Is 75%stenosis bad

[worker38]

Hi everyone. I have been told there us %75 stenosis of the lad. Just on meds at the moment. Has anyone had a stent fitted at this point or even worse a heart attack or is this narrowing not bad enough to cause a major problem. Thankyou all

[Chappychap]

This may sound counter intuitive but there's not much correlation between how blocked your arteries are and the risk of a heart attack. For example some people have well over 90% blockage, suffer disabling angina, but have never had a heart attack. Other people can be well below 50% blockage, are very active, then out of the blue suffer a heart attack.

The explanation is in how heart attacks actually happen. There's a popular misconception that arteries get furred up, then bits of the "furring" break off and whizz around your arteries until they hit a narrow section of artery, and that's what causes a heart attack. That scenario is possible, it's known as an embolism. but as the explanation for a heart attack it's actually relatively rare.

A better way of understanding the great majority of heart attacks is to think of heart disease or atherosclerosis as being like acne in the arteries. The arteries will have multiple "spots", they can be stable and hard spots that just won't burst, or they can be puss filled spots that will burst easily. When the spot ruptures the liquid contents instantly solidify as they contact the blood stream, turning into a waxy clot. This clot is still anchored to the spot (in other words it's not whizzing around the artery) but it's now solid and likely to block the blood flow, and it's this that causes most heart attacks.

So here's the thing, different people can have different versions of atherosclerosis. Some have spots that rupture easily and cause heart attacks, others have very stable spots that may grow and cause crippling angina but rarely burst. This is why stents are life savers when inserted during a heart attack, they push open the clot and allow the blood to get moving again. But stents aren't very effective at safeguarding against future heart attacks, after all, no matter how many stents you have there's always going to be far more "spots" scattered throughout your arteries.

One final point, a very useful side effect of statins, especially when they're taken in conjunction with Ramipril, is they tend to stabilise these "acne spots" in your arteries, turning the volatile, liquid "puss" into a more stable calcified deposit.

Hope that helps!

[worker38 in reply to Chappychap]

Thankyou so much. That explanation makes me feel a lot better. I wish doctors would take the time to explain instead of just saying you need to take these tablets etc

[Brixcos in reply to Chappychap]

Great explanation, I never knew that (and had a HA followed by CABGX2 in Dec/Jan). Thanks, Chappychap x

[VickyHK72 in reply to Chappychap]

Thankyou so much for your explanation, makes so much sense and I finally understand now how these things work! As someone else said, I wish doctors would explain things in easy to understand terms like you have! Thankyou!

[controlcause]

I agree with chappychap. I have similar situation. This is known as stable CAD. Ischemia trial dealt with 5179 patients

[Qualipop]

When I had a heart attack I had two stents fitted in a totally blocked artery. I had to go back for another angiogram later because they said I had two more part blockages. When they did he angiogram they decided stents were not necessary as the blockages were "only 65%" but more importantly there was a good blood flow through them.