Hi - I had a coronary angiogram two weeks ago and the consultant that performed it said I would need a bypass operation and put me on some medication. I have another appointment for a medication review at the end of May but have heard nothing else - I don’t even know what is wrong with me, just that I have a blocked artery. What should I be doing? Should I increase my exercise or do none - I am scared stiff I will have a heart attack. I have phoned the consultants secretary twice but she has just told me to wait until my appointment and she can tell me nothing before then, but has advised there is nothing in my notes about needing a bypass. For some context I am 48 and was experiencing some discomfort (like a tightness, not a pain) when exercising and had an ecg which was normal. As both my parents and all my grandparents either are living with or have died early (late fifties, early sixties) from heart issues my consultant decided to sent me straight for an angiogram before doing any other tests.
Need a bypass - what happens next? - British Heart Fou...
Need a bypass - what happens next?
The main benefit of both stents and bypass surgery are to remove the symptoms of angina, they actually don't reduce the risk of heart attacks all that much. What they do deliver however is the absolutely amazing gift of a second chance, in other words a heaven sent opportunity to reduce the risk of a heart attack via subsequent medication and life style changes.
Unless your angina is of the "unstable" variety you probably won't be top priority for the bypass operation, that's actually great news as it means your cardiologist doesn't see any exceptional or imminent dangers. But at the same time, best prepare yourself for delays and postponements!
Some seriously good news is your relatively young age. Open heart surgery is a major undertaking, and is never chosen lightly. You'll be asked to sign a consent form that will tell you the risks of a bad outcome are about 2%. But that 2% figure is the average, and the average heart surgery patient is in their late 60"s. Given that age is a major determinant of surgical risks it means your individual risk will be much, much lower.
One final point. I had a bypass three and a half years ago. The results were absolutely transformational. Okay, the first few weeks following the operation were no picnic, but after that I found myself fitter, stronger and with far more zest for life than before. Genuinely, it was like turning the clock back ten or even twenty years. I now sleep like a baby and spring out of bed each morning with an insatiable appetite for life! However, I've also staged a root and branch review of my life style. Unfortunately we can't ever "cure" our heart disease, but with a little luck and a lot of application we can slow its progress to an absolute crawl. It's occasionally hard work, but those extra years of fit and healthy life are worth any and all life style changes.
Good luck!
Thank you so much for replying - very much appreciated! I have been mildly panicking but feel much calmer now 
It is perfectly natural to be concerned you are still young so obviously want to know where it leaves you.
You probably saw a cardiology but the bypass needs to be done by a cardiac surgeon so probably your notes are being transferred across.
I was told in January 2017 I needed a bypass was put on beta blockers and blood thinners and heard nothing until May 2017 when I had an appointment with the surgeon, my bypass was June 1st that year.
It was a long wait with no updates at all, I did have 1 appointment with the original cardiologist but saw one of his staff just to see how things were going.
Speak to your GP if you have any questions he/she may have had an update from the hospital and can advise you.
Thank you so much - that is reassuring xx
It is usual ( certainly in my experience) for a letter of the investigation to be issued to your GP with a copy to you. Within it will be a summary of what was found and the follow up plan. However this can take up to 3 weeks (sometimes longer ☹️) to be issued. Your GP will certainly have to be told of the medication you have been prescribed, since they are now responsible for issuing repeat prescriptions. And the medical secretary will not be able to divulge any medical details of your case, but should be able to advise on progress on any documents which are issued to you and your GP.
Thank you - my gp has been sent a letter about the new medications and have been informed that the angiogram was done, but nothing else. The medical secretary only knew about my next appointment for a medicine review, nothing else - well, nothing she was telling me about lol!
It would be useful if you had a copy of the letter if you haven't actually seen it. It may be available on-line if your GP subscribes to an online service like Patient Access. Failing that ask at your GP reception for a paper copy. My guess is that the medication review is simply to find out how you are getting on with your medication(s) and how they are managing what appears to be angina. Unfortunately at present that does not confirm if a major intervention like a bypass is required as you have found out. But if stents were required they would probably have been fitted at the time of your angiogram, assuming you can accept them.
They don’t do stents at the hospital where I had the angiogram - if I had needed one I would be referred to the same place I would have the bypass, but I was told I needed a bypass as one of my arteries is blocked. My gp doesn’t have anything in line but I will ask for a copy of the letter - thanks for that. A good tip!
I got a copy of the letter today - my LAD is totally occluded and my RCA shows borderline disease. Does anyone know what that means - I googled and read about “widow makers” and scared myself silly x
It is perfectly natural to be anxious as you have a lack of information. As Chappychap so eloquently put, "cardiologist doesn't see any exceptional or imminent dangers" and that is good news. I feel that you will still always worry, 'what if'. I am sure the cardiologist knows how blocked it is and he would have stented immediately, if severe and possible. He/she will keep eyes on you I am sure. Your next appt in May - ask all your questions and make a list. Good luck and take care.
Not all severely blocked coronary arteries can be stented. I have some like that. Apparently something to do with how they are blocked, artery size, and the route the artery takes .
Yes I do know that. My artery is blocked and cannot be stented
Dear Basilsmum1973
You are perfectly normal in your reactions to the shocking news that you have had.
It must have been in the back of your mind that one day this may happen with the sad history of your loving family.
But take heart { no pun intended } in the heart field of medication and procedures we have come on leaps and bounds.
Yours is a new case that even you don’t know what has been found yet, but believe me this is one of many tests that you will have to try and map exactly what is happening with your heart and it’s functioning .
Try not to over worry, you are now in the system and the cogs are turning for you, your turn will come I promise and when it does we will be here to help guide you on your journey.
From now on you will never be alone, we already are beginning to know and be concerned about you.
Take care, and who is Basil ? And are you really his mum?
Thank you so much for your lovely reply - I got a bit emotional, in a good way!! Basil is my Lhasa Apso (dog) and I love him as much as my daughter so yes, he is my son lol xx I do take heart and will trust in the system xx
Oooooooooh, I see, yeah I have a little old Jack Russell called Cam { his brother that died was called Bear, you work it out !} he's 15 going on 2 ! LOL x
Hello Basilsmum (and your lovely dog)!.My husband was 68 when he went for an angiogram in May 2018 as he was having bad angina attacks and couldn't walk very far without having to stop and catch his breath (and wait for the pain to subside).
The notes from the hospital took weeks to get processed and he was put on lots of tablets to help his BP (he had perfect blood pressure) and various thinners and of course GTN spray.
He was told when he had his angiogram that he needed 3 bypasses and eventually had 4 in November 2018 following several cancellations!
He had and still has a new lease of life afterwards and of course before the operation we were told the "what could happen" bits but to be honest, it was an easy decision.
I think someone said on this forum that consultant's secretary's aren't allowed to divulge information and we found that to be very true.
I hope all goes well for you.
Lots of love. Jan xxx
Thank you so much - it is so reassuring to hear about others positive experiences xx
👍💕💕 xxx
Best is to get another doctor to get away from waiting anxiety. You need information. It does not hurt to get another since you may be thinking of a second opinion later. Keep well, relax and get away from stress for the time being.
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