Collateral circulation

[Heartfire1230]

I have been diagnosed with a blocked right artery during angiogram following indigestion type pain on exertion (riding pushbike ). I was amazed that I hadn’t had a HA . Cardiologist said I was saved this by collateral circulation which had naturally bypassed the blockage. This apparently cannot be stented as the blockage is too large / difficult. I am awaiting a further review having been put on bisoprolol, atorvastatin, clopidogrel, isosorbide mononitrate and lansoprazole.

My question is, has anybody else had experience of this diagnosis? Whilst I feel extremely lucky thus far, I feel like a heart attack waiting to happen, am unsure how robust the collateral phenomenon is and need reassurance that I will be able to exercise safely again. I also wonder if by pass is an option or will be suggested at some point as “other options / procedures” available to the cardiologist were believed to be “ too risky”

Any thoughts from this brilliant supportive group would be appreciated.

[Heartfire1230]

thank you for your reply which provides me with comfort that all is not lost!

I am still waiting for a return visit to the cardiologist and I can develop my questioning of him to see what other options there could be.

Much appreciated

[APC65]

Hi, I have a similar story to your own. I had relatively minor chest discomfort on walking, which I recognised as ‘new’. I went to GP who fast tracked me to chest pain clinic. angio on 29th Dec confirmed 100% blockage on LAD but supplied by collateral’s. I also have severe blockage on a branch from circumflex artery. Still in shock!! I have seen cardiologist and he explained that the artery blockage has probably been building for a long time and only recently become fully blocked, hence recent chest pain symptoms on exertion. The collaterals have served me well but now the artery is 100% blocked they will struggle if I put too much demand on my heart. So taking it easy until double by pass scheduled for Feb. I absolutely appreciate the feeling of ‘waiting’ for heart attack to happen …. Have taken up yoga and meditation to help manage that for next few weeks- and it is helping. Am taking Isosorbide mononitrate and aspirin to I keep me ticking and Atorvastatin to prevent anything getting worse. Do you have a cardiac nurse specialist team locally, they may be able to do a telephone consultation to explain your collateral supply whilst you wait for cardiologist appointment. Good luck.

[Heartfire1230 in reply to APC65]

I wish you all the best with your upcoming op and following information passed here from others with bypasses, I’m sure you will be fine.

I do occasionally speak with excellent cardio nurses who provide advice and support. I was due to revisit for a follow up in November but despite a number of chase up calls from me, have heard nothing from the cardiologist team for my next appointment.

Keep us up to date with your progress

[tunybgur]

Angina or heart pain is normally the result of poor blood flow to the heart muscles caused by restricted arteries, but a heart attack will often be the result of a blood clot or piece of debris breaking free and blocking an artery. Angina doesn't mean a heart attack is imminent.

Collateral flow is the heart trying to bypass these restrictions but will unlikely be sufficient to replace the full flow from the restricted artery.

Statins normally help by somehow stabilising plaque which builds up blocking the arteries, and stops bits breaking free.

Good luck

[Heartfire1230]

Thank you all so much for taking the time to reply and explain which helps to confirm and come to terms with my fears.

This really is a great place to sound off and put things in perspective.

[MountainGoat52]

It is good that the appropriate medical professionals are on your case and considering the best course of action for you. If it comes to recommending that you have a bypass, don't be worried about taking that course. It is certainly not a route to the rocking chair. As Thatwasunexpected has said, many of us that have had surgery go on to do greater things. In my case, I now climb mountains, not just hills... 😀

[Heartfire1230 in reply to MountainGoat52]

ah that’s great. Well done to you. That’s the motivation I need. Thank you

[Debug]

I had my RCA blocked 100% and my LCA blocked >98%....They first stented the LCA. My cardiologist said that I had collaterals and was not at risk of a heart attack.

He advise me to do walking to improve my symptoms and that I may not need the RCA opened since it is a high-risk procedure.

I had chest pain and shortness of breath. It was severe during exercise.

I was getting a little worse every day.

They opened the RCA and i am on my way to 100%. The collaterals did not supply enough blood to walk fast.

Your Doctor needs to be highly trained and the 100% blockage may not be able to open and then if the pain is severe enough a bypass would be done.

Good luck

[Heartfire1230 in reply to Debug]

ah yes that’s the worry, the not knowing if the collateral is adequate and what else is in the armoury to try next. Mind you , I’m still waiting to see cardiologist. They wanted to see me 3 months after angiogram. Nearly 6 months later still waiting…..

Thank you for sharing

[ChoochSiesta]

I had a similar situation. They did a triple bypass.

[bexy190]

Hi just wondering how you are doing? my mum has CAD 1 artery is 100% blocked and another is 95% blocked. She also needs aortic valve replacement. They are not going to do anything with her blocked arteries because they say she would not survive the surgery. I am constantly worrying she’s going to have a heart attack now, I don’t understand how can she live with 2 blocked arteries, they say she has collateral circulation from 1 of them. So just wondering how you are and if you have any words of reassurance? 😔