Coronary angiogram

[Gooner1947]

Saw cardiologist yesterday in Newport, S.Wales. I have aortic stenosis and he is arranging a coronary angiogram. Is that another term for inserting a Stent?If I have to lay flat it would cause me problems. Can I request calming medication or maybe sit up ?

[RufusScamp]

An angiogram involves using a remote camera to look at the inside of the blood vessels round your heart. A stent may be inserted at the same time if necessary. I was offered, and took, a sedative which helped me. If you have problems lying down you really need to contact the cardiology department to discuss it before you go.

[Gooner1947 in reply to RufusScamp]

Thank you. Apparently I have aortic stenosis.

[Ageingfast]

You and I are the same age. I had aortic stenosis and perhaps you would like to know how well it has gone for me. I had scans every year for five years. At first it was called mild stenosis then it became moderate stenosis then it became severe stenosis, at which time I needed a new aortic valve put in.

The op was amazingly decent. So much better than other hospital stays. I got my own room and staff were in and out and were very pleasant indeed. Went home a week after the op, then it was three months whilst I recovered. It is now four years on and I have no problems at all. I have come in for coffee after crawling on my shed roof to replace the felt. So you can guess I am fully recovered.

Hope this helps you put your situation in place

Sooty

[Gooner1947 in reply to Ageingfast]

Thank you so much for your reply. Very encouraging indeed. I started to feel a bit breathless about a year ago. Didn't think anything of it really. Just rested, go my breath and carried on.

Even spent this last winter out in The Philippines.

I noticed it a but out there but still didn't think anything of it. More or less to local tuk tuks etc if wanted to go anywhere. Handled the long flights ok too.

But a week or so back in UK I started to feel more breathless.

This was last mid April. Saw my GP and he got the ball rolling which brings me up to the appointment with cardiologist yesterday after all the tests etc.

That's when I found out where I am at and what's planned.

Once again, thank you for your encouraging reply.

I am still dreaming and hoping we can go to our cottage out in Philippines next winter now.

[Ageingfast in reply to Gooner1947]

Maybe you are further along the path. Doesn’t matter, it will be done when necessary and not before. A key issue for me was when I started to stumble forwards.

Being our age group we don’t need a replaceable metal valve. The excellent non metallics will see us through our life span.

You might have the option for a TAVi. Much much faster recovery time. But not 100% successful. Might have to revert to open heart surgery (OHS).

Good luck

Sooty

[fairgo45 in reply to Gooner1947]

What tests did you have to get your diognosis

[Gooner1947 in reply to fairgo45]

Over past few months. Chest xrays, blood tests, ECG's, CTscan, Echocardiogram After all those GP said I have Atrial Fibrillation. Then saw cardiologist last Tuesday and he said after checking everything that I have aortic stenosis and will need coronary angiogram.

[fairgo45 in reply to Gooner1947]

Wow you certainly had the full gamit of tests so you didn't have afib at all or is that as well as ?The coronary angiography is not so bad so don't worry about it too much.

Good luck with your aortic valve getting fixed

[Gooner1947 in reply to fairgo45]

To be honest I don't know if I have AF. The GP told me that after another ECG at GP surgery. Then I saw cardiologist the other day and he said aortic stenosis.

[Thonglor in reply to Gooner1947]

Dear Gooner 1947

I was 75 when my Aortic stenosis was first discovered, and I had no symptoms whatsoever at that time. Echocardiograms every six months after that with gradual symptomless deterioration, until 3 years ago when it became severe. At that time I did have symptoms, arm pain, modest chest pain with exercise, etc. But it did take 8 years to develop to that extent, and during that time I lived my life totally the same as before.

Open heart surgery in late 2021, at age 82, with tissue valve replacement and triple by-pass at the same time.

I live in Thailand, but my wife is Filipina and we have been to visit her family several times since then. Just a relatively short flight from here, of course, but we have also been back to east coast of USA without any problem. I am planning to go again shortly, and it is not my health that might dissuade me from doing it, but the cost.

However, if you do decide to go to Philippines either soon, if immediate treatment is not necessary, or after the operation, I would be happy to pass on a few pointers based on my own experience.

Good luck.

Alan

[Gooner1947 in reply to Thonglor]

Thanks Alan. That's so encouraging!My wife of 43 years is also a Filipina and we spent the winter there this year at our cottage there by the sea on Mindanao. Agusan del Norte. Spent most time between Butuan and Carmen.

Still hoping and praying we can visit next winter.

Would appreciate any pointers etc.

Thank you

Peter

[Thonglor in reply to Gooner1947]

Hi, Peter. I was just wondering whether you have any progress with the testing and determination of the level of your aortic stenosis.

Oddly, my wife is also a Mindanao native, from Davao Oriental outside Davao City, to where we fly in when we are visiting.

Hope that you manage to get to your seaside home this winter, but I assume that it will depend on the ultimate diagnosis of the extent. I would not want to rely too heavily on the medical services out there, not to mention the possible difficulty in getting from where you stay to a major city hospital. I did experience severe gallstones accompanied by acute pancreatitis there some 20 years ago, and was treated for about 10 days at a major hospital in Davao, but getting there at that time was a nightmare. The roads are much better now, but still subject to occasional closure from landslides. The staff were gracious and excellent, but the equipment definitely not so much. I returned for treatment in New Your City, where we were then living, and it was like on a different planet. The New York gastroenterologist remarked that the CT scan screens (which I had been given) were "rather primitive" but she did say that the radiologist interpretation of them was "excellent in the circumstances".

If you do go, I assume that you will have medical insurance and you might want to carefully check any "Existing conditions" exclusion. You would want to disclose your situation to any insurer before purchase, and have comfort that firstly any exclusion would not invalidate the policy in the event of an unrelated medical emergency situation, and secondly if possible that complications from your condition would be covered. I imagine getting that covered would depend on its existing severity. You might also want to investigate medical air evacuation insurance, depending on how far you are from a large city hospital.

Good luck.

Alan

[Gooner1947 in reply to Thonglor]

Hi AlanYes will have to wait till after the angiogram when they will probably decide what to do after that. No, the cardiologist didn't mention the condition of the aortic stenosis. Of course, at the time it was all rather confusing to me and a lot to take in.

This Sunday I have a whole aorta ct scan and a week after that a Carotid Vascular Ultrasound.

Since they put me on furosemide (water tablets) my breathlessness has improved a bit. So I'm grateful for that.

As regards possible travel to Philippines. Yes I am aware of all the difficulties.

Mindanao, is on UKFO list as "all but essential travel". So, yes, any insurance is not valid.

So what do we do? Just not ever go again?

I'm 78 now. Personally I'd rather spend the winter months out there.

The only medical help we could take out is PhilHealth. That's what we have been doing these past years.

If the actual worse came to the worse then I would rather be put to rest out there.

We do have family around too.

We have booked nothing yet. If we are given the ok to travel then I will definitely consider it.

But that's how I feel at the moment, Alan.

Hope all is well with you.

Kindest regards

Peter

[Thonglor in reply to Gooner1947]

Good day, Peter

Hope that you are feeling well. We assume that you would have the results of at least some of your tests by now, and whether you have been given the "all clear" for wintering in Philippines.

We are presently in New York, scheduled to start the return to Bangkok tomorrow. Quite chilly here now , but I understand that the floods in Thailand are continuing and Bangkok may be affected by the time we get back. Coupled with unexpectedly early air pollution in Bangkok, we might decide to seek temporary safety in Philippines ourselves before too long.

Best wishes

Alan

[Gooner1947 in reply to Thonglor]

Hi AlanHaving my coronary angiogram on 16th October. After that apparently have to wait 5 months for TAVI.

I did ask nurse on my pre assessment last week about travelling this coming winter.

She told me she will talk to the cardiologist about it.

As yet, she has not got back to me. But still hopeful

[Boharford in reply to Ageingfast]

Which type of valve did you choose?

[Ageingfast in reply to Boharford]

I opted for the cow made Edwards Resilia. A lot of the option was to do the best I could for the surgeon. I was told (?online?) that the valve would cost £28,000 but in fact it cost about £6,000. It has been trouble free for four years. Nowadays I believe it comes with the option to add a TAVi if the client outlives the valve.

Sooty

[Boharford in reply to Ageingfast]

Thanks

[Mark_1968]

I had one of these 7 weeks ago. It’s over and done with in about 45 minutes. If there is a blockage that is restricting blood flow they will insert a stent to open that artery. I had 5 blockages including one on the main LAD, but none were quite blocked enough to stent. So this does not end up on a stent unless you need one. If you do, it’s painless and yes you can have calming medication, I think 95% of people do.

Don’t worry too much. It’s 2024 and fast and safe

[Gooner1947 in reply to Mark_1968]

Thank you so much for that reassurance. Much appreciated

[Franks-Nan]

Hello, yes they gave me valium, they took one look at me and said " get the box of tricks out", they also asked what music i liked, i said anything. So as they started, i was away with the fairies whilst BonJovi was playing Living on a prayer!! i didnt need any stents after all

[Gooner1947]

Thanks for that!!

[Thisishappening]

I was really anxious before the procedure. They gave sedation via the canula remotely, no pills! It was all amazingly relaxed, no pain or discomfort at all. At one point my BP dropped and I felt a bit faint, again a remote shot of something brought me straight back, all the time the medics were working away, fantastic. It was much less discomfort than a dental filling, there really isn't anything to worry about. Good luck.

[Gooner1947 in reply to Thisishappening]

Thank you

[Sooty2020]

Hi Gooner1947. I had a coronary angiogram where a 95% blocked right coronary artery was found and I was stented immediately. They will only stent if a blockage is found and is, I believe, more than about 75/80% blocked. Before the procedure, I was told the coronary angiogram was just to have a look which sounds like your case. I’ve had another coronary angiogram since to check everything ok - no further stent needed and declared fit. I didn’t have any calming medication. I was 55 when stent fitted. Had I not gone through the procedure, doubt I’d be writing this now. You will be fine and it’s just an hour of your life possibly to extend it. I am sure they will help you with your fears if you make sure you let them know. Hope it all goes well for you.

[Gooner1947 in reply to Sooty2020]

Thank you. I'm just hoping whatever they do will stop my breathlessness.

[Bumpitybump]

My aortic stenosis lead to an aortic valve replacement, now one month post Op and other than AFib I am doing really well. The CT Angiogram I found was really simple, in a calming setting. One of the main issues with aortic stenosis is it is often undiagnosed, like you I was breathless especially when walking up inclines, much better they identify it now and can keep an eye on your condition. Very best of luck.

[Gooner1947 in reply to Bumpitybump]

Thank you for that. Yes my breathlessness walking up inclines is worse. How is your breathlessness now? If that could be solved I'd be a happy man.

It seems as though I'll have to wait 3 months for the coronary angiogram.

After you had the angiogram and they decided to replace valve (sounds a complicated operation) what sort of timescales were you looking at?

Hopefully it won't come to that but just want to get my head around things.

How are you feeling now my friend? Hope all OK.

Peter

[Bumpitybump in reply to Gooner1947]

As far as I understand it the echocardiogram checked the level of stenosis in the valve and the CT angiogram checked the health of heart and arteries . My stenosis was due to a bicuspid valve (the most common congenital heart condition) my heart and arteries were fine. The results for the CT Angiogram took four months, I expect the time line varies in different areas/ hospitals. The valve replacement is major surgery but I would suggest not to start worrying about that before you know that is what you are heading for. If you do need a valve replaced then you can find out the very high success rate the Op has. I would just suggest you chase for appointments and chase for results, sadly the system is swamped and waiting lists are long. The results of tests will enable them to prioritise your treatment appropriately. Very best of luck.

[Gooner1947 in reply to Bumpitybump]

Yes the cardiologist did mention that the echocardiogram showed up the problem as being aortic stenosis.

[DianaElaine in reply to Bumpitybump]

May I ask if you had AFib before the surgery, or did you develop it after the valve was replaced? Thanks!

[Gooner1947 in reply to DianaElaine]

My valve has not been replaced yet. The angiogram was all part of the procedure leading to a TAVI which I expect will be next year sometime. My first diagnosis by GP after being breathless was AFib after the Xrays and ECG.

After CT scan, Echocardiogram I was referred to Cardiologist.

The cardiologist diagnosed Aortic stenosis and arranged the coronary angiogram.

He did say a new valve will be needed.

Had coronary angiogram last Wednesday.

I also had a Whole Aorta CT scan and a Carotid Vascular Ultrasound.

Hope all that helps. Take care.

Peter

[cappachina]

Hi I was 75 and had a TAVI aortic valve replacement Last year I have problems lying down without moving Told them and had extra sedation I was fine You have to lie flat for 3 hours after op and that was bad I should have asked them for something for that too Home the next day A year later valve is working perfectly and should last me 20years which should see me out

[Gooner1947 in reply to cappachina]

Thank you

[momander]

You can't sit up.im afraid!! You have to lie on your back. I have a curved back and also herniated discs so its very painful to lie on my back You can ask for pillows to put under your feet. The sedation did not work for me and I've had this procedure twice. It might work for you though. I wish you all the luck.

[Gooner1947 in reply to momander]

Thank you

[DianaElaine in reply to momander]

If the sedation didn’t work for you, were you able to feel pain? What did you feel?

[momander in reply to DianaElaine]

HiI am one of the small percentage of people for whom the sedative doesnt work. It was extremely uncomfortable, very sore indeed. If the sedative works then I am led to believe it is not as bad. Also, depending on what your initial complaint is, will determine how long you are on the table. I was on the table for nearly an hour. We are all different in our experiences .

[Gooner1947 in reply to momander]

What procedure? Angiogram?

[momander in reply to Gooner1947]

Yes, coronary angiogram

[Qualipop]

I have severe spinal problems which stop me from lying flat. Formy angiograms I had to so they put a lot of pillows under my legs and neck until I could cope with the position. I was also given a sedative. They areused to treating people with other problems and the procedure itself is nothing to worry about. 10 minutes after it I was in recovery with a pressure bandage on my wrist and having tea and toast. I went in for 9 am and was home an hour away by 1.30pm.

[Gooner1947 in reply to Qualipop]

Thank you so so much. I feel so reassured now.

[Qualipop in reply to Gooner1947]

It was awkward and took a while to get me in a position that didn't re ally hurt . I've had to lie on my side for 20 years but they were patient and persevered. The only thing I Objected to was that they wouldn't let me watch on the screens. It's done to check for blockages. They will only fit stents if blood flow is compromised. AT my first one, after a heart attack I had two stents fitted. The procedure didn't bother me at all. Then i Had to go back a month later to check on a problem they thought they'd seen. STrangely that time I was really nervous but hey were great. They did find two blockages , 64% blocked but blood was flowing fine so I didn't get stents.- just tablets.

[Gooner1947 in reply to Qualipop]

Thank you. You're helping me feel much better about it all

[Qualipop in reply to Gooner1947]

Don't worry about the procedure, it's usually straightforward but be very thankful if they suspect a problem because between you and them you can now get treatment and change anything you need to change before something bad happens.

[Gooner1947 in reply to Qualipop]

Yes you're right and thank you

[Peter-l-h]

I was 75 when moderate stenosis was diagnosed with forecast of surgery in 3/4 years. pacemaker fitted at this stage. In 6 months was rechecked found to be severe and a tissue valve inserted by TAVI. Brilliant experience discharged after 3 days. No post hospital pain killers. No problems since and now on 2 yearly reviews. The replacement hip since ( unconnected) much longer recovery !!! PLH

[Gooner1947 in reply to Peter-l-h]

Thank you.