Heart Attack Risk. : 2 cardiologists... - British Heart Fou...

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Heart Attack Risk.

ChoochSiesta profile image

2 cardiologists have recommended a bypass. Saw my surgeon today. Told him I have no symptoms even when exercising. To my astonishment gave me the option of no treatment (follow up in 6 months). Enthusiastically took advantage. Snag is I have a 10% heart attack risk every year. Was I wise? Utterly terrified of a stroke during surgery.

48 Replies

If 2 Cardiologist's said bypass, then sorry, but as someone who was very fit and suffered a Cardiac Arrest whilst in the gym, I would not choose to wait to see if I have a HA or worse a Cardiac Arrest!

Gaz_chops profile image
Gaz_chops in reply to Gaz_chops

I just read in your Bio that you have already had 2 heart attacks!!!!!!!!

Do you really want to live waiting for a third? Each one has/will potentially damage your heart, in turn that will probably increase the chances of a Cardiac Arrest which has a survival rate of ~10%.

Hello ChoochSiesta,

Welcome to the forum, reading your bio it looks like you have already had 2 heart attacks, and as 2 Cardiologists have recommended bypass to you it’s a case of when can you do it.

I had Aortic valve replaced and bypass done 5 years ago and without surgery I wouldn’t be here now. I was in hospital 7 weeks prior as they tried to get me fit enough to face the op.

You say your frightened of having a stroke while your on the table, I can’t say that it doesn’t happen we have a couple of members who this as happened to, but we have many more who are now living their lives as they should. I am one of those, and grateful every day.

I can appreciate how scary it is, but these very clever medical teams are the best at what they do, as in most things in life there is no guarantees, but if you weigh up the chance of having another heart attack against having a stroke!

Best wishes Pauline

Can you give us some further information (I understand if not) How did you know there was a problem if you do not suffer any symptoms.Was the recommendation based on something that was seen as a result of an angiogram and if so what?

I can't get my head around them recommending a bypass then saying he is happy to do nothing.

TBH as someone who had a stroke after angiogram and then a bypass I would always recommend having it but how bad are your arteries?

Had the angiogram, they decided a bypass would be better than stents. Two arteries are affected but not enough to give me any symptoms. The waiting list is 6 months anyway.

I had the by pass as it was felt the blockage was in a difficult place to stent and was in my LAD. I too had to wait about 7 months before the by pass, I have to admit I was recommended a by pass by the cardiologist and this was supported by the surgeon so I never thought twice. My father had died at 52 with heart failure as did his father before him (47 years old) so I wasn't going to take any risks.I have since read you have had 2 HAs previously, did you have angina or warnings about these?

I had chest pains on the first. I didn't know anything about the 2nd at all, it just shows on the MRI.

For me that 2nd incident would make up my mind for me. You had no symptoms same as now yet still had a heart attack - no-one can tell you what to do, a bypass is a serious operation and does come with risk, I think it is a matter of sitting down and doing your own risk assessment. Good luck in making your decision.

The bottom line is that whatever our decision is, no treatment is available for 6 months due to the waiting list. The list priority is 'needs based' so if I start getting symptoms then our decision can be reconsidered. So basically I've spent the last month since the angiogram stressing about having a bypass. Now I'm stressing about not having it. Of course stress is also bad for you. Thank God I retired last year.

You probably didn't mean to but that reply made me smile as I can see what you mean. I actually put some of the blame on the cardiologists, either you need the bypass or you don't I think they should have laid out the risks of not having the bypass. I was told by a cardiologist and a cardiac surgeon that I needed to have one so I did, much easier when you don't have to make a decision.

The meeting yesterday really put me on the back foot. I went in expecting him to say "you really need this bypass". But he did not say that.My opening comment was that since my meds changed I have had no symptoms and feel fine. He then said "leave it 6 months and we will meet again". Wow! That was my "Get Out Of Jail Free" card.

I so appreciate all the help from this site, it really helps. I think I may have come to the wrong decision, but we'll see what the next 6 months brings!

I can’t imagine anyone here is about to contradict the advice of two cardiologists.

I understand the hesitancy about what you might see as optional surgery but why risk a life changing or even a life ending event by ignoring the advice you have had?

Because it is a major operation with significant risks. There is no right answer. Its like Russian roulette with 2 guns, which gun do you fire?

No it’s not like Russian Roulette at all.. Its a choice between a regularly performed procedure with low risk. and a complete gamble on the other.

All the best.

Handel profile image
Handel in reply to NathanBlau

Well said Nathan

It is a very safe operation. More than 97% success rate where you are healthy and no symptoms.

GWP1952 profile image
GWP1952 in reply to ChoochSiesta

I was told the risk is 1% across all cases. For me as a fit and healthy person it was estimated at 0.1%. I took more of a risk driving home after the consultation.

Mollhon profile image
Mollhon in reply to NathanBlau

I went in to have an Angiogram, just a day clinic, Surgeon informed me I was going to be admitted and would be having a triple bypass the following morning!Bit of a shock, but the good part was, no time to even think about it.

That was 6 years ago, I’m 70 now.

Good old Harefield Hospital.

My one complaint is, that nobody, not one Doc or Nurse had a chat with me about the surgery, unlike on the TV, where the surgeon, comes and has a chat with the patient, explaining the procedure.

Plus side on that, ......I didn’t know what to expect, that’s probably why the nurse told my husband that I was so unbelievably chilled as I was being wheeled down to theatre. 😂

Heather1957 profile image
Heather1957 in reply to Mollhon

They must have seen something serious to decide to do the Bypass the next day, I waited about 3 months for the angiogram and then about 3 months for the Bypass.As you say you had no time to get worried about it, which is definitely the best way.

Mollhon profile image
Mollhon in reply to Heather1957

Mmmm....3 months waiting, thinking about the op, did you watch any videos on the subject?😕

Heather1957 profile image
Heather1957 in reply to Mollhon

I started to then decided against it! TBH I was relatively calm about the bypass for some reason. I was scheduled to have it on a Wednesday morning, 2nd on the list. I had my pre med, had an antiseptic shower and it was cancelled!! The first surgery had taken longer than expected. I was told I’d probably be sent home and to wait for another appointment. Nothing happened the rest of Wednesday, on Thursday I was told no decision had been made then Thursday late afternoon I was told I was 1st down on Friday and barring any emergency it would go ahead which it did.

I was far more stressed about the angiogram than the bypass, I was discharged after 4 days straight from ITU as they needed the bed.

NathanBlau profile image
NathanBlau in reply to Mollhon

We just missed each other - 5 years ago at Harefield for me! Pleased to hear all is well.

Rogo23 profile image
Rogo23 in reply to Mollhon

That sounds about right. Went for the angio and stents, watching it on the big tv, first squirt surgeon makes a bit of a grunt and looks a little bit concerned, second squirt, surgeon mutters something that sounded a bit like bu**er,and pulled out the probe.

I was told cabg x3 and two days later I woke up with a rather fetching scar.

Oh and Mr R said we gave you a cabg x4.

Surgeons do tell you porkies.

Feel really good now though started week 21,and am really grateful.

Hello :-)

For a couple of years deep down I knew something was not right with my heart but through fear I ignored it

Resulted in 3 heart attacks and I was lucky as some have a heart attack and are not so lucky

When they told me I needed a triple Bypass or 2 years to live it was a no brainer , Bypass obviously

Like with any op even a tooth been pulled there is always some risk and they have to tell you what they are even though rarely do they happen

I was not in good shape by the time I had my Bypass op but still I came through it

If they are saying this is what you need I seriously would not gamble if you were to have another heart attack you may not be as lucky

I am by nature a nervous wreck

I suffer with severe anxiety and if I went through with the op anyone can

I would be more anxious of having a heart attack every year than the very slim chance of a stroke having a Bypass

I know you have to do what is best for you but maybe think about this some more :-) x

If the surgeon had said to me 2 years, then yes, it's an easy decision. He had my angiogram there and gave me the 2 options.

I know what you are saying but if he is still putting a Bypass on the table as an option it says to me that it is needed and you might not be as lucky to get that option again

But as I said this is your choice but even without the 2 years I would have still took the Bypass rather than risk more heart attacks and maybe not surviving them :-) x

It's interesting that you say that you're terrified of a stroke during the operation. You don't mention dying or heart attack during the operation, purely a stroke.

Was this simply a slip of the pen, or do you have a very focused dread of strokes?

Stroke is my worst nightmare. The thought of spending the rest of my life disabled in a nursing home is just horrific. The surgeon knew I was going to bring it up, it's a common thought process.

I can sympathise with that.

Before my bypass surgery I also reflected on various outcomes, and the possibility of a serious and disabling stroke was indeed one of the worst potential conclusions.

However, the hard truth is that we all face the risk of a stroke, with or without surgery, and all we can do is mitigate that risk as much as possible. The key point here is that avoiding or delaying surgery may actually increase your stroke risk rather than reduce it.

Another key factor in my own decision making was that my heart disease was probably driven by my own drift towards the very early stages of Type 2 diabetes. T2 diabetes is actually the biggest single cause of disability in this country, bigger even than strokes. So I also had to factor that into the equation.

After a lot of research I came to a conclusion that open heart surgery was the optimum solution for me. But I certainly didn't arrive at that conclusion lightly, and I also realised that a radical root and branch overhaul of my lifestyle would be required after the operation. But I put my faith in a three pronged approach, the surgery to give me a "second chance", and medication and life style changes to then slow the progress of my heart disease to an absolute crawl.

Three years after the surgery it's a strategy that seems to be working (touch wood!), my key metrics of cardio vascular health are now all well in the safe zone and I feel far healthier and also far safer than I have for many years.

What ever you decide, good luck for the future.

Good to hear you are doing well, and good to hear your story. My surgeon specifically asked about any other conditions that I have and this was a factor in his advice. Having none and no heart symptons I could sense his reluctance to operate.

As I said earlier 4 days following the angiogram I had a stroke which is a possibility after an angiogram as the dye can dislodge some debris! I had some visual issues as well as balance problems as well as ‘twitches’ in my left arm. I was admitted for tests then after MRI was transferred to a stroke ward in a different hospital. Apart from still getting minor twitches in my left arm I have made a full recovery.

I live alone so a more severe stroke frightens me too, but more associated with an angiogram.

I had no visble symptoms was up and about running around the day before bypass yet when I had it surgeon said it was needed

Obviously no one can force you to have an operation.

The risk of stroke during a bypass is 1% vs 10% risk of HA. I like the first odds better. And if you do have a HA there’s no guarantee you will be in a place where you can get help.

Arteries in the brain and elsewhere are potentially prone to narrowing and blockage when you have coronary artery disease - not just those that supply blood to your heart. The risk of a stroke actually increases following a HA.

Part of the work up ahead of my triple CABG was an ultrasound check of the carotid arteries in my neck which supply blood to my brain. My assumption is that this was done to check for risk of stroke and mitigate if necessary.

Personally, if 2 experts have said CABG needs done then I wouldn’t be waiting knowing that another HA or worse might be round the corner. Good luck.

I Had the Misfortune of Having 2 separate Bypass ops in the Space of 20 months at the age of 40 & 42 The second due to finding out I had an Issue with the Arteries from my chest wall which where used in the first op . I was given a choice have them or chances I'd be dead as brutal as that . Though personal choice I'd take the op again if I had too . I'm back driving a HGV have never felt better .

I was fine and all tests were negative - they thought the pain was muscular. When I had all the tests intensively , that is an angiogram etc it was a different story. How glad I had the bypass. I feel recycled

I know this is a friendly, helpful forum, but you need some strong words pal. Get off your high horse and listen to what you've been told. Of course you're afraid, every one of us is scared every single day, but we're in the hands of experts,so stop being so stubborn and looking for somebody on here to agree with you because the advice you've been getting from these good people is correct. Do as you're told and stop thinking you know best.

I'm not apologising for being blunt, you need to grow up.

Normally I would agree but the cardiologist didn’t seem too bothered about the decision so not sure how serious it is!

It's 7 weeks now since I had my bypass operation - I never ever thought this would happen to me - I thought I was a healthy and fit man at the age of 62 years, and still working away as a tiler.Came home from work one day and my heart couldn't stop beating fast - it just wasn't normal and I also found it hard to breath- I was rushed to the hospital and while in hospital, I took a heart attack - best place to be eh!

They managed to fix the problem with a stent and I thought that was that and I was going to get home soon - but the doctors told me my other arteries are not good, and they advised me to have a triple heart bypass or I will have another heart attack.

I took their advice, stayed in hospital for another 4 weeks and had the operation- as no way I wanted to go through another heart attack.

I really hope you make the right decision.

For me it was an easy decision. My HA was solved with a couple of stents, but I knew that I was still at risk of another HA even though I was fit and well. The doctor that treated me referred me for bypass surgery and I had this 11 months after my HA. The risk of dying during the surgery was outlined as being 1%, a figure which covers all cases. The surgeon estimated the risk to me as less than 0.1%. I am now even fitter than I was. I love hill walking and a couple of Munros in a day is no problem and I'm nearly 70. 😀

I think you should have the bypass. The chances of you having another heart attack and /or stroke far outweigh any complications during surgery. The cardiologists do these operations as routine every day. Until I had my HA in May I had had no symptoms either. My surgery was classed as “unremarkable “ as were the other 4 ladies in the cardiac ward I was on.

I hope this helps you to make the decision.

I was told I needed a triple bypass due to blockages I only had 2 unstable angina attacks and tbh the 1st one I didn’t really twig what it was so went to Dr 4 days later as felt odd still. Anyway ecg and angiogram on HD showed lots of issues and 90+% blockage on 2. Was terrified but amazing cardiologist once doing the final scan thought he could stent and asked if I wanted him to try so I agreed. It took a while but several stents later all ok and nearly 5 years on still ok.

I did pass out awhile after the process but they think it was linked to the trauma as needed to go in via radial then femoral artery to do it.

Still think it was worth the risk, so I guess what I’m saying is there may be another less invasive option if you let them have a go :)

I was fit, had a heart attack and was kept stable for a week then had a quadruple bypass. The wonderful surgeon and his team saved my life and at no point did I think about a stroke. I would be dead now if I hadn’t had the surgery 5 years ago, instead I felt better than I had in years.

I would have done the same. The reason, diagnosis, and treatment are continuous and the choice you made is part of the diagnosis and treatment. So, you are still under 'diagnosis and treatment'. Just please continue. One other thing, a forecast of 10 percent is OK, but please remember 'the past is gone, we don't control the future, so what we have is here and now. Good luck

I just want to thank everyone for their help here.This morning I woke up and everything became clear, I just thought I can't live with this heart attack risk, sooner or later it will strike. I need to get this bypass done.

Once again, thanks to all the above people, I may not have come to this correct decision without you!

I feel less stressed out now that I have come to this conclusion.

Just had a phone conversation with the PA of the surgeon and have been booked in for the bypass mid January. Fortunately he had a gap in his diary. It's an Off-Pump job which is a good thing too.

Try to have a good Christmas and keep posting we’re here to support each other.

Best of luck to you I am sure it will go well and you will feel relieved when it's done.

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