My dad (62) has at least four significant arterial blockages (over 70%) one of which is in his LAD. He's scheduled for an angioplasty tomorrow and possible stenting, but with so many blocks I'm worried they'll have to do CABG. Has anyone been in this situation and only treated it with stents and meds?
Background:
~260 lbs
-family history of heart disease
-cardiac calcium score 2200
-has been on statins for years. cholesterol is under control. just started a beta blocker a few days ago.
-stressful job. lifelong non-smoker and non-drinker. non-diabetic.
-still moderately active (he got a flow / stress test due to pain between the shoulderblades while exercising)
Any words of encouragement would be appreciated. I'm really freaking out and so worried my dad is going to die.
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My mum had a (miraculously mild) NSTEMI last July after ignoring symptoms of angina for about 15 years. They only kept her in post heart attack on pretty much a gut feeling related to tonnes of PVCs on monitoring and the fact that her systolic bp had been over 200 on admission. Her troponin never actually went higher than 35, and her ejection fraction is still normal. When they finally managed to get her into the cath lab about 6 days later, they found she had a total blockage of the LAD, and that she required 4 stents total. All done then and there. The consultant told me it was a miracle she hadn’t dropped down dead, and that the only time he ever saw arteries as bad as hers was in diabetic patients: suffice to say, they tested and she’s not even close to being pre-diabetic, never mind full on. Apparently her heart muscle had somehow learnt to compensate for the lack of blood flow, so she has no lasting damage. She’s an ex smoker (quit 30 years ago), not a drinker, cholesterol relatively ok, health weight and bmi, but put politely, not someone that deals with stress well and very quick to become overly emotional about things. Her diet wasn’t the best, even though she wasn’t overweight. There’s also an extensive family history of heart problems, with her dad dying of a heart attack when she was 18, her mother needing a pacemaker at age 60, and her grandmother dying of valve disease in her late 40s.
It’s now been 14 months since then, and whilst she’s just as blasé and in denial about her health as she ever was, she’s probably fitter than she’s ever been. The first 3 months emotionally took a toll, but once she’d properly recovered from the angio (they had to go in through the femoral in the end, and she found it quite uncomfortable for a while after), she was fine. She’s still taking all but one of the post HA meds they put her on, but otherwise you’d never know any different.
Wow that's crazy what the consultant said - I'm so glad she's doing all right! Up until recently I didn't think they could treat 100% blockages with stents but it seems like a lot of people have had them.
An angioplasty showed I had four blocked arteries at 70% or more. The LAD was 85% blocked. After further tests and a peer-to-peer review it was decided I was basically unstentable and I was referred for a quadruple bypass. These guys are at the top of their job and you need to remember it is their day job.
A couple of comments. Besides reducing cholesterol statins reduce inflammation often a precursor to plaque. They also stabilise plaque a process that increases the Calcium Score. Really only a cardiologist dealing with your father can camment on it. Secondly his weight suggests unless he is really tall he is either overweight or obese so losing weight would be beneficial. I would suggest he follows a Mediterranean diet as recommended by the BHF.
Thanks - he is definitely overweight, but still fairly tall. He's 6 foot 2 inches. Did your doctors decide on bypass because of the blockages themselves? Or other factors?
The good news is that he doesn't have to lose to much weight. Two friends did well with Slimmimg World so it may be worth him joining. One in fact dropped from 18 stone to 13 stone!
They decided on a bypass because I would have needed a lot of stents and the chance they would be of limited success. It was felt that bypassing would give a better outcome. I had the surgery over two years ago in June 2018...
Yeah - he's gone on a very strict heart healthy diet and has already started losing weight. Even if it doesn't reverse any of the damage I'm hoping it'll put less strain on his heart and help him keep his arteries clear post-stenting.
My fiancé was due to have stents in September 2019 but during the procedure they found out the blockages were much more extensive then first thought and the one on LAD was on a “wiggly branched section of the artery”’the doctor was not happy to continue and we were sent home whilst the cardiac team discussed the best option.
It was decided he needed a double bypass (that then turned into a triple.) and he had the surgery in January 2020 - it became urgent in the end as his angina became unstable just before Christmas.
Hope all goes well for your dad tomorrow, remember to look after yourself too.
He’s doing ok - He’s struggled mentally and had a few issues along the way and the Covid situation didn’t help (as he missed all his rehab.)
I was amazed how quickly he started to get better, he was sitting in a chair eating less then 24 hours after surgery and walking a bit by the day after that.
Wishing him well! Unfortunately the no visiting rules will make it harder for you. Try to get a good night's sleep as tomorrow could be a long day. Thinking of you both...
Update on my dad: his angiogram went fine, but they didn't put any stents in as the blockages were too extensive. His doctors want to take some time to decide between bypass surgery and a multi-stent procedure I'm not familiar with ("crush"?). This definitely isn't the outcome I was hoping for and I'm feeling pretty anxious about it.
I also just found out a friend I had contact with in the last week tested positive for covid. So heaping a concern about infecting my dad on top of his prognosis. I have been wearing a mask around him and limiting contact, but I know he's high risk.
Update on my dad: his angiogram went fine, but they didn't put any stents in as the blockages were too extensive. His doctors want to take some time to decide between bypass surgery and a multi-stent procedure I'm not familiar with ("crush"?). This definitely isn't the outcome I was hoping for and I'm feeling pretty anxious about it.
I also just found out a friend I had contact with in the last week tested positive for covid. So heaping a concern about infecting my dad on top of his prognosis. I have been wearing a mask around him and limiting contact, but I know he's high risk.
Thanks for update 😊 sorry your dad didn’t get the outcome you were hoping for. It sounds very similar to what happened with my fiancé as his case went to a multi disciplinary team to decide on bypass or a differing stent surgery.
Did your dad get to go home after the angiogram or have they kept him in whilst they decide?
Sorry to hear about the additional stress of your friend, again I can sympathise as my fiancé came out of hospital just as Covid started spreading and I work in a hospital that had Covid patients- I was terrified of bringing it home, but all you can do is take all the sensible precautions you can.
Thank you 🖤 I just got a covid test yesterday and it came back negative so I’m hoping it wasn’t a false result. They let him come home after the angiogram - we all stayed in a hotel across from the hospital so we could be nearby. I think his doctors are supposed to call sometime next week. Thank you for the well wishes!
I took the fact they allowed my fiancé home after the angiogram as a good sign, as some people have to stay in hospital until their bypass as the angiogram shows something that makes it risky for them to go home. x
Hope everything goes well for your Dad today. My hubby had a quadruple bypass in April 2018, when he was 69, after the cardiologist decided that stents weren’t going to be possible in his case.
Although it is a major operation it is routine to the team who carry it out.
Take care of yourself too, it is too easy to forget yourself and end-up shattered!
Hi, I went into Basildon on Christmas Eve 2019 for a triple CA BG but had a quadruple done. I’m 73 and walk a lot, recently done a 5 miler & a 9 miler. Not had a problem since I had my 6 week check up. So grateful to our NHS.
Hi. Lots of good advice already but wanted to wish your dad well for today.
The first positive is that this has been identified now. For many the first they know of a problem is a heart attack.
Whilst the difference between stents and CABG is huge for us, it is less so for the Drs. They will do the less invasive procedure if possible but it’s important to recognise that they don’t see a CABG as a particularly high risk procedure. Their decision will be based solely on what they think will give a patient the longest and best quality of life.
In terms of the disease itself, it’s unlikely it can be reversed from the stage your dad appears to be at now. That said, the Dr may decide following the angiogram that your dad can be treated with medication. If it’s decided to stent (which they may do at the same time as the angiogram) or CABG then this won’t stop the disease (atherosclerosis). However, it will reset the clock by giving him clear arteries. By taking the prescribed medication and following advice on exercise, diet and lifestyle, he can either stop it progressing or dramatically slow any progression.
Most importantly, the problem has been identified and your dad is now being monitored, treated and is in the best possible hands.
Hi there, I had an Nstemi 17 months ago and was rushed to A&E where, after a very long day and loads of tests it was discovered (via slightly raised troponin levels) I was suffering from a previously undiagnosed genetic disorder which had caused bad arterial blocking of over 90% in 3 or 4 of my arteries. It was a huge shock as I’d had tests because of ectopic heartbeats only months before and was told my heart was fine. However, to cut a long story short, I was informed I needed emergency quadruple CABG surgery.
I had to wait in hospital for an emergency CABG space for 19 days (which in the end turned out to be a triple) and though I was terrified at the time I now realise how fortunate I was that the NHS found my condition and got it treated so quickly by such amazing and wonderful people. Also, it found a genetic condition which had caused the problems that had caused the loss of several family members (who it was thought had lifestyle diabetes had which caused their heart conditions) and also led to tests on mine and my late brother’s children which discovered a niece with the condition and led to early treatment.
I now know that many of the problems I had previously put down to being unfit was down to the illness which was affecting my health and despite my intense trepidation and fear at the time I now realise just how lucky I was to find my condition and get it treated and I have no doubt in my mind that my CABG saved my life which, in the end, has made it worthwhile.
I do hope all goes well with your dad and wish him all the best.
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