Recent Angina Diagnosis,Two Angiograms and still no stent because it's difficult?

[Getbacktonormal]

Hi , I am Adam and 51 years old. I had a cough and shortness of breath that started in March this year. Got referred to a cardiologist, had an echocardiogram which showed slight leaking aortic valve. I also had a positive stress test indicating a blockage. I was put on monomil XL 30mg , ranexa 350mg twice a day, aspirin 75mg, bisoprolol 1.25mg and GTN spray. I had an angiogram in August which showed a blockage where the blue arrow on the picture is. I was told it was too tricky to put a stent in at that time. Went back in this Friday to have a stent fitted , procedure was slightly different as I believe I was given something as I was told I would get breathless and I could barely breathe. Again I was told it was difficult to do and they didn't want to cause further complications. Cardiologist said something about the blood flow being positive but the other was negative? Not sure what that meant. Anyway sent away with more medication Nicorandil 10mg twice a day.

Will see consultant in about 4 weeks time. He spoke about possibly doing angioplasty but not putting the stent in. I have been off work since August and he will no give me the ok to return yet.

Does anyone have any explanation or experience as to what he said and why he wouldn't fit a stent.

Many thanks

[Kristin1812 Heart Star]

This all sounds rather unclear to me, and unsatisfactory for you. But I’d be surprised if anyone here could explain ‘what he said and why he wouldn't fit a stent’.

In the meantime, you could try to ask your GP to clarify. But you could also prepare the exact questions you need answered when you see the Consultant in 4 weeks. Hopefully you will get more clarity then.

[Getbacktonormal in reply to Kristin1812]

Hi, thanks for your reply. I was looking if there was anymore information I could use to discuss the reason why no stent after two angiograms. Getting my questions ready as I have to get a proper answer and a way forward. Thanks

[Getbacktonormal]

Hi, thanks for taking the time to reply. The image is off the internet. I was shown a zoomed in angiogram image so I don't know if it's the junction or the one above. Something I need to clarify but time in hospital to talk to them is so limited. Previously the cardiologist spoke about the stent protruding into the junction and causing complications. Just got to gather as much information as possible and nail him down for answers. Thanks

[richard_jw]

I had a STEMI 2 years ago. The Right coronary artery was completely blocked causing damage to the heart muscle. In my case they could not put a stent in because of the coronary artery was too wide. So they tried to clear it with clot busting drugs both during the angioplasty and overnight via infusion.

My point is that there may be other ways to fix a blockage than by using a stent. A year ago, I had an check angiogram, and as a result of the procedure a year before and the subsequent medication, all main coronary arteries are clear.

[Getbacktonormal]

Hi, thanks for your reply. When they gave you clot busting drugs did this cause breathlessness, I ask as they gave me something and warned I would get breathless but didn't say what it was during angiogram. I hear what you are saying but I can't understand on the first time they tell me it's difficult and then book me back it to have a stent fitted if they can't do it ? Thanks

[Speeder]

Hi Adam ,

From your diagram and the blockage ; very much reminds me of what I faced in July 2021 . I had an angioplasty procedure where a blockage was found in the LAD at a branch with another smaller artery but no stent could be fitted as a result : however following a discussion with a consultant , it was decided to attempt to place a stent within a stent to create a branch.This was successfully done using stents manufactured in France . Now feel great with no pain or breathlessness at all.

Sometimes a talk through with a consultant can make good things happen .

Hope this helps to reassure that a solution will be found for you .

All the best ,

Eddie S.

[Getbacktonormal in reply to Speeder]

Thanks Eddie for your reply I will certainly look into that. Appreciate you replying.

[Hidden]

Hi, I found myself in a not to dissimilar situation last February. I too had been suffering from breathlessness whilst walking playing tennis 🎾 from August2021. Eventually had an Angiogram in February 2022. That confirmed I had a severe stenosis (tightening)at the top of the LAD. Unfortunately , like yourself it was to awkward to stent the reason being it was on a bend where the Artery joined the heart. On the upside I was fortunate to be offered a cancellation back in late September and had a double Bypass. Not sure if your problem was similar to mine but it looks like it can be sorted. Best of luck. Denis

[Getbacktonormal in reply to Hidden]

Hi Denis thanks for your comments. I have been to GP today to get copies of my discharge letters. It turns out I have a mild blockage of the RCA . I seem to have the unique option of a ramus (intermediate artery) that has a significant blockage. RFR test was positive at 0.85 but the FFR value was -0.85 so they opt to treat with medication instead. According to my notes there is consideration to include amlodipine on top of existing meds. At least it now gives me a clearer picture to see if there is an alternative to medication for life. Thanks