Severe Proximal RCA Disease and Moderate LAD Disease - NO FURTHER ACTION!

[Segovia123]

Hi - I had a call from the cardiologist this afternoon, after a team consultation they have decided they will not be performing an angiogram and hence I will not be receiving any stents. They have said a stent would not decrease my chances of having a heart attack, and therefore it's not worth the risk. They also said my % blockages are estimates, and they would not know exactly without doing an angiogram which they would only do with the intention of fitting a stent. I don't know if I am elated or disappointed. Apparently my MRI stress test wasn't very good, and I have been advised to cut down on my cycling, but they can't say how much is too much. He said 99% of our patients don't do any exercise, and I am a unique case. I feel like a second opinion is needed

[Lowerfield_no_more]

If you are considering a second opinion on your circumstances there are several web based NHS sources which advise more or less the same, but one significant disadvantage appears that you may have to go back to the GP to get you referred elsewhere, and that will involve being put on a waiting list. The alternative, if you can afford it, is to seek a consultation with a private medicine cardiologist, but if you go that route you will no doubt have arm yourself with all of your relevant medical history and that may be difficult to extract from the NHS although you are, as I understand it, entitled to have access to it. But even if the private cardiologist considers an angiogram should be carried out (with or without stenting) it is not enforceable on the NHS, although you could decide to pay for it to but at considerable cost.

[Happyrosie]

you are entitled, as Lowerfield says, to a second opinion. You should have full access to your medical records via the NHS app - if you haven’t got this, speak to your surgery.

[DWizza]

Blimey ! That update would severely pee me off! Second opinion deffo! How can they not do the Angiogram? Why wouldn’t a stent help prevent heart attack ? If you are at risk what’s the way forward apart from cutting down cycling ? It stinks , something not right here . I hope you find a way forward 👍🏻

[pasigal]

Stents are now seen as overkill for all but the most severe blockages, with medication seen as the equal and less invasive option. I had two stents implanted in my LAD with 90% blockage and had a heart attack eight months later. I am also a keen cyclist so I was in great physical shape. I'm not surprised that your doctor doesn't want to do an angiogram at the moment as the LAD is really a more crucial artery. If you want to keep cycling at high volume, it might be worth it to seek out a private sports cardiologist... And also press your current one for more information about your limits.

[Segovia123 in reply to pasigal]

Sorry to hear about your heart attack, it does make you wonder about stents, inserting something into a vein which is already constricted sounds a bit alien to me. Coincidently the cardiologist has just called me and after consultation with the resident sports cardiologist I have been told to carry on as normal! I have an enlarged vein that they will monitor in 12 - 24 months.

[wischo in reply to pasigal]

What!! the LAD is the most dangerous artery to have a blockage in and a drug regime is not recommended for that artery. The answer is to stent the blockage or bypass it. Bad luck on having your heart attack shortly after your stent but that could have been a thrombus or a collapsed stent and is not what most people get. I am 5 years pre LAD stent and feel great and all tests are clear as are a substantial amount of people here. I would look for a second opinion.