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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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In What Circumstance Angioplasty Is Avoided?

Hi! I had an angiogram last week and they found a 60% blockage along with a tear on the inside of the main artery of my heart. They called it borderline and decided not to do an angioplasty. When I asked them about it after, they said it would get worse and the only way I will know is when symptoms get worse. I already have shortness of breath, cough, and chest pain when I go upstairs or lie down. I don t understand why they just didn t stent it if it was borderline. I also have Fibromyalgia/CFS , severe OA and Sjogren s syndrome. I am on lots of meds including Crestor and aspirin. The problem is now that I am stressed out over this knowing I have a ticking time bomb in my chest. I have not been sleeping well. I don t know how to forget about what is going on when I also have so much more to worry about.
Wed, 11 Mar 2015
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Cardiologist,  's  Response
Hello! Thank you for asking on HCM! Regarding your concern you are right. Sometimes it is difficult to decide the right way when the coronary stenosis is borderline (around 70 - 75% which is the cut off for angioplasty and stent implantation). Several times a stenosis of less than 75% may cause serious damages. The best way to decide about clinical significance of a stenotic lesion is to perform its functional testing, that is fractional flow reserve (is measured in the cath lab). As FFR is not frequently available in routine clinical practice, the only measures to be followed is to be aware of clinical symptoms and always to consult immediately the cardiologist for a physical review, ECG and if necessary lab cardiac enzymes. Hope to have been helpful. Greetings form Dr. iliri.
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In What Circumstance Angioplasty Is Avoided?

Hello! Thank you for asking on HCM! Regarding your concern you are right. Sometimes it is difficult to decide the right way when the coronary stenosis is borderline (around 70 - 75% which is the cut off for angioplasty and stent implantation). Several times a stenosis of less than 75% may cause serious damages. The best way to decide about clinical significance of a stenotic lesion is to perform its functional testing, that is fractional flow reserve (is measured in the cath lab). As FFR is not frequently available in routine clinical practice, the only measures to be followed is to be aware of clinical symptoms and always to consult immediately the cardiologist for a physical review, ECG and if necessary lab cardiac enzymes. Hope to have been helpful. Greetings form Dr. iliri.