Hello. I had a heart attach 2 weeks ago while playing tennis.
I have received angioplasty treatment in hospital and been discharged. I did not see the consultant after the procedure so it not get the chance to ask about the condition I have the the outcome of the treatment I received. My discharge report says... mid LAD has severe disease with an ulcerated lesion, LCx bifurcation lesion in high OM...and...Calcified atheroma involving the origin of the LAD and mid RCA noted....
Can anyone give me any advice as to what all this means? It seems to me you need to be an expert to understand any of this..
Thanks for your support.
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tennis-guy
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Hi. The heart muscle is supplied with blood by the coronary arteries which run around the heart itself. There are two large arteries (right coronary artery (RCA) and left main coronary artery) they split into four main arteries that feed the heart. The left main splits into the left anterior descending (LAD) which supplies a lot of the left ventricle and the left circumflex (LCx) which mainly supplies the left atrium. The LCx has a branch called the obtuse marginal (OM). Lesions are build ups of plaque in the arteries. Ulcerated lesions are ones that have split open. Bifurcation lesions are ones that are next to a junction or branch in the artery. Plaques eventually calcify into calcified atheroma (hardening).
OK. That's seems a great explanation to me, thank you. I wonder if there is anyone out there with the same or a similar condition who could let me know how they have got on?
Glad it was useful. You will certainly find many on here who will have shared similar experiences. My heart attack was a blocked LAD which was stented. My other arteries were unobstructed. Thankfully there was little damage and I have recovered well. From my perspective there were four key parts to that journey (which I am still on after a year and a half)- physical healing, psychological healing, getting the drugs right and lifestyle changes. I wish you all the best with your recovery.
Thank you so much for your advice. The whole experience so far has been challenging. I am very glad you are doing well. I would love to know more about your recovery but much appreciate your help already Very best wishes
I too had a HA , complete blockage of LAD, all other blood vessels were fine. I had a stent put in and 6 months on, I'm back to my 4 days a week at the gym ( 2 days weight lifting, 2 days cardio, none gym days getting some good hour plus walks in).
Phone the hospital cardiologist department and insist on some explanations from them as we will all differ into our specific conditions, so be armed with as much information as you can get, this will help you manage this event both mentally and physically.
You will be offered cardio rehabilitation which is immensely beneficial and gets you back on track to fitness and activities.
As mentioned, initially there is the physical and mental healing, then getting used to the medicines, eventually ( and this is up to you) getting back to a normal life.
There will always be worries and anxiety as you move through the next few weeks ,months and even years but they will go from being at the forefront of your mind to the back of your mind.
take care ,rest and ask questions and push the cardiologist for explanations.
Thank you so much for your story which is reassuring. I have not yet been offered any rehabilitation and wonder if I will. Should I be asking or is it just a question of waiting? I am a bit concerned about both of you talking about getting used to the medication. If you don’t mind me asking, did you struggle with yours and what did do to deal with it?
Everyone is different in how they react to meds. I guess there are many that get on well with the standard package they put you on and hopefully you do. About six weeks after my HA and starting Atorvastatin I had a very rare but extreme reaction to it and ended up in hospital with my liver effectively on strike. Stopping the statin resulted in a miraculous recovery after a couple of days, but doctors were not willing to try other statins. I am now on Ezetimibe and Inclisiran instead. I wouldn’t worry about that happening, it is very rare, but some people do get other less serious side effects with some statins and have to “find the right one”. I also got the “Ramipril cough” which is quite common and normally just results in a switch to Losartan, as they did for me. Finally I switched from Bisoprolol to Nebivolol. I didn’t really have many issues with Bisoprolol, but had decided based on my own reading and research that Nebivolol would be better for me and my GP agreed to prescribe it instead. I probably just do things the hard way, hopefully the meds just play nicely for you! I would ask about the rehab. I didn’t find it particularly challenging physically, but did get some reassurance from it as I built up my exercise levels.
You will probably have been started on a fairly standard “cocktail” of drugs taken by patients with this type of heart disease. Depending on your previous symptoms you may have been prescribed some, or all of them, before your heart attack. Following my stent to a severely blocked LAD I was prescribed:-
Perindopril 4mg. This is an ACE inhibitor and its main function is to lower the blood pressure. Side effects include an occasional slight dry cough and dizziness when standing up too quickly. Both tend to lessen as you get used to it.
Bisoprolol 5mg This is a beta blocker. It blocks adrenaline and makes the heart beat more slowly with less force and also reduces blood pressure. Side effects include tiredness, feeling cold in the extremities, runny nose. I think it is preferred that the patient takes the maximum dose tolerable (within a guideline). Your dose might be adjusted to find the appropriate level. In cold weather you can dress appropriately to lessen effects. When exercising I notice that a long warm up period helps to raise the heart rate to the right level.
Pravastatin 10mg This is a cholesterol-lowering drug but it also stabilises plaque in the arteries which can prevent future ruptures which can potentially block the artery. Side effects can include muscle pain. If this is severe when you first start it consult your GP. You may be offered a different statin. Many on here report good results on changing their statin to another.
Aspirin 75mg This is taken for its anti-platelet property. It helps prevent heart attacks and strokes by lowering the chance of blood clots. Anyone who has had a heart attack or has other risk factors would normally be prescribed this for life. Side effects include gastric bleeding and if you’re troubled by this might be given a further medicine to protect the stomach. NSAIDs like Ibuprofen or Naproxen should not be taken with aspirin so discuss this with your GP if appropriate.
Clopidogrel 75mg This is also an anti-platelet drug and nowadays is prescribed for one year following placement of a stent. Side effects include bruising and/or bleeding. If troublesome again discuss with your GP.
Depending on your circumstances you may have been given a different ACE inhibitor, beta blocker or statin but you can recognise the class of drug as the generic name will have a similar ending.
You should have annual blood tests by your GP surgery to check your kidney function, liver function, cholesterol levels, and blood glucose levels.
I had HA last year and in the usual meds, the only issue I had was on ramipril in that it gave me an awful cough which didn’t happen until I had been in it for 4 months and coincided with me having a cold and everyone was talking about the 100 day cough so just went with that. Everything you read says it’s a dry cough but mine was more of an irritation, and it made me gag, nearly be sick, and look a complete mess by time the coughing fit was over by April I had had enough so called GP, he said “oh thst will be the ramipril, came off it and was fine within two weeks. I am going into detail as I wish I had read this post and hadn’t put up with it fir so long as it was so embarrassing and I literally ate cough sweet after cough sweet to try and stop it happening when out or in the office.
I had an ACE cough so bad, that when I went to see Joe Pasquale on stage he thought I was heckling him with my constant dry cough. It was so embarrassing. I didn't ever go to the cinema or theatre or in fact anywhere quiet after that. I'm no longer on ACE inhibitors so the problem is solved.
cardio rehabilitation they usually send a letter around the 4 to 5 week mark. Until then I would rest and recover.
The medicines are usually a statin( cholesterol)aspirin, an anti clotting medication ( to protect the stent), bisoprolol( beta blocker), ramipril ( blood pressure) and a stomach medicine to protect against some of the above.
Medicines effect some people and others not effect at all.
I do get spaced out at times and seem more sensitive to the combined effects of bisoprolol and ramipril. I tend to drink a lot of water noe as for me ( as everyone is different) it seems to combat this.
But give the medication time to bed in and then you will be able to see which ones don't suit you, the doctors will then make changes to help you.
As mentioned I highly recommend phoning the BHF nurse helpline, they are great at answering questions and reducing anxiety.
Don’t hesitate to run all this by the BHF nurses online chat or phone call. They are excellent support that I and many others on this forum have used. I highly recommend it , instant piece of mind for me when I had numerous questions post Nstemi heart attack and quadruple bypass surgery July 2023 . 👍🏻
Hi, I just wanted to say I am so sorry to hear about the aftercare (or lack of) you received following your heart attack. I can’t add any medical info - reading the replies has helped me too. It’s very sad your experience is so vastly different from my own. Fortunately for me I received a visit in hospital from Cardio Rehab who left me lots of literature & advice. Also I was seen by Consultants in the hospital post op who updated me. I gather attending rehab is most definitely beneficial for the road to recovery & I look forward to my first one tomorrow. It appears you are going to have to be the one to push for this & other info, so good luck & hope you are soon back to how you were 👍🤞
I think many will agree that whist the treatment by the NHS for heart attack victims is excellent the follow up procedure by consultation is somewhat lacking in many areas within the UK and it is left to the patient to obtain information about their condition. I have chased my results of certain tests many times and this has not been at times easy to do.
MY discharge letter was just as bad. I had to go to my GP and ask for a translation and explanation. I never saw the cardiologist at all except when he did the angiogram and stents but even then he didn't explain anything. You could try the BHF nurses .
2 weeks is a bit early yet to get the offer of cardiac rehab but when you do - take it. It's by far the best thing you can do for yoru confidence and recovery. You shoudl hear something in another couple of weeks. If you get to 5 weeks with no news then start enquiring. Cardiac treatment is wonderful but follow up and mental support is shocking. For mental support don't be afraid to ask your GP and also for an explanation of your condition. You should get advice on how to change your lifestyle to help stop your condition from getting any worse. I got that from the rehab nurse on diet, exercise, alcohol and smoking
Much good advice here. I found that letter difficult to understand but gp and cardiologist took me through it. It was however useful to lodge initial life assurance (critical illness) claim, something I didn't even consider was possible until about 6 months after event. Just mentioning incase applicable to you your situation - so much to take in after such an event. Good luck, Rich
Thank you to everyone who has posted on my thread. I am overwhelmed by the kindness of people who are willing to share their knowledge and experience. I am on the following medication (which I take to be a standard recipe issued to heart attack patients):
bisoprolol 2.5mg in the morning
atorvastatin 80mg at night
aspirin 75mg in the morning
ticagrelor 90mg twice a day morning and night
lansoprazole 15mg in the morning
ramipril 2.5mg at night
I understand the doses are subject to change (titration I think is the technical expression). I am at a comparatively stage (it is 2 weeks and 2 days since my heart attack).
I don't have any life insurance (death or critical illness).
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