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Angiogram report analysis - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2293 Questions
User :   Hi Dr,
Angiogram report details of my mother XXXXXXXX XXXXXXXX 51years (20+ years of diabetic):
LMCA-- normal
LAD-- 90% mid segment
82% distal segment thin vessel
LCX -- Mild Disease
OM1 – 85 to 90% proximal segment
80% distal segmen
RCA-- 98% mid segmentI want to select the stent option instead of CABG is this a good decision?
User :   Hi
User :   Hi
User :   am reading the query please wait
User :   ok
User :   LMCA-- normal
User :   LAD-- 90% mid segment
User :   82% distal segment thin vessel
User :   LCX -- Mild Disease
User :   RCA-- 98%
User :   yes
User :   so there are theree vessels involved
User :   some cardiologists offer by pass surgery
User :   yes with 5 blockages
User :   I prefer by pass surgery
User :   yes.. doctors gave two options..
User :   i thought it might be a risk for recovery..
User :   stens placement may not be successful
User :   i want to opt for drug eluting stents
User :   is this will not work?
User :   Drug eluding stents are ok
User :   but it is at the discretion of Cardiologist \
User :   If he can capable of inserting stents he will
User :   if he think stent may not be successful then he will advice bypass surgery
User :   If the cardiologist offered stents drug eluding stents are superior
User :   Now a day nobdoy using metalic stents
User :   Are you with me?
User :   yes..
User :   so can i go with drug eluting stents?
User :   You can
User :   one of cardiologist said that they can insert three stents..
User :   and they will ignore the OM1 artery..
User :   as this will not effect much it seems..
User :   is this correct?
User :   yes
User :   they basically target LAD-- 90% mid segment
User :   LCX -- Mild Disease
User :   RCA-- 98% mid segment
User :   ok.. any best cardiologist do u know in hyderabad? i want to consult and want to take second opinion..from them..
User :   at present my mother is at home..and her diabetis is fluctuating like any thing.. from past 5days when they did agiogram..
User :   Dr. XXXXXXXX AAAAAAA Consultant Cardiologist
User :   ok.. i thought of meeting DrGopichand in Star hospital also.. only if cardiologist strickly says surgery..
User :   i will try to get an oppointment with Dr AAAAAAA AAAAAAA .may be tomorrow..
User :   is there any risk for my mother if we delay for 13more days ?
User :   Risky is there all the time
User :   sooner the better
User :   It is urgeny
User :   but emergency
User :   I mean she has to get it done in 1om
User :   hmm ok .. presently she is under medication..
User :   OK t strict medical control is must
User :   Hope she is on all heart medications
User :   yes and we are giving insulins also
User :   ok
User :   just i am waiting my insurance to renew next month.. that is jan 1st..
User :   we did angiogram just 3days back..
User :   OK
User :   Insurance will pay for both
User :   Do you have any other Questions?
User :   so we can go for stent right..
User :   thats all i have.. i will try to contact dr AAAAAAA
User :   You are making me take the decision for you
User :   do want me to tell ur name as referal...
User :   I will go for stents
User :   thanks
User :   Ok
User :   Thank you for consulting us
User :   Bye
User :   thank you
User :   bye
User :   any cardiologist online? How to chat with another doctor..?
Doctor :   You can go ahead
User :   Angiogram report details of my mother XXXXXXXX XXXXXXXX 51years (20+ years of diabetic): User :   LMCA-- normal
User :   LAD-- 90% mid segment 82% distal segment thin vessel
User :   LCX -- Mild Disease
Doctor :   Ok
User :   RCA-- 98% mid segment
Doctor :   What is the doctor's opinion?
User :   OM1..85 to 90% proximal segment
User :   80% distal segment
User :   they identified 5 blockages..
User :   doctors gave me two options.. CABG and stent
User :   for stent..they will only repair LAD and RCA
User :   so which one to go with..
Doctor :   I would suggest to go for CABG as she is diabetic
Doctor :   THe hospital stay is lengthy
Doctor :   and the recovery is slow
Doctor :   but the endurance is good as I opine
User :   what about drug eluting stents?
Doctor :   I am not very keen on them
Doctor :   If it is single vessel and less number of blocks, I would have suggested stent
Doctor :   Each drug stent can be very costly
User :   yes.. i have insurance ... and at present the doctors said they will place 2 stents..
User :   one in LAD and one in RCA..
User :   OM1 will not effect the person it seems.. so withmedication.. we can cure little bit
User :   LAD and RCA are mjor so they told they will place the stents in those artieries
Doctor :   Ok
Doctor :   I agree with OM1 as it covers less than 10% of heart muscle
User :   ok.. as she is diabetic..i donot want to take the risk of recovery if we go with surgery..
User :   thats why I am planning to go with stent..
User :   is this a good decision
Doctor :   Ok
User :   ?
Doctor :   Drug Eluting stents can be effective too for 10+ years
Doctor :   The efficacy is equivalent
User :   hmm ok
Doctor :   If you have insurance you can go about it
Doctor :   You should not be confused at this moment
User :   yes pretty much
Doctor :   You can take a second opinion from a different Interventional cardiologist about the drug eluting
Doctor :   WWW.WWWW.WW
User :   any cardiologist u want to refer in...?
User :   ok ..
User :   One more option I have in my mind is
User :   after placing stents.. infuture .. we consult dr for every 4 to 6months..we will see if any thing happens..then we will go with surgery right?
User :   or for surgery there will be any age limit?
Doctor :   Her general condition should be good
Doctor :   and the Cardiac anesthetist has to give approval
Doctor :   We cannot determine the eligibility of the surgery in future with the present condition
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