No stent but 100pct blockage- what next?

[Nomorecakes]

Hi,

Had a HA in Sept 23 totally out of blue,normal BMI , non smoker -didn't even realise i had one until the wife basically forced me to go to the GP who sent me to hospital immediately and confirmed the HA.

Whilst in hospital they tried to put a stent in but unable to due to v heavy calcification ( the cardiologist described it as 'like porcelain'). Discharged from hospital a couple of days later with what appears to be standard cocktail of drugs.

Subsequent follow up MRI and phone call with Cardiologist who confirmed that the artery was fully blocked but his view was it couldn't get worse and that " coronary intervention would involve higher risk than usual given the disease is in the distal part of a calcified tortuous right coronary artery and the benefit of intervention does not outweigh the risk".

Accordingly just on normal meds with aim to get LDL to under 1.4 which was achieved per blood tests last week.

so is that it ? is the blockage just managed with drugs for rest of life or do they try something else ?

My next follow up appointment is 5 months away and i'm worried that i'm just a ticking time bomb and it could all happen again even though I feel fine and am back to doing almost as much as i used to albeit a bit slower.

[BeKind28-]

Hello

I am sure others will come along that have had a similar experience and be able to reassure you

If they think to do anything like a Bypass would be more dangerous then at this moment the medications will help and the other arteries I presume are fine which if so is a good thing

If you were not satisfied though you could always ask for a second opinion

Easy for me to say don't worry but try not to eat a good diet , exercise and take your meds and know they have you under their radar now which is a good thing to if anything were to change x

[pasigal]

That would really worry me, but if it's any consolation, the RCA is less important than the LAD and maybe the circumflex. I have a pretty high level of blockage in my RCA but stents not possible. I have 2 in my LAD which was almost totally blocked, and 2 in the circumflex after HA. There's more and more evidence that medications are equally effective as interventions are in all but the most severe or dire cases.

[Wooodsie]

Hello Nomorecakes, I can see why you are worried, but there are lots of papers out there that discuss the efficacy of medical interventions v pharmaceutical treatment. Basically, they say that if there is a blockage, the surrounding arteries expand to allow blood to pass through them. Do some research, but avoid so called expert videos, unless they are peer reviewed and published by NICE, Pubmed or NHS, or other recognised medical journals. Hope this helps. Try this link for starters. Sounds like you may be one of the lucky ones 🤞ucl.ac.uk/news/2011/sep/bac...

[Prada47]

Hello Try not to worry (easy said ) but the Cardiologist knows what he is talking about.

I have a 100% blocked RCA which is also more Risk than Reward to try to open.

LAD and Circuflex have both been bypassed and Native LAD has been opened with stents after being bypassed. This has been a 7 year journey so no easy fix for me lol. I do live a pretty reasonable life with not many things I can't do.

Heart Failure is under control with medication so like I said try not to worry, if I had, I would be a wreck after 7 years of worrying !!

Regards

[STUBAX]

9 years ago I had an NStemi, followed by an angiogram which showed a 100% blockage of the RCA, they tried to clear this at a second angiogram but failed. They said not to worry as the heart had 'repaired itself by growing new collaterals (blood vessels) to feed the area below the blockage. I have suffered no problems since, touchwood! Don't worry about it, it's a common condition.

[doktordru]

Sounds similar to me - I drove/walked into A&E on the advice of my GP as we were due to fly to NYC in 48hrs - complaining of awful pains in my arms/neck/jaw. Long story short but had an Angiogram the next day during which the clinician doing the driving as it were, said he was not going to push through or words to that effect and that we could manage this with meds. This was July 2022. So went through year one with the big bags of drugs and and now on Bisoprolol and Atorvastin plus the trusty dispersible aspirin. Feeling great - I've gone from 94kg to 79kg via diet and BMI is circa <22 and have followed all the cardio rehab programs offered - 1 of which I still do once a week alongside my running. Blood tests confirmed all the respective scores are in the right place LDL being 1.3 from memory. I also used the Taking Therapy that was offered as I was also feeling the 'what if' - but have moved on and now look at what happened as a bonus and an early warning that I've been able to do something about! Others have already said it - but take hold of the things you can control, and take advantage of any help that's out there - it might not all be of value for you but some of it will I'm sure. Good Luck!

[dlowell]

Consider talking to cardiologists that specialise in complex calcium modification like rotablation and shockwave balloons. Dr Sukhjinder Nijjer in London is one of them.

[Nomorecakes]

thanks to everyone for all their comments,good to see i'm not alone on this and think i'm just going to get on with life, look after myself, be reasonably sensible and see what happens next 😀