Proximal LAD Stenosis: Hi all, Had a CT... - British Heart Fou...

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Proximal LAD Stenosis

Jmob profile image
Jmob
61 Replies

Hi all,

Had a CT Angiogram last week and just spoke to the GP about it yesterday. Apparently I have 50 percent soft plaque stenosis in the proximal LAD. Need to go for an angiogram to do more tests and they may fit a stent depending on the amount blood flow through it.

Doc was pretty upbeat, said it was not terrible but needs attention. I came out of the doctors feeling better than I had for a while. I then (stupidly) did a bit of my own 'research' on Google and I got the impression this is a high risk area to have this kind of blockage.

Just wondered if anyone else had been diagnosed with the same and maybe also if they had any positive stories to share?

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Jmob
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61 Replies
Boxroad profile image
Boxroad

Hi I have my angiogram in two weeks time with possible stents being fitted if possible, my LAD is over70% blocked, you say you had a ct angiogram? Did they insert a tube in your artery or was it just a scan of the heart

Jmob profile image
Jmob in reply to Boxroad

Hi boxroad.

Thanks for replying. It was just a CT scan, no tubes inserted. They pumped a dye into my arm and then do the scan as it goes in. I think the catheter one is the next step though and I'm getting booked in for that soon. They say they'll put the stent in then and there if needed.

My father in law had 2 stents fitted about 5 years ago and he's been on the phone almost daily telling me not to worry. He said it's easier than going to the dentist!

I'm still struggling to process it all though, as I'm sure you are. It's only a week since I had that scan done and it's turned my whole world upside down.

Good luck for the angiogram. Hope it all goes well and that you feel better soon.

Boxroad profile image
Boxroad in reply to Jmob

You can watch a video of stents being fitted on British heart foundation you tube, very interesting, I had my or op call on Tuesday he told me it takes between 15 and 45 mins but you have to stay in recovery for a while after just to be safe, what hospital will you be booked into?

Jmob profile image
Jmob in reply to Boxroad

Thanks. I'll check it out.

My father in law said that about the recovery. He reckons the op itself was over pretty quick but then you have to wait around a few hours in recovery, mainly just to make sure you don't spring any leaks!

I'll be at the Freeman Newcastle. I'm told they're very good at this kind of thing. How about you?

Boxroad profile image
Boxroad in reply to Jmob

I am going into Essex cardiac centre in Basildon, I am just hoping it stop the pain in chest if I move about

Jmob profile image
Jmob in reply to Boxroad

Best of luck and I hope you feel better soon.

francesw47 profile image
francesw47 in reply to Jmob

I had my third angiogram on Monday this week - no sedation and all went well. I broke a tooth on Tuesday and went to dentist yesterday and had a crown fitted. I have to say I agree with your father in law - having the angiogram was a breeze compared with the dental visit. Been one hell of a week here!!I'm sure you will be fine - honestly!!

However, you have had a shock and it is never pleasant being told that you have a heart condition. It puts a lot into perspective. And waiting for treatment is often worse than the treatment itself. It also sets a different baseline for your life - and there may well be lifestyle alterations to make.

One piece of advice - do not listen to Dr Google. He's sensationalist, often inaccurate and frequently out of date.

Do let us know how you get on and what the outcome is.

Jmob profile image
Jmob in reply to francesw47

Thanks. I will do.

gilreid1 profile image
gilreid1

🤦‍♂️🙇🏼‍♂️google? Does not have your records listen to your doctor and be positive

Gil

Jmob profile image
Jmob in reply to gilreid1

Ha, ha. No I suppose not 😀. Thanks. Will try!

Chappychap profile image
Chappychap

50% blockage sounds alarming, but it's actually fairly modest. There are many people on this forum who didn't experience any symptoms at all until they had stenosis at 70, 80, or even 90%.

A smart way of making sense of this is to thank your lucky stars you've found out relatively early on about this problem, because as well as medication/stenting it gives you a heaven sent opportunity to make some major life style changes before the underlying heart disease gets worse.

The hard fact is that heart disease is incurable. Stents or even a bypass operation can only tackle symptoms rather than the underlying disease itself. It's really down to us as individuals to try and slow to progress of our heart disease to an absolute crawl by diligently taking our medication and living profoundly different life styles.

Good luck!

Jmob profile image
Jmob in reply to Chappychap

Thanks chappychap. That's a very good way of looking at it.

Smudgebuttonjessie profile image
Smudgebuttonjessie in reply to Jmob

As chappychap said 50% sounds alarming but in reality it isn’t, you have the advantage of this being found early and treatments can be done. I had no symptoms but was accidentally found to be 95-99% blocked which required emergency bypass surgery. They should manage to get stents in you if required during your angiogram PCI and you won’t be any wiser during the procedure that it was done until they tell you, you are awake throughout but will be given a sedation, recovery is 1-4 hours with a special wristband on then you can go home. You will most likely be given medications to take for the rest of your life but in the grand scheme of things that’s nothing. Try not to stress and worry too much, there are plenty of videos you can watch and groups like this one that can reassure and support you. Take care and stay safe x

Jmob profile image
Jmob in reply to Smudgebuttonjessie

Thanks smudgebuttonjessie. I think I need to 'give my head a wobble' as my wife would say and put things into perspective a bit. I'm sorry to hear about your problems, I can't even imagine how hard that must have been. Hope you're feeling better now and that there's some light at the end of the tunnel.

Smudgebuttonjessie profile image
Smudgebuttonjessie in reply to Jmob

I had my last procedure done yesterday and my consultant is very happy now, i am finally on the right road to recovery. Your wife will keep you firmly on the ground and there’s lots of support on here x

Lacarno profile image
Lacarno in reply to Smudgebuttonjessie

Going back to when l was diagnosed with heart disease my angiogram revealed one artery was 75% blocked and another was slightly furred up but to my knowledge they didn’t put a stent in my Brother has stents and can’t understand why they didn’t fit one l now have A Fib as well

Smudgebuttonjessie profile image
Smudgebuttonjessie in reply to Lacarno

Hiya, i’m surprised they didn’t put a stent in at 75%, hope you are being monitored and the AF isn’t troublesome for you. I’m very fortunate that they found mine as i had no symptoms.

Stay well and safe x

Debtyd profile image
Debtyd in reply to Jmob

Hiya...FYI I'm one of those that had no signs.i went to docs 14mnths ago at age of 49 with a winded feeling in my solar plexus area.got given things for gastric probs like Hiatus hernia but it didn't really work.after 2other gp opinions later and a lot of exhaustion .. found mad bp 211/117 ish...eventually after nothing was detected on ct or ekg went in for invasive angiogram as I'd had enough feeling rubbish and bp was still a nightmare.they found a "total occlusion to LAD artery" 100% blockage near the valve.... so I had 2 stents after 3hrs of chiseling through and it wasn't at all anything to be seriously nervous about..and I'm a big old wreck when it comes to pain lol..i consider myself very lucky as it had been there for many years undetected even when they investigated a heart murmur when I was a child..nothing...but this type of blockage doesn't happen over night it's many ýears of build up.what I actually find most scary is if I hadn't pushed for further investigation I could've just died at any time...id been literally living on borrowed time and not known....SO...just go and have your procedure do not worry it's not a horrible place the staff are amazing and make you feel at ease.and remember that they're not there to kill you off they are there to save your life.... I had my op in Southampton wide awake and watched the whole procedure on the screen...its definately special workmanship.xx.Deb.xx

Debtyd profile image
Debtyd in reply to Debtyd

Oh and I'm still having the same symptoms as when I first went to docs so I think something else is amiss somewhere else other than my heart lol just no is perfect these days xx

Jmob profile image
Jmob in reply to Debtyd

Thanks for taking the time to reply. Hope you're feeling better soon!

Lacarno profile image
Lacarno in reply to Chappychap

Well my family used to moan at me you shouldn’t be doing this or that l got fed up of it , asked my cardiologist he said listen to your body , so l do l carry on as normal when l can, rest when tired

Truckerclark profile image
Truckerclark

I git 2 stents fitted just under a year ago to my LAD , I had chest pain & tightness ,with lightheaded moments , after a excercise stress test I was taken in 4 days later to get angiogram/ angioplasty done ,I watched it on screen and can assure you it’s one of the best things I’ve ever had done ,taken away most of my chest issues as I have angina too not all , but this operation is very common and lots of people have great results after it ,,, you’ll be fine Trust the consultants ,,,

Jmob profile image
Jmob in reply to Truckerclark

Thanks. You're right, I have to listen to the experts. Am sure I'll feel better once it's over with.

Truckerclark profile image
Truckerclark in reply to Jmob

It’ll take a bit of getting used to having stents in ,but you’ll forget after a while they are even there so just try get on with life after it’s done , it’ll feel so much better once they are fitted if needed

Smileyian profile image
Smileyian

I have a 40 - 50pct stenosis in LAD as well as Prinzmetals. In Singapore the Cardiologists consider this mild to moderate and would not consider stenting unless the stenosis was aro 70 pct unless other co- morbidities dictated it necessary. The LAD is a very important artery but now you have a diagnosis, you will naturally be monitored and lead a lifestyle and diet commensurate with this knowledge. My very best to you.

pasigal profile image
pasigal

I would be surprised if you got a stent for a 50% LAD blockage, frankly. I had 90%, had 2 stents fitted. But the latest protocol seems to be, so long as your heart is healthy, to really lower your cholesterol with drugs and monitor blockage level.

However, not that this should scare you, but my dye CT showed around 60% blockage, but when I had the angiogram, it was 90%.

Good luck, a stent or 3 is not the end of the world, far from it, but I would recommend educating yourself as much as possible.

Jmob profile image
Jmob in reply to pasigal

Thanks. That is a bit scarey. Did you have any symptoms before the angiogram?

pasigal profile image
pasigal in reply to Jmob

Not really. I went for a routine blood checkup and cholesterol was elevated, so that's how I got to the angiogram/stent stage...in hindsight I was having some dizzy spells when I would stand up quickly that have gone away with the stent, as well as some possible angina under heavy exercise. But nothing that would have signaled "imminent heart attack." I'm a cyclist so my heart had forged new paths around the blockage.

Xtorti0n profile image
Xtorti0n

Hi Jmob, I was told "moderate narrowing" in LAD. No stents needed from angiograph. Major lifestyle overhaul + low dose statins. Cholesterol now at 0.9LDL, 1.4HDL. I did "Dr Google" on this stuff - DON'T ! You'll dredge up worst case scenario stuff and be forever fretting. Just do everything sensible to look after yourself while being mindful that life is for living 😀

Petosmum profile image
Petosmum

Hiya,

I hope that I'm not about to scare you, I'm hoping this will reassure you. I had a heart attack in January 2020 although I thought the pain my chest was just a pulled muscle! I got blue-lighted to hospital, straight into the cath lab for a procedure. Once I was up on the ward and had come down from the sedation and pain meds, I was told that I'd had 100% blockage in my LAD and they'd put a stent in. I was sent home after just 4 days which was a little scary but, I am about to be discharged from cardiac care now and can continue life as normal. This has been an extension of my recovery due to all the lockdowns but I feel amazing now and am still amazed when I walk around without a pain in my chest. I turned 47 in October which wouldn't have happened if I'd not had the procedure, the surgeon told me (several times) that I shouldn't have lived. That's a scary thing to hear but I'm too stubborn for that, clearly 😊

I would suggest that if you're doctor is upbeat about it, it really is no cause for concern and will prevent you getting to the situation I was in. Best of luck with it all, I'm sure it will be totally fine.

Jmob profile image
Jmob in reply to Petosmum

Thanks. It does put my problem into perspective a bit.

Bradee12 profile image
Bradee12

Hey Jmob,

As mentioned, stents are a breeze compared to the dentist! You just lie there, mildly sedated, whilst they thread the stent up to the blockage, then all good. I had an emergency stent fitted last May, after I had a big heart attack due to 95%+ LAD blockage. (Felt like an elephant was sitting on my chest - ambulance, the works). Then 6 weeks later, the Doc put in a second stent for a 70%+ blockage. But it had taken 66 years to get there! So my friend, relax. These cardio guys are pretty good these days. And... do try to be nice to your dentist.

😀

Jmob profile image
Jmob in reply to Bradee12

Thanks. Hope you're feeling better and thanks for getting back to me.

Warrington15 profile image
Warrington15

Hi. I had a similar blockage from CT but then the Angiogram just said “mild disease” and I was discharged back to GP. So that is a possible outcome. Just a word of support as well - I did find the process of going from an otherwise fit 53 year old park runner to someone with heart disease quite traumatic. I have got used to it and it has changed my attitude to life in a positive way - a bit more empathy towards people with chronic illnesses and I try to live in the moment a bit more. But the first couple of months were tough and I think your concerns are quite normal - thought I was going to die any minute. Best to keep off google - deadly. All the best - Rob

KF123 profile image
KF123 in reply to Warrington15

Warrington

I know just how you feel - I was climbing swiss mountains a 16 months ago and then last september was in hospital having 3 stents inserted . I feel like my active life has crashed and if anything am in more stress/pain/ache now than before!! ALso this Covid Crisis has meant i have had no support at all from the Cardiac Unit of my local hospital - they cant even be bothered to phone to see how i am !!

Jmob profile image
Jmob in reply to Warrington15

Thanks Rob. Am finding it quite tough too. Does give a bit of a change in perspective.

falah12345 profile image
falah12345

Just had a stent in LAD almost two wks ago it was a post covid heart attack i was told I had 90% stenosis I am ok apart from post covid symptoms

just trying to think if i had LAD or LCA! i just can’t remember !

SamuelJB profile image
SamuelJB

Hi....yes I have same as you....diagnosed 4 years back whilst this can potentially be high risk my understanding is that this depends on the condition of the plaque. There is no one size fits all approach...some people can have this for many years with little or no consequence other can gave progressive advanced plaques that can cause problems....in my case they will not attempt stent until they have too and advised me to lower LDL, exercise and diet or use statin to slow any development of the partial blockage. It's good that they have found this....heres hoping that your Cardiologist gets something sorted out...in my case it's very much watch wait and see before planning any stent but every case will be different.

Jmob profile image
Jmob in reply to SamuelJB

Thanks. I just have to try and stay positive till the angiogram I suppose.

PowderBlue profile image
PowderBlue

My husband (53) was diagnosed January 2020 with 70% narrowing of his LAD with no symptoms at all. We had to wait until October (delay because of COVID) for the angiogram and they fitted a stent at the same time.

He is still powering on, so we are very grateful it was caught. What a gift! I was so scared as, like you, I googled, and discovered this artery is known as The Widowmaker because so often with this artery there are no symptoms before a heart attack and that’s when they discover the blockage, but I am learning to calm down a bit.

It’s great that they have caught the condition for you and are going to address it - please listen to your doctor in saying it’s ok. It’s really common, and the treatment my husband had was so brilliant. I used to work as an HCA in Radiology 20+ years ago - ironically with arteriograms and stent fitting procedures - and the technology has come on in leaps and bounds even since then.

You are in great hands - give yourself permission to take a deep breath of thankfulness and relax into the knowledge that you live in this country, in this time, where stuff like this can be fixed. Wishing you all the best for full and complete health.

Jmob profile image
Jmob in reply to PowderBlue

Thanks. Glad to hear your husband is doing well. I do just need to relax and listen to the docs.

Dutyops1967 profile image
Dutyops1967

I had a heart attack 4 weeks ago and LAD was 100% blocked. I had 3 stents put in. With any procedure there is risk. I was lucky, I'm sure you will be ok if they decide to stent. At least you know about it and can get the right treatment. Best regards mark

Jmob profile image
Jmob in reply to Dutyops1967

Thanks. Feeling a bit better now and think am starting to put things into perspective a bit. Hope everything goes well for you.

jmpond90gmailcom profile image
jmpond90gmailcom

I had emergency angioplasty at the Freeman Hospital for a 100% blocked LAD on August 2nd 2020. I had one stent fitted. I have damaged a lot of my heart due to the blockage and subsequent heart attack. I have now had an ICD fitted just in case. Although what you are going through is scary you are also fortunate to be able to nip it in the bud before it becomes a problem. I hope everything goes well for you and if you have any questions don't hesitate to ask👍♥️

Jmob profile image
Jmob in reply to jmpond90gmailcom

Thanks for the reply. You're entirely right, I've been given a chance a lot of people haven't and I need to stop feeling sorry for myself and look at this from a different perspective.

I'm really sorry to hear about your problems and hope things are going better now.

I'm guessing you must be near me by the way? Freeman's where I'll be going. I'm told they have a great reputation for this kind of thing.

jmpond90gmailcom profile image
jmpond90gmailcom in reply to Jmob

I was on the 2nd day of my holiday when it happened. I live in Cheshire. I am learning to live with Heart Failure now. I hope you get sorted soon🤞♥️ Dr Google will mess with you! Keep listening to your body and the medical professionals also fellow patients 👍👌

Jmob profile image
Jmob

Hi All,

Just wanted to say thanks to everyone for replying. It really does help and I feel much better every time I read one these replies.

I need to try and see the positive side to this. Things really aren't all that bad.

It looks like a nice day outside. I'm going to take a break from Google and maybe go for a walk and try to enjoy it.

This forum is amazing by the way. Hope everyone has a great weekend!

SamuelJB profile image
SamuelJB in reply to Jmob

Life is in living each moment.....now is all anyone ever has so your in a great place when you can choose to be living life to the best you can leaving the rest to the Cardiologists. Hope you have a good weekend and are more at ease. Regards

imps4 profile image
imps4

Imps4, hope this isn't seen as hi jacking your post,but I had a ct with dye about 6 weeks ago for what I thought was a look at my mitral valves. While chasing up the results cardiologist rang me back unexpectedly and said I had plaque and as I m not on any tablets at the moment said asprin and statins. Neither of us know my present cholesterol levels and it s left me confused and anxious. Commonsense tells me until I get the letter I wont really know anymore. Worrying more about the statins and being female. The replies you got to set my mind at ease abit.

Jmob profile image
Jmob in reply to imps4

I know. There are some really helpful people on here. Just got to try not to worry I suppose but it's easier said than done.

Don't know much about the Statins I'm afraid. I've only been on them a week but no problems so far! I'm sure some of the more experienced people than me can comment though.

Good luck.

SamuelJB profile image
SamuelJB in reply to imps4

Hi I have 50% LAD plaque....no symptoms...not on statins....lowering LDL using natural foods and antioxidants to slow any plaque development....Cardiologist monitoring and will act if and when they need too. Be encouraged there are treatments available and now that this has been discovered your in good hands. Trust all will continue to be good for you.

imps4 profile image
imps4 in reply to SamuelJB

It was the fact that he said statins without knowing what my cholesterol levels are that worries me slightly.

SamuelJB profile image
SamuelJB in reply to imps4

I think statins are very readily used to reduce cholesterol.....I was not good on them in past others are fine....I prefer to avoid and try diet and lifestyle and focus on reducing arterial inflammation (clean lean and green food avoiding sugar and processed whatever) However...currently I am rethinking this approach I may have to go back on them if my LAD plaque is still developing. By brothers are on Statins and it’s effective and good with them. Trust your Cardiologist they do know best.

imps4 profile image
imps4

Thanks

fergusthegreat profile image
fergusthegreat

In the past, during non emergency angiograms cardiologists decided whether or not to stent based on a visual assessment of a coronary stenosis.Currently best practice is to perform a test called fractional flow reserve which measures the pressure drop across the narrowing.

Any result below 0.8 is normally stented, mine was 0.59 so hence a stent.

Anything above 0.8 is usually left because it is not effecting blood flow.

When I was in hospital a patient with an 80% blockage was not stented because the stenosis was not effecting blood flow so it's unlikely they will stent a 50% blockage.

Jmob profile image
Jmob in reply to fergusthegreat

Thanks for the reply. This matches what the doc said too. I've got my head round it a bit now. Worst case they out the stent in but that's not the end of the world. Will just have to wait and see and in the mean time the not to stress too much.

fergusthegreat profile image
fergusthegreat in reply to Jmob

It's a strange issue. Results from the Ischemia trial suggests that there are no clinical benefits to stenting vs medical treatment in stable coronary heart disease.Average residual stenosis after stenting is 10%.

I cannot understand why a 10% narrowing is not better than 50 or 60%.

Given the choice I will always opt for the stent 😊

Carealot profile image
Carealot

Hi, almost 2 yrs ago, following an angiogram, I was told by cardiologist that had triple arterial disease...including blocked LAD. He had entered 75% on a piece of paper along with a diagram. This was followed by a nuclear scan and exercise stress test. He had earlier mentioned bypass but because this would involve “lifting the heart out”, it was risky and so he preferred to medicate. Another factor in the decision was that I am allergic to aspirin which would be necessary once stent in. Also, the stress test showed the blood flow was diverting satisfactorily down other, smaller, arteries. He explained that it’s like taking all the A and B roads rather than the motorway. So, I’m now on amlodipine, propranolol, anti hypertensive, blood thinner and atorvastatin...plus others for a variety of ailments(also recently diagnosed with bronchiectasis and asthma)! One thing that did stick in my head and was a good takeaway was that he said it had taken all these years to get to this stage so to just think about that. I have normally eaten a good healthy diet, exercised, am reasonably slim and rarely drink alcohol. I am female and 72. I am now discharged from cardiologist’s care and just trying to get on with my life. Pandemic has limited my exercise but fingers crossed, I’ll build up gradually again. I wouldn’t worry if I were you ...just live healthily and report any changes. Take care

Jmob profile image
Jmob in reply to Carealot

Thanks for taking the time to reply. Puts my little problem into perspective a bit.

That's a good point about taking this long to get to where it is. To be honest, my diet could probably have been a bit better. Definitely some room for improvement and that's what I'm going to do.

Best wishes and I hope everything goes well with your recovery!

controlcause profile image
controlcause

I have multiple stenosis% >=90% stenting failed so medication is doing good. I did not have heart attack. How you are doing now?

Jmob profile image
Jmob in reply to controlcause

Hi there,

Am doing great now I thanks. I had an angiogram about 3 weeks ago now. I was very worried about it before but the scan itself was nothing to worry about in the end. Only took about 25 mins and by half past 9 that morning I was back in the ward having a cup of tea. I didn't need stents in the end, just need to keep taking the statins which I now do religiously. Am lucky so far in that I've not had any side effects. I also had a bit of a lifestyle overhaul and have lost weight, am eating better, exercising daily and to be honest I feel much better for it.

The main thing I learned is to stay off the internet (except for this forum which really helped me) and not do my own research. I was driving myself mad reading stuff that I didn't really understand and was probably out of date anyway.

Hope you're doing well too and wish you all the best for the future.

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