comorbidities. It is a life long process and daily one, even with medication, angioplasty, stent or bypass. People tend to think I had stent/bypass so I am good and I don't need to do anything. All of it can get clogged again with fat if we keep our unhealthy life style. Stay strong and disciplined to take care of your own body.
Just wanted to point out that the primary function of statins is to stabilize plaque and prevent new build up, not dissolve it. Although there have been some studies showing that high dose Lipitor and Crestor can reduce build up to a small extent, folks should manage their expectations in this regard. I completely agree that Crestor is the way to go over Lipitor.
Hi, I can't help thinking that your finness regime has something to do with it. Why do sports people push themselfs to such limits. So many super fit people have AF, its only my opinion but walking is the best exercise you can get. If we were meant to run every where we would have four legs.
I would reduce the running more the pace than the distance, but both would be worth trying to see if it helps.
A helpful way of viewing this situation might be to see that these conditions were already present, but now you are aware of them. With appropriate medication, lifestyle modification, and medical follow-up, you have the best chance of minimising their impact on your future.
Just wanted to say thank you to everyone on this thread of replies. I had one night with no sleep and then last night with many of your reassurances and advice ringing in my brain I slept well the next night.
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