Help

[Gardensuburb]

I have recently been diagnosed with angina. I have artery disease ( 50-65% stenosis on LAD but my cardiologist says I don`t need a stent as my symptoms are being managed with various drugs including nitrates and statins. Is that a situation that other angina sufferers find themselves in?

[shopman]

Do you still get Angina and are doing anything that may be starting it? Do you have a GTN Spray and if so do you use it and apart from headaches does it have any effect?

[Chappychap]

Hello. I appreciate that a diagnosis of 50-65% stenosis may sound alarming, and for sure it's not something that you want to take lightly. But it's actually not quite as terrible as it first sounds.

In reality it's quite difficult to detect stenosis below 50%, and consequently 50% is normally taken as the threshold for a diagnosis of atherosclerosis (obstructive heart disease). Indeed there are plenty of people on this forum who had no angina symptoms, and weren't even aware of any heart problems, until they had stenosis of 80 or even 90%.

That's why your cardiologist is in no rush to progress to stents. They will very sensibly want to first see if the problem can be managed with lifestyle changes and medication. It's easy to think that stents are a "get out of jail card", but that's simply not the case. Stents can be a lifesaver when inserted during a heart attack right at the site of a blockage, and they can remove or reduce the symptoms of angina, but there is virtually no evidence that stents inserted in other circumstances have any effect whatsoever in delivering additional life expectancy or reducing the chances of a stroke/heart attack. We have literally miles of arteries in our bodies and individual stents can only open up a few millimetres of artery.

And stents (or even a bypass) aren't a cure for our atherosclerosis, unfortunately we've got that for life. But the good news is that most of us can reduce the progress of the disease to an absolute crawl if we're serious about life style changes and diligently take our medication.

Good luck!

[Gardensuburb in reply to Chappychap]

Thank you so.much your balanced and very informative reply.

[Hidden]

I was / am in a similar situation - just before the pandemic started I had chest pains and went to A and E. several tests later I was shown to have stenosis of 80-90%. They gave me all the usual meds (Ramipril, Ranexa, aspirin, Monomil - and added Bisoprolol a year later). The consultant talked about a stent, but felt it wasn’t possible at the time / Covid. I was monitored (phone consultations) and had a scan and 24 hour monitoring thing attached (early morning now - can’t think of the word !). Tests came up well and consultant said all being managed by the medication / he’ll contact me in a year. I have improved my diet a lot since diagnosis (not that it was bad) and lost 1 1/2 stones. I try to exercise daily - though I’ve lapsed recently 🙁. In many ways I feel better than I did 2 years ago!

[Plum53]

Hi , I have an 80% blockage in my Lad diagnosed 5 years ago . I am being treated with medication was told blood flow was good and I have since been discharged from cardiologist and returned back to gp care. I was told if my symptoms change or increase then GP will refer me back to cardiologist. To be honest I wish I had 50/65% instead of 80% . Good luck to you and try not to worry too much. I think I spent the most of two years expecting to have heart attack. What a waste of my life. The worry of it took over my mind but I’m loads better now. Best wishes going forward

[Gardensuburb in reply to Plum53]

Thanks for your honesty but is really helpful and good luck to you for the future too.

[Kristin1812 Heart Star]

My Cardiologist told me. recently that they are not doing stents as readily as they have done, as they were getting better results with meds. Does anyone know if that’s the principal now, and led by NICE?

[Haresear55]

I had a heart attack in October with 100% LAD blockage. Stent was inserted, and other blockages treated with medication. I have a 60% blockage lower in the LAD but a stent is considered when it is 90%. Medication and monitoring is the treatment. Follow medical advice and diet recommendations. We are here to support your concerns.

[Gardensuburb in reply to Haresear55]

Thanks so much your response

[Frylight]

I found out on Monday, following a CT scan, that I have 50/60% furring in two areas. I am now on 40mg do Avorstatin, and a disposable aspirin first thing. I have been told by the hospital that I’m not in worst position, but at 64 and neither a drinker/smoker I am more than a bit worried. I will listen to what they say, lose a bit of weight, up the the walking and stick to the meds. I also have the spray, but since December have had no pains, though I have lost a stone in weight since then. It’s all a bit too real now isn’t it……..☹️