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Diabetic, cholesterol, lipids, chest pain. Ablation for afib, ostial blockage in LAD. Can the blockage increase?

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General & Family Physician
Practicing since : 1995
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Im 36 and type 2 diabetic that is somewhat controlled by pill form. Have trouble with choslerrol and lipids. Had an ablation a year ago for afib and now free of afib. also had a heart XXXXXXX a year ago and its shows I have an ostial 40-50% blockage in the second diagonal branch off the LAD. My question can this change and increase quickly and cause complete blockage? Recenlty had chest pain and was admitted for it. 2 nitro relieved the chest pain and then had just a regular stress test. It was negative. Had a nuclear stress in feb of this year and it was normal.
Posted Tue, 12 Jun 2012 in Hypertension and Heart Disease
Answered by Dr. Pragnesh Vachharajani 45 minutes later

Thanks for posting your query.

I can appreciate your concern.

Please understand that deposition of cholesterol inside the walls of heart vessels is a gradual process and develops over a period of time. You will be surprised to know that this process of atherosclerosis starts from birth it self. Again the blockage that you have was not critical. The severity of the blockage depends upon location and percentage of blockage.

What even done till date is fine and proper. Your TMT is also normal that is good.

You should following precautions on regular basis to avoid problems in future.

1. Quit smoking-this is must, as it is one of the major risk factor for developing heart disease.
2. Plan your diet well. Take frequent small meals. Avoid high fat diet, cold drinks etc. which are dense in calories and increase your cholesterol.
3. Do regular exercise. This is must for everybody. Exercise makes your heart stronger, prevents deposition of fats in the vessels, and controls your blood pressure and diabetes. Discuss with your doctor about the level of exertion that you can do on regular basis. Exercise is must for you.
4. Control your blood pressure and diabetes. Poor control of diabetes leads to more deposition of fat in the blood vessels and can lead to increase in blockage or more blockages.
5. Continue with anti cholesterol medications given to you. This drug lowers down the cholesterol and prevents further progress of blockade. They even make the plaque(the fat mass that blocks vessel) stronger, that prevents its breakage and avoid things like sudden block of small arteries due to a phenomenon called thromboembolism, in which a small vessel gets blocked due to this.
6.Keep follow up with your doctor on regular basis.

You should not worry, but take proper precautions like advised above to remain healthy and fit.

I hope this helps.

Please write again if you have something more to ask.

In case you do not have further query, please accept the answer.



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