Failed angiogram

[tazcat123]

Hi all, only my second post on here.

I’ve just got home from a failed angiogram. Back in 2019, I had a NSTEMI resulting in a stent fitted on the LAD. After roughly 6 months, I started suffering angina pain on exertion. I reported this to my cardiologist who subsequently referred me for an angiogram. In the meantime, I managed the symptoms by stopping before the pain got too bad. Because of COVID, my appointment understandably was put on hold, but I finally got called this week. After a lot of to-ing and fro-ing and about 2 and a half hours, they told me they were stopping because my D2 branch was sub totally occluded and during the attempt to clear it, they pierced the artery wall and created a small bleed. The concern was that it may have progressed into a cardiac tamponade. Thankfully it didn’t, as the exceptional work they did during the procedure prevented this from happening. It was decided to keep me in and monitored me using echoes before letting me home the following day. Now at home and resting, I’ve been informed that in a few months, I will be called back in for a second attempt (unless my symptoms improve). My worry is this...am I now a ticking time bomb, as I now know the reason for the pain is an almost >99% blocked artery. Before I went in, I was sort of ok with the fact that something wasn’t quite right and was looking forward to getting it sorted. But now I know what it is, and the fact that these (absolutely fantastic, skilful , caring, compassionate) heroes on the team, weren’t able to cure it this time round. I worry that things might get worse before I go back for another attempt. Am I over thinking 🤔.

[Clerkenweller]

The glib answer would be that you are overthinking it. However it is completely understandable given your story. Worrying will not of course do anything or help. As most of us here know anxiety is not good for heart conditions. So what to do? Talking about your concerns is good. Be gentle with yourself. Try relaxation and meditation techniques. If you don’t know any the project of researching them and practicing them will in itself be a distraction. Finding someone to help with that would be helpful. My thoughts are with you.

[tazcat123 in reply to Clerkenweller]

Hi Clerkenweller. I thought as much. I suppose it’s natural to worry about something you have no control over. I’m on the list for a re-try, but my thinking is, if they couldn’t do it the first time round, why risk another go. If it can be lived with, that’s fine, but my worry is that this occlusion has only taken just over a year to develop (not mentioned on last admission). So how long would it take to progress to a dangerous level. I’m on permanent light duties at work so that’s fine as I’m in production and it’s quite heavy manual work. So, if work are happy to continue the support, and the condition can be lived with and managed, I’m happy to carry on as we are ( I have gtn sprays everywhere 😊)

[Clerkenweller in reply to tazcat123]

I’d have a frank conversation with the cardiologist before deciding whether or not to proceed. The key thing is what’s the prognosis if you don’t have it done?

[STUBAX]

To put it in perspective I have a 100% occluded RAD, they tried to clear it during the Angiogram but failed. That was 5 years ago and so far all is well.

[tazcat123 in reply to STUBAX]

Hi STUBAX thanks for the reply. Do you suffer any symptoms or warning signs. Myself, at work, after 2 flights of stairs, I’m quite breathless and sense the beginning of that familiar tightness, always ready with the gtn. If they can’t fix it, that’s fine. I was just concerned about what happens further down the line

[STUBAX in reply to tazcat123]

Only symptoms I suffer are spasms in my back, thought it was angina but don't get it during exercise. My heart has self healed by joining collaterals from the LAD to below the blockage in the RAD to supply blood below the blockage, it seems that this can be common.

[Battle2020]

Hey, my question is how come they missed this during previous angiogram (6 months previous)?I feel that angiograms are done so fast and when they spot a problem then thats it . Id like to think that they look for other potential issues.

I had my angio and they told me that I required a stent ( or 2) in the big artery feeding left side of heart . I was then told that this would be done the following day . Preped and ready the next day and whilst undertaking the procedure they decided that my arteries were clear and that I was suffering from cardiac artery spasms (vasospastic angina) therefore no need for stents. I'm just confused that one day I'm told that I have a narrowing of arteries and the next day I'm told they are fine ?? Cause a spasm only lasts for a few seconds so surely that should have been picked up on the first angion and NOT diagnosed as a narrowing. Im very confused and untrusting of the cardiologists.

.

[tazcat123 in reply to Battle2020]

Hi Battle2020I had my HA and stent in aug/sept 2019 (seems crazy to see that written down), but because we've lost nearly a year due to covid it seems shorter than that. After my recovery, I followed all the correct protocols i.e Diet, exercise, Cardiac Rehab etc. It was fine, I actually felt ok, but after about six months, I noticed that after quick climb on the stairs, I was feeling a little tired. This went on and gradually got worse. I went to see my Cardiologist, who at first suggested a nuclear perfusion scan, but then decided to go straight in for an Angiogram, that way, if they found a problem, they would be able to fix it there and then. My worry is that, on my discharge the first time round, it was noted that I only had mild atheroma in the other vessels with no mention of the D1 or D2. Now, it seems they are both severe ! So, if its progressing that quickly, how long before it becomes unstable.

[Battle2020 in reply to tazcat123]

Hi , I'm sorry things are going in the wrong direction for you. Im just really struggling to get my head around it all . I was diagnosed 2 days before Christmas and then I got covid so my body has been through the wars and every pain or unusual sensation I get worries me . Im also finding that one day I'm good and the next I'm absolutely rotten. I really hope you get the help you need and get things back on track . I wish you all the very best for the future .

[Milkfairy Heart Star in reply to Battle2020]

Hi Battle2020, Vasospasms can last much longer than a few seconds.

Mine can last up to an hour in length.

When they do happen it is very difficult to tell them apart from a permanent blockage if they last for a long time. There are quite a few people who end up with unnecessary stents for this reason.

During my angiogram with acetylcholine, I had spontaneous and acetylcholine induced coronary artery spasms which caused ST elevations and depressions on my ECG, my artery kinked and constricted.

Oh and I had severe chest pain and needed some morphine.

Vasospastic angina is often overlooked so perhaps cut the Cardiologist some slack?

You could have had an unnecessary intervention. Once in place a stent is there for good.

Stents can actually make vasospastic angina worse.

[Battle2020 in reply to Milkfairy]

Hi MF, I didn't mean to come across harsh towards the cardiologists. Its the lack of info Nd feedback that I didn't get following the diagnosis that has left me totally confused and worried that something else may have been missed .I take.on board your points and consider myself lucky that I didn't get the stent(s) . Im perhaps confused also about duration of my spams as im finding that I get them o e after the other ( horrible sensation in my chest) followed by a heavy feeling in my chest or across my back. I would describe it as lots of little spams followed by the heavy chest . Prolonged periods of spams leave me absolutely drained and uncomfortable.

I was busy the other day and did too much and during my dog walk I felt like I was going to drop . My wife said is I was as very pale and unwell looking . 20 mins rest did the trick as felt a lot better ,but still had the heavy chest and pain actoss the back. I suppose I still have to bear in mind that I had covid only a few weeks ago and I'm sure that has affected me quite badly- get v tired quickly.

Im just so confused and fed up with it all .

Thanks again- you're very well informed and helpful

[Milkfairy Heart Star in reply to Battle2020]

Being diagnosed with 2 little understood conditions within days of each other would I expect be bewildering and confusing for anyone.

I often have a feeling of my heart being bruised and the tiredness and exhaustion is awful.

It is still very early days for you.

When I was first diagnosed nearly 9 years ago there was even less information about and I had no contact with anybody else with the condition.

Be patient with yourself, pace your activity and rest. It's absolutely okay to crash and fall asleep in the afternoons.

[STUBAX in reply to Battle2020]

The problem was spotted during the first angiogram, they had enough to do on the left artery so scheduled the second angiogram.