Back in November, I’d had a stent fitted as I’d had a 90% blockage in my LAD. The CT Angiogram done before the Angiohram detected narrowing in multiple arteries.
I was 44yrs of age then.
Since I’ve made positive lifestyle changes.
I’m left wondering though, how is any of us routinely monitored to ‘keep an eye’ on those other arteries that already had narrowing. Yes, they may not have needed intervention back in 2021, but things might change and worsen over time.
I don’t want to have to wait for a heart attack to happen before further treatment is done.
I should add my symptoms that resulted in the investigations being done were very non- specific. Not obvious symptoms like central chest pain. More sent for hopeful reassurance given my Dad needed a quadruple bypass age fifty-three then died of a heart attack age sixty.
I’m chuffed they stented that 90% blockage of course. But I am anxious about that artery re-occluding or others getting worse over time and I haven’t been aware of any monitoring scans etc that keeps an eye on progression to prevent me facing say a heart attack in the future, that I might or might not survive.
Does any of this make sense?
Huge thanks all, Sally 🥰
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simplysal
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Hello I presume you are on Statins to stabilise any plaque and any other meds ?
I think they would only check you again if you present with symptoms i.e. Angina or Breathless. If you are worried and you can, have a word with your GP to set your mind at rest.
Sorry I should have added that. Yes I take all medications as offered to me, to include daily aspirin, statin and a beta blocker, as well as meds for my underactive thyroid.
I was only on prasugrel for six months following the stent as being on that and aspirin caused very low iron and they became more concerned if risks from anaemia so discontinued the Prasugrel six months in. But yes I take everything else religiously.
When you know there are problems there, it can be hard to feel as carefree as I once had and there’s always that anxiety over the ‘what ifs’. As my symptoms were so non-specific, difficult to distinguish between a twinge here and there in chest that might be heart related, or not. If I went to A&E every time I experienced an ache in left arm or under left breast, I’d be in there often lol!
I was given reassurance from a doctor from cardiac team that I don’t experience pain when walking on the treadmill, so I try and starve off the anxiety by mteminding myself of that.
Hi there you need to go back and see your doctor, ask them to refer you back to see the cardiologist team at the hospital so you can have your yearly checkup scan using a CT angiography. You should been checked in November ,2022. One of the problems with the NHS is once you get discharge from the hospital it's hard to get back to get check again, iam having the same problem. I got all my scans done in March 2023 and my echo is due this month but my appointment has come to see the cardiologist team at my local hospital for end of March 2024. That means my echo won't be done now until June 2024. That will be 8 months pass the time when it should been done. My Aortic root dilation is already at 4cm, so iam so worried what will happen to my health in the mean time.
hi Jayjay you spoke if a yearly check up scan? I was told by doctors and a private cardiologist that unless you experience any adverse feelings you are seen as sorted. If you do have anything specific then the cardiology dept is there for you but you need a doctors referral. There was no mention of a yearly checkup. As far as NHS is concerned you have been stented , given medication so off you go.
I suppose in a perfect world there would be follow ups., I did get a review after the first year ( my event was 2020)but since then nothing. It’s been me paying privately if I had a real concern and for thst I had to ask the doctor to refer me. There has never been any mention of a yearly scan.
I know exactly what you mean. I have a family history of early death from HA (my dad had 2 before he was 40, a triple bypass at 45 and died at 57) and went for a CT angiogram nearly 3 years ago (like you I think this was for reassurance) and found mild atheroma in my LAD - I know that doesn’t sound too bad but it sent me into a total tailspin as it brought back the pain around my dads very sudden death and now I have kids that magnified my worries so much. I made a lot of lifestyle changes and went on statins (turns out we have a genetic high cholesterol condition) but after 2 appointments was discharged from the lipid clinic! But I feel like what if my next symptom is a massive heart attack? I have been to a&e a few times when I’ve got myself worked up and convinced I’m having a HA - they admit me then send me home after a few days with no real investigation.
The way I look at it is I am doing absolutely everything I can - I eat well, I exercise 6 days out of 7, I try not to get stressed, I sleep well etc - and so I’m in control of every factor I can be in control of! I also try to listen to my body (but not too much!) it’s a really hard balance and I don’t know if I’m doing it right. Lately I’ve wondered about seeing a preventative cardiologist privately but not sure they could tell me anything more. I’m 51. I just try to live my life as happily and positively as I can and hope for the best! But it seems madness that I’m not monitored in any way other than a blood test once a year to check cholesterol and liver function (statins can affect your liver)
I had total blockage of LAD which led to a STEMI a cardiac arrest. Fortunately I was already in A&E at the time. Like you I had no obvious symptoms.
They put in one stent but noted that there was moderate stenosis in various other arteries.
Sent home on the usual medication- statin, aspirin and ticagrelor - the latter for one year.
Since then I haven’t seen anyone apart from the routine annual blood test and BP measurements at my GP surgery - which all seem fine. I also have a family history of early cardiac deaths-my father passed away suddenly at just 48.
That was over ten years ago and since then I have more or less forgotten about my heart issues and got on with my fairly busy life which includes a lot of overseas travel . I’m now in my mid 70s.
I tend to agree that once they have fixed the problem then you are no more at risk than anyone else. And that too much unnecessary monitoring can actually increase anxiety.
But I guess everyone is different so it’s up to you whether you should seek further referral or tests.
Hi- I so understand! I’ve just come back from a night at A&E as had chest pains yesterday- I had v similar blockage, stent etc as you. they’d changed my beta blockers to Isodur (my request as bisroprpol was making me feel like running through treacle). I then had such a huge headache and very high BP, and chest pains - last night that ended up in A&E- bloods and trace, and all fine, told me it was likely tummy related! Even though yesterday a got a fuzzy left arm when cycling up a hill- like you my symptoms were v minor and once on amlodopine they went- only the CT scan showed the blockage which was fixed in 2021 , but with the first angina I also went to A&E and trace and bloods normal. Yet this time I’m sent home and told to exercise (last time after CT scan they phoned me to make sure I didn’t cycle up the hill home!), and I know the meds mask the angina symptoms. Like you also below 50 and slim and fairly fit- scary!
How to get another second CT scan?! (I didn’t stick around to talk to A&E docs too long as had to take my boy to school- but will ask GP later..)
simplysal Yes, I was (am) in nearly the exact same situation. 90% LAD blockage in July 2020, 2 stents, no obvious symptoms other than family history and me turning 50, was found during a series of tests...right cardiac artery also had significant blockage but not stented.
April 2021, suffered cardiac arrest from likely plaque detachment in circumflex artery -- 2 more stents. So you can imagine the levels of anxiety I've had in the past 2 years!
That said, I'm on the highest doses of statins (80 mg atorvastation, 10 mg ezetimible) plus aspirin and bisoprolol. I continue to exercise and eat well (within reason, a few treats now and again). I just saw my cardiologist for an exercise ecg, all went well. I asked her specifically about tests to see if any other arteries are narrowing or the stented ones are "acting up."
What she said was that next year (April, I imagine) I'll have another MRI (maybe with contrast dye) or CT angiography (with dye), but unless I have symptoms there isn't much else to be done, and just "trust the process." Along with regular blood work to check cholesterol levels.
I'm with those who say "control what you can control," i.e. diet, exercise, lifestyle. Easier said than done but I try every day to de-stress...doesn't always work!
Hi, back in 2014 I had 94% blockage in the LAD and had a stent, moderate plaque in other arteries. I cut out the processed food and added a brisk 30 mins exercise to my daily routine. No NHS follow ups post rehab is standard practice. For peace of mind I pay privately for a 3 yearly echo cardio of the heart. This did find a slightly calcified heart valve at the last check up but nothing to concern them at this time. I find keeping up the exercise gives me reassurance that I am as best as I can. 👍
My father in the end had a total of 7 stents. He lived to 85 years but was aldo told to monitor his tiredness levels which is a simple indicator if things are narrowing again. I recently had atrial fibrillation just aged 53 years and then a stroke 2 weeks later. Luckily a mild one. Am still waiting for an angiogram so hopefully will get sorted soon. Good luck with monitoring and wish you well for your recovery.
LIke you I wish there was monitoring. After my H|A and two stents I was told the LAD was narrowed by 65% in two places but not bad enough to need stents. Now 5 years on I'm left wondering whether they've got worse. My GP did send me for an echo scan and ECG and I had a holter monitor for 24 hours. All were ok. I understand that another angiogram with attendant risks is just to invasive to repeat just to check.
I have moderate plaque / stenosis in all coronary arteries but no stents. I'm still under the care of a cardiologist at the moment.
But thereafter, in addition to my statins & gym work etc. I intend to add an annual ecg with treadmill (even if I have to pay myself) just for peace of mind that if I'm going to collapse perhaps it'll happen in the right place (a hospital / clinic) 😅
Personally I would be in favour of a regular Health MOT. Realistically that would be every 2/3 years over the age of 50 and a more detailed one every year over the age of 60.
I don't think resources or finances would stretch it to younger people (like you!) although in principle I agree that ultimately they would likely save money and keep people healthier.
I had a stent fitted mat the same time as you , 2 years in November. I remember your posts from then! I have had no check ups or contact with my GP or Cardiology Department and like you wonder if other arteries can be blocking even though I take heavy duty statins and aspirin. I did contact my GP online to say I was experiencing some tightness in the chest , shoulder and some breathlessness although not on exertion. I was referred to the hospital on the 20th March but have heard nothing! I guess it is assumed that if I am not presenting at A and E I am ok. I feel that at least I should have a medication review after 2 years . It does play on your mind
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