My husband had his appt with the cardiologist to discuss the findings from the Angiogram He is referring him to the Liverpool heart and chest company for consideration of a bypass. Stenting he says, is not possible ( the blockage is before and after the existing stent and another on a large branch from the LAD )
The blockage he says is 85% which scared the life out of me . But as my husband is displaying no symptoms of angina and in good health ,the consultant says he’s not concerned and that when when we get the appt with the surgeon we must stress his family history. (Father, died at 50 and uncle 60 from coronary heart disease , also his mother at 70)
It’s seems to me that because he has no symptoms he may not be considered for surgery until the blockage starts to cause a problem , or not a pressing case . So we’re confused as why an 85 % blockage would nt be urgent
Your thoughts on this will be so much appreciated everyone .
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Kewen
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A high level of arterial blockage doesn't automatically equal a high risk of a heart attack.
Some people have heart attacks in their thirties or forties with relatively low levels of blockage, often well below 50%. Other people get to their sixties and seventies with arterial blockage at over 90%, but without ever having had a heart attack.
The difference is that some people tend to have "hot", unstable plaque that's more likely to rupture, other people are more likely to develop plaque that quickly calcifies and becomes stable. Forgive the gross analogy but hink of it like acne, some spots easily burst, other spots can become very swollen but they're hard and refuse to burst. That's what the plaque in our arteries is like.
As an aside, one of the valuable benefits of a daily statin is that it promotes and accelerates this stabilisation process.
thankyou Chappychap for such a good analogy . I didn’t know there was unstable and stable plaque , or that’s what statins actually did . .. stabilise the plaque. It still worries me, an 85% blockage , that must impact on blood flow to the heart . Hubby had two stents 17 years ago from 90 % and 80% blockages Now the stent in the Lad has moderate stenosis, other is fine. So they’ve served him well till now .
Hi Kewen, I understand your concern. When you and your husband get in front of that consultant, don't put on a brave face. Tell him/her that it is impacting on your mental as well as your physical health and relationship. Explain every symptom but don't play them down at all.
When I went for my coronary angiogram test, I told the consultant that I was doing regular exercise, didn't get breathless, used a GTN before exercise, blah blah blah. He said I didn't need the test, but I persuaded him to do it anyway as I was there and needed peace of mind. I had the bypass op less than a week later, he couldn't believe I was still alive, let alone able to exercise.
Hi Kewen, Your husband's position is very similar to the one I and my wife faced last February following an Angiogram carried out at Aintree Hospital Trust. I too was in good health, or thought I was. Having only experiencing slight breathlessness on playing tennis 🎾 and brisk walking and cycling and putting it down to age (72years) . So, to look at the giant screen at the end of my Angiogram and have a serious blockage/stenosis pointed 👉 out at the junction of the LAD where it joined my heart ❤️ was a massive shock. Like your husband my stenosis because of it's location couldn't be stented and the only alternative was Bypass surgery. I to was reffered to Broadgreen Chest &Heart Hospital for Bypass surgery. Both my wife and I had a few sleeplessness nights-cups of tea at 3am which I'm sure you're going through now. I only wish I had known about this site back then as it would have given me a great deal of comfort to read one of our contributers pointing out that that your heart can function perfectly well with a severe stenosis and statins can help to keep plaque breaking off whilst you're waiting for a Bypass. Eventually I saw my surgeon in July and was I lucky to take advantage of a cancellation of someone else's operation 26th September. On the upside I had little time to think between being offered the op and having it carried out. I can't speak to highly of my surgeon (called into see how I was faring following my Bypass every day I was in hospital). I was operated on Monday pm out by Saturday evening. Looking back the care I received was excellent and I have no doubt your husband will receive the same. Best wishes the future. Denis
I agree that percentage (unless it's 100%) doesn't necessarily equate to risk level. I had 90% plus LAD blockage a few years ago, with ZERO symptoms, before I was stented up. I then had a heart attack due to a plaque rupture in another artery that was only 20% blocked. Grrr...anyway, hang in there, I think your husband is not in immediate danger.
Chappychap you are lucky you have got a good doctor. Although there is a blockage there are no symptoms because collateral arteries would have developed very well which supply the blood. Hence there is no need for stenting. I had 100% LAD blockage and was fine as i had collaterals. But one bad cardiologist pushed me for bypass and then my life got ruined. So if there are no symptoms then there there something called natural bypass which is in progress and there is no need to worry.
yes collaterals are evident on angiogram. Simple logic is, no symptom with blockage itself implies that collaterals exist. But it is important not to get panic. I went for urinary stone removal and as part of routine test ECG indicated heart attack. But i never knew i had a heart attack as I was asymptomatic. As cardiologist suggested I went ahead with bypass without taking multiple opinions. Soof after bypass, I started having severe breathlessness, and after running around with various doctors it was diagnosed as heart failure. I was told that bypass has two major complications 1. heart failure 2. stroke. Doctors say that bypass is successful but heart failure is one of its complication. It is just like operation was successful but patient collapsed.
Oh sorry to hear that , how are you doing now? That’s a side effect I didn’t know about . We’ve had the call this afternoon to see the consultant on Monday. So that will be something we’ll be asking about.
Nothing was mentioned on hubbys angiogram about collaterals though , we will ask about that as well.
Hi Kewin, my case is similar but more serious. I am 75 yrs old male from Mumbai, India. I had bypass with 4 grafts in Feb,2021. 15 years before bypass, I had unnoticed heart attack with 80% block in LAD. I was treated 12 hours after heart attack. Means muscle must be dead. Angioplasty was done 25 days after attack. This time block was before stent in LAD. Also there were 3 more blocks ~70-85% blocks. As commented before soft & hard plaques are there. Fortunately 4 1/2 hours bypass surgery was successful. Today, I am fit & fine. Cardiac surgeon said, you are going home with 50 years person's heart. So don't worry so much. Bypass is better than stent, since block occurs before stent.
Tthat does sound similar to husbands situation . We’re they able to differentiate between the types of plaque? I wasn’t aware they could do that . I hope you are well , But so good to hear such a positive outcome. Thankyou
My 1st heart attack in 2006, I presume, I had hard plaque & due to no knowledge of action to be taken after angina pain (angina pectories), LAD plaque was ruptured next day. In 2 nd case in Feb,2021, Twice,I had mild chest pain, when taking walk on 11th & 12th Feb. After angiography, showing blocks in 4 arteries, bypass surgery was done on 22nd Feb. Surgeon has not indicated details about type of plaque. Reason for these block was, I had stopped taking ecoprin & statin tablets, 5 years after angiography, thinking, I have no problem. I came to know about type of plaques, from one of the replies rec'd by you. Hope these details are ok. If you need any further details, feel free to write to me.
Due to Bypass, surgeon did not touch blocked arteries & same were bypassed. I think, hence no question of checking type of plaque. I think most of patients are not told about type of plaques, they have.
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