Dilemma of choice of having angiogram and stent procedure

[Pots11]

Following a telephone appointment 2 weeks ago the doctor said he was willing do a partially blocked artery stent if I felt I needed to if still getting problems I told him I was eager to get done I am also to see him in about 2 months for echocardiogram besides to see how my heart is behaving now. I have already had a successfull angiogram and stent to blocked artery that caused heart attack early in December. For weeks I have been waiting for to jump at chance have partially blocked one stented as well However this last 3 weeks I have started to see a marked improvement after about 14 weeks of spasmodic angina pain and some breathing problems and he said I may have a slight improvement or maybe none after this stent procedure Because of this welcomed marked improvement in the last 3 weeks I have a dilemma of yes or no to stent at this time because of my marked improvement I have heart damage and some hardening of the arteries but pleased with how I am now feeling very pleased in fact gardening walking a some biking.

[RufusScamp]

Hard to advise you one way or the other. As a precautionary tale, I was diagnosed with severe heart failure, but had a walking holiday in the Alps a few weeks later. The problem could still be there, but your body might be adapting. Could you have the angiogram with them deciding then if the stent is necessary?This is my observation, NOT medical advice. Your doctor or cardiologist are the best people to discuss it with.

[Heythrop51]

If I were you I would go for the stent as you have a highlighted narrowing that I would assume increases risk.

[firstlight40]

Of course it's your decision, but given the risk of a partial blockage turning complete and causing issues I'd have stents.

Last year I had a mild HA and ended up with six stents in two arteries both with severe narrowing, I feel a lot more confident having had them done in pushing harder in exercise and general life. I don't carry a gtn spray with me any more. However I'm a bit younger than you (57).

Of course medical professionals give advice but I hope my perspective helps

[firstlight40]

Thanks, I have one available if I go away, in my car, or are a long way from medical care (eg I'm in Thailand right now) but I don't carry it with me 24/7. Of course the future is not predictable but I'm happy with the level of risk for me personally. Others may have different risk perceptions and that's fine.

In my risk perception i take into account:

1) My cardiologist told me 'you are fixed', I have EF of 65%, with no perceivable damage from an nstemi MI. My cholesterol ldl is now at 1.6 and I'm continuing on well tolerated dapt.

2) i just got well into stage 5 on a Bruce stress test with no ischaemia (hgv drivers only need to get to stage 3)

3) I live 4 minutes drive from an a&e hospital with resus facilities and 10 minutes by helicopter from a cardiac centre.

And I'd certainly not give anyone else a gtn spray or an aspirin. I'm not a doctor or trained first aider and such a statement is irresponsible on this board

[Hidden in reply to firstlight40]

I agree with Outoftheblues regarding the GTN spray. I am 55 and had a HA and stent fitted as an emergency on 25th Feb. I am now feeling very well, walking 5 miles a day, when I can fit it in, but ALWAYS carry my spray and always will as long as it’s on my repeat prescription list ! When I left hospital after my heart procedure and after the Registrar had finished doing his final checks on me, US etc, he gave me a card to fill in to carry with me always. It’s all my contact details and states what someone should do with my GTN spray ! I hope that if I collapse that someone goes through my bag or pockets and sees it and my spray and gives me it if I can’t do it before an ambulance arrives!!! That’s what it’s for !!

[Hidden]

100% with the last two posts, we are not fixed, we never know when for instance a piece of that plaque in our arteries may detach itself and cause another blockage.I've had angina for 8+ years and had a HA last year.....I've had occasion to phone 999 or 111 about four or five times about my heart, on every occasion they have discussed GTN usage and told me to chew two aspirins.

When I go out I tap my pockets to check spray, wallet, phone.

There's always a spare spray in the car as well.

[Hidden in reply to Hidden]

I also tap my pocket! I keep mine in my jeans during the day and by my bed on a night. Good idea to keep one in the car though. I will put one in the glove box now!

[richard_jw]

18 months ago I had a STEMI. For technical reasons they could not stent it. So they used a balloon to try to clear the clot. Then put me on hefty anticoagulants and anti platelet meds.

There was always some doubt about whether the clots had really dispersed, so they did an angiogram, with a view to removing any clots still there.

Angiography appears to be the gold standard in examining coronary arteries, and is relatively low risk.

I was happy to have the angiogram done especially as it revealed clear arteries.

[MountainGoat52]

I had a couple of stents in my RCA when I had my HA. I was referred for possible surgery as I had narrowing on the left side. The surgeon offered me a bypass op or further stents. I elected to go for the bypass, but either way it was made clear action was required to reduce the risk of a further HA. At no point was it a case of doing nothing. My feeling is therefore to take what is offered on the basis that it wouldn't have been offered if it were not considered to be of benefit to you.

[nellie237]

I think I carried a GTN spray for a few months after my HA in 2012, and used it once or twice for what I think was probably a bit if stent settling pain, rather than angina, but that was it. We are all different.

[nellie237]

I'll ask my GP, and see what he thinks of your analogy. I disagree completely with your statement that we are not all different.

[uzininemm]

Perhaps you could explain this 'mmm' which you start posts with.

I am not sure as to how I should treat it.

[uzininemm]

Thank you.