Severe coronary heart disease

[benjijen]

Hi there,

I've been on this site for 4-5 years due to my inflammatory arthritis. I was taken into hospital with pains in July and had an angiogram on 8th September. Told I would be in to either see surgeon or for stents in 4-5 weeks. Still no appointment and I'm getting worried. I know it's severe and 2 arteries 70-80% blocked plus another blocked midcourse. They have agreed to do stents. This has now taken over my mind from the RA!

My question is, has anyone else been in this position and know just how severe this is? I know it's not an RA question but could really do with help as I can't find what I'm looking for through google. Am tired of ringing hospital and leaving messages on the answerphone and not getting a response!

[helixhelix]

I have no idea I'm afraid - but even tho' the NHS is in a dire state they are still alert to not leaving patients in dangerous conditions so if they don't think it's a blue light issue needing immediate treatment then it probably isn't. Have you spoken to your GP about it? He or she may be able to explain the position you're in more clearly, and also nag for an earlier appointment on your behalf. Either that or turn up at A&E saying you have chest pains.....

In the meantime make sure you look after yourself, good food, gentle exercise and rest.

[benjijen in reply to helixhelix]

Thanks for replying. I saw my GP and she is also chasing them as believes it should have been dealt with. I sometimes wonder if age comes into it. I'm female 62.

[helixhelix in reply to benjijen]

62 is no age! If you were 95 they might be a slight hesitancy, but mid 60's there should be no concern at all. On the contrary a good team will recognise that stents now will give you a qualityof life long into the future and thoroughly worthwhile.

[andyswarbs]

Sorry if I sounds like a broken record but check what you are eating. A bbc programme last week argued to avoid all processed meats for instance as these carry a high risk of heart disease. Stop them and your problems can go away. Ldl clohesterol comes from meat and dairy. stop them and...

[Chez1]

See your gp and get them to check to see what is happening if the hospital said 6 weeks they should have been in touch.

[DelicateInput]

I wonder if it is at all possible to go to another hospital as that one sounds overloaded. Although the NHS spends a high proportion of its budget on heart disease, and it is an NHS priority, there are still long waiting lists in certain areas - whilst other areas seem to be either overfunded or have a healthier population. As an example, my mother waited over ten years for a coronary bypass during which time she had three mild heart attacks, whilst a lady I knew in my part of London (ex-nurse) was admitted within two weeks. My mother was in a far worse state. Of course, London has a much younger population and many young working people are privately insured.

Sometimes, though, it depends on what you say and how much fuss you make. The nurse in question saw a private consultant and said she was going dizzy - hence she had the operation on the NHS within a few days as dizziness is a sign of impending heart attack which can be fatal.

It is an extremely good thing that you can now have stents in place of a bypass operation. This is a small procedure and I think if you try another hospital you will get this done sooner. The two main hospitals I am aware of are Harefields and St Mary's in Paddington - could you not get a referral to one of those?

I'm afraid coronary heart disease is connected with RA though you say yours is non-specific. It furs the arteries in later years in people who have had RA a long time - albeit there might be other factors. My mother had RA at 31 and coronary heart disease at 62. The worst thing you can do is smoke. It would be sensible to follow a heart healthy diet (look on British Heart Foundation website) though personally I think it won't make much of a difference to your immediate problems. I'd be careful with exercise as if you exert yourself it could bring on a heart attack - just confine it to non-aerobic and things like weights and body movement ie exercise that does not make you breathless.

[nomoreheels]

Hiya benjijen. I know it must seem an age when it's you having it but 4 to 5 weeks isn't overly long to give as a timescale from the diagnostic angiogram but you may get a better idea using the Guide to NHS waiting times, nhs.uk/choiceintheNHS/Right.... Just tap 'services near you' & select & enter the relevant options, sometimes they actually update it & gives an idea of waiting times at your specific hospital! It's normally day case & you're there a matter of a few hours though if it's done in an afternoon or was trickier than expected for some reason then they may prefer to keep a check on you which could mean an overnight stay. It's a good idea to check if the intended interventional cardiologist has performed more than 75 angioplasties!

You're in a better position than some as you've not had a heart attack & whilst it's a necessary procedure it's preferable to needing more invasive open surgery down the line so though it might not seem it it's in a way fortunate you had signs of problems back in July & an angiogram without having had a full blown attack.

At this time prior to angioplasty diet will make no difference whatsoever, particularly if you have family history of high cholesterol (parents, grandparents even siblings) & related associated problems cardio-wise, the likelihood is you'd be predisposed to heart trouble at some time or other & of course RD can have a part to play for you personally. Once you've had the procedure it's highly likely you'll be asked to attend cardio rehab, it's certainly worth it if you're unsure if it will benefit you. There you'll have cardiac physio team/possibly nurse led physio & group talks 're diet, lifestyle changes etc.

A friend of ours had an angiogram within days of my h's first one though his was following a heart attack (mild) & he was fortunate enough to only require stents to be fitted.... my h hadn't had a heart attack yet the arteries which were viable weren't in a suitable state for stents so needed Coronary Artery Bypass Surgery (CABG) with cardioplegia, this was back in Feb 2015.

I hope some of this is helpful & do keep us updated won't you. x

[benjijen in reply to nomoreheels]

Thanks for your reply. Unfortunately our hospital (Royal Sussex County, Brighton) doesn't seem to publish waiting times although my cardiologist seems to have performed many of these procedures. I was told when I had my angiogram that I may need surgery but made it clear I didn't want it unless absolutely necessary. I'm seeing GP again tomorrow to find out if she has had any luck. I don't think it's so much that it hasn't been done, it's that my messages have been ignored and I was told initially it would be done in 4-5 weeks. If I'd had an appointment through I think I'd feel more positive. I think the main cause for me is the hereditary factor (both sides of family). I eat properly (plenty of the obligatory fruit and veg!) am not a big meat lover and have never smoked. With the RA, underactive thyroid and couple of other things, now this, I feel I've been falling to bits the last 7-8 years!

I'll keep you updated.

[nomoreheels in reply to benjijen]

I know what you mean, if you have an indication of when it's likely to be or even a firm date you can prepare, both mentally & diary-wise. No excuse for not returning messages left though, that just winds you up doesn't it? Well, I hope your GP's had more success. Good to know your cardiologist keeps his hand in though, that's a bonus, far better if they're adept at it. Hopefully this & any lifestyle changes you can or need to make will prevent reocclusion & possible need for further intervention. Yes, please do keep me updated. x

[DelicateInput in reply to benjijen]

So do you have undifferentiated inflammatory arthritis or RA? My unacknowledged post earlier referred to the effects of RA on the heart, which does not occur in other types of inflammatory arthritis. The key is in the name "rheuma" as this relates to the heart.

My mother had no heart disease in the family, nor any of the predisposing factors relating to heart disease - low cholesterol, moderate blood pressure (130 even in her 70s and lower before), extremely active and never kept still, normal weight (9st at 5ft 3in all her life). The fact of the matter is that RA does cause heart disease. It causes inflammation in the arteries and thus it reduces the lifespan of all sufferers by between 2 and over 10 years, depending on severity. However, if you do not have RA, it does not apply to you.

As regards stent surgery replacing traditional bypass surgery, this is the case in nearly all sufferers. I don't know why anybody would think bypass surgery is still routine. I worked for a company a few years ago which manufactured the machines and computers for stent surgery and many doctors came into the offices to train to use them. Without a doubt, my mother would have benefited from it, as opposed to the horrific effects of major bypass surgery at an advanced age, if it had been widely available on the NHS. You do need to be careful in the waiting period.

[benjijen in reply to DelicateInput]

Thanks for your reply. After my angiogram the registrar who performed it told me he didn't think it was suitable for stents and had to speak to the consultant. I made it clear I didn't want surgery if at all possible. Mainly because I react to anaesthetic, last time I had an op I was in a bad way for 48 hours due to reaction. I'm so relieved they are going to do the stents instead. I've been reading about it and they've really improved treatment in recent years.