what happens if restriction on blood flow continues?

Hello

I feel like there is an elephant in the room which isn’t being discussed or perhaps it doesn’t need to be because it really isn’t there or we’re not at the point to discuss such things (with cardiologist). Or it’s the elephant I don’t want to acknowledge? But its better that elephants should be acknowledged 😊

So here’s my question / conundrum:

If my congenital heart defect is causing continuous compression (harder heart works the harder the compression) that restricts blood flow (and therefore oxygen?) through my LAD - and assuming no med works (hasn’t so far) and assuming surgery is not available or advisable or won’t help - then repeated / prolonged restriction on blood flow will if hasn’t already cause myocardial ischemia?

If yes to myocardial ischemia (which I think is the case) then this can potentially cause heart failure, arrhythmia or even heart attack plus changes to the heart (have mild LVH at present only)?

I’m not trying to scare myself, I prefer to be informed (that usually greatly helps with any potential anxiety) and “size up that elephant” 😊

Cardiologist has not had such a conversation but I suspect as we are still investigating we’re not there yet?

I’m not trying to scare myself, I prefer to be informed (that usually greatly helps with any potential anxiety) and I’d like to “size up that elephant” 😊 hope is great but one has to have a sense of reality too.

Your knowledge and experience I always appreciate greatly. 👍 should add I get this could be a how long is a piece of string question! But I’d appreciate thoughts on the above

[Tos92]

Hi Hidden

I will be following this post as I’m also interested in what others have to say due to also having a myocardial bridge in my LAD.

I have gone through the exact same thinking process as you and have wondered whether myocardial ischemia can occur as a result of having a bridge. I know I have ischemic changes due to elevated troponin back in January 2022 when I had the NSTEMI. I do think the bridge had a part to play in that as I believe the doctors felt that this was the particular artery that spasmed.

However, in saying that, we know that myocardial bridges are mostly benign and people live a normal and healthy life without ever being diagnosed with it. Therefore, I do wonder if myocardial ischemia may only be present in those that are symptomatic? And those who remain unsymptomatic have a less likely chance of developing myocardial ischemia? Or maybe the chances of developing myocardial ischemia are the same despite being symptomatic or not?

There are however studies which have been published that show that myocardial bridges are a cause for myocardial ischemia, especially in those who have vasospasm, endothelial dysfunction and compromised coronary blood flow as a direct result of having a bridge. On that basis, I personally do feel that this is possible.

It’s hard to determine as our condition is so niche.

I’m due to see my cardiologist in a few weeks. I will definitely ask him this question, although he is not a myocardial bridge specialist therefore, I am not overly confident he would know the answer but the question can always be asked nevertheless.

[Hidden in reply to Tos92]

hello yes I think the same as yourself, mine has been shown to be impacting blood flow so now I’d like to address this question. I have a cardiologist appointment with my local cardiologist (not the one who tested) next week so I will ask them too but like yours not an expert but open minded enough to have referred me for testing.

Now I have a diagnosis as much as bridges can be diagnosed (there are no thresholds for decision making like there are for stenosis I.e. what’s mild, moderate or severe, they can only say causing significant impact and therefore likely bridge is cause, it’s so annoying but it will take years and years before there is more knowledge and research), I can start to ask these questions.

👍

[Hidden]

I was hoping you’d come along 😊 that’s so interesting about new arteries developing (the body and heart are extraordinary sounds like as if the heart / body is trying to fix itself / compensate) but note the limitations.

I get what you’re saying though. The cardiologist at last angio I heard him say the heart is de conditioned (I am not surprised). But a quick search shows implications but that deconditioning can be reversed through exercise 🥴 but as exercise would aggravate things ……. So I get the lack of exercise could likely be the greater culprit than the defect itself. But no certainties.

It’s good to think things through. Thanks.

[Challenger2009]

Hi, I have sort of the same issue my RCA is completely blocked but have a collateral bypassing it, so in theory the cardiologist tells me it is a wonderful thing but I have terrible angina and now I am told my heart is deconditioned and I need more exercise but that is easier said than done when some days getting round Tescos is a mission, my issues started June 2021 and I'm still back and forth as my cardiologist refused to believe it was all heart related insisting some of it must be coming from my lungs but all test for the lungs have come back perfect and the lung doctor say it is cardiac, finally at my cardiologist appointment on Friday they have finally conceeded it is angina but due to it not damaging my heart they won't do anything else and I've just to continue on medication.

[Hidden in reply to Challenger2009]

Asda is my choice of exercise and used to hope in early days at least someone might trip over me in the aisles. It’s such a tricky and vicious cycle - exercise would help to recondition but exercise would also exacerbate the angina. Rock and a hard place someone said on another post I wrote re whether I could exercise (answer largely was no).

But this may not seem like something to celebrate but congratulations on getting your doctors to concede at last, that’s a big achievement in itself to be believed.

I guess we both will have to manage on medication and hope they keep an eye on us and monitor for any changes - ourselves and by doctors.

I wish you well as best as you can achieve. 👍

[Challenger2009]

We certainly will, but I won't hold out much hope regarding keeping an eye on us, just getting to see a cardiologist is hard enough but just need to keep plodding along see how it goes, I've sort of just got used to being limited in my ability to what I can do for the time being.

[Hidden in reply to Challenger2009]

fair point!

I’m yet to get used to the limited ability / get my head round it.

👍

[Lizzy-loo]

A fellow Bridger here too, so I read your posted questions and thoughts with interest - and the replies also 🙂

I'm fairly newly diagnosed (January this year) so it's all a bit of a steep learning curve for a not very well understood condition, it would seem.

More food for thought here as well, so I'll be following this post also...

[Hidden in reply to Lizzy-loo]

yes definitely been a steep learning curve, significantly harder when rarer conditions as we end up “gently educating” our doctors! Be prepared to push and self advocate. But we can learn from each other👍

[Milkfairy Heart Star in reply to Hidden]

"gently educating our doctors" is certainly a skill I have been honing over the years 😉

[Hidden in reply to Lizzy-loo]

sorry forgot to say welcome to a very exclusive and unique club!