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Angioplasty recommended - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Heart Attack
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3391 Questions
User :   I had an angiogram on March 17, last week, and it showed RCA mid third eccentric 80 - 90% stenosis, a small to medium runoff was noted. This was described as a critical lesion. There was also subcritical disease present in the LAD. I have angina symptoms when I exercise vigorously, and have always been very active. The symptoms are minimal, just chest discomfort, tightness, so my exercise capacity is reduced. I already am, and have been living a heart healthy lifestyle for many years. My cardiologist is treating me with aspirin, Crestor 10 mg. and 2.5 mg. of a betablocker, 3 days a week (my heart rate is already quite slow). Only real risk factor for me is age, 68, being female and family history. Is it very likely that the blockage will cause a heart attack at some point, and would I have warning signals, like increased angina? Should I be a candidate for angioplasty, or is the blockage too big?
Doctor :   Hi
Doctor :   Pls. give me few secs. to go through your query.
Doctor :   Ok
User :   OK Take your time reviewing my notes
Doctor :   Let me advise you on a patient that I treated , a very healthy patienet of mine , 63 yrs of age , used to walk every day for 45 mins. in the morning, 45 mins, in the evening and had no symptoms but had a triple vessel block and was advised a angioplasty, So I would say that you are a Candidate for Angioplasty
Doctor :   Your condition needs an angio because of the block in RCA.
Doctor :   Though there are no major risk factors, a block that large itself indicates for a Angioplasty.
User :   Are you a cardiologist? So are you saying it can't be handled successfully without angioplasty? And is the size of the blockage a problem?
Doctor :   I am A General Physician and had worked closely with cardiologists.
This would be my suggestion, and you can have a 15yr to 20 yr life expectancy after a successful angio, as you are just 63.
User :   Would you say there is much risk to waiting a few months, and would I have warning of an impending heart attack by increased angina symptoms?
Doctor :   Yes you are right, angina itself is a symtom for an impending MI. Please do not wait long and go ahead with an angioplasty, it is very safe and successful as you might be knowing .
User :   What would you say are the risks of not surviving angioplasty in a major cardiac centre?
Doctor :   And as you have said you have chest discomfort on exercise , so please take this as a warning sign. And go ahead, you will be fine.
Doctor :   Ok.
Doctor :   In US the success rate is 99.1%
User :   I gather that you are saying that the 80 to 90% blockage is treatable by angioplasty - (ie not too large a blockage)
Doctor :   Yes, sometimes the surgeon may opt for a Bi-pass surgery as well.
User :   OK. Th;anks for your comments, very helpful
User :   That's all
Doctor :   Thank you for consulting me.Take care.Bye fo r now
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