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Suffering from diabetes and BP. Suspected for heart block. Suggested for angiogram. Is it safe or is there any alternative?

Hi Dr, My father is 62 years old now.He is having diabetes since 25 years.BP also started 2-3 years back. Nowadays he has high BP continuously.And he underwent through ECG checkup and TreadMill Test. It seems there are some variations in the heart rate.We did the same test at two hospitals and they concluded that there may be some heart block .And suggested to go for angiogram.So he booked a date for angiogram and may be soon after that angioplasty will be done by them if blocks are there. Could you please guide me on this.Is there any alternate to it.
Asked On : Fri, 13 Jul 2012
Answers:  2 Views:  77
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Ayurveda Specialist 's  Response
Hello Remya and thanks for writing in at HCM
I am jr. to a cardiologist in India and read your mail in detail. You have described that their are some changes in ECG and had undergone Treadmill test. As your father is Hypertensive and diabetic and if his TMT is positive for Inducible Ischemia than there is strong indication of Coronary Angiography to rule out Coronary Heart disease . Other risk factor for Coronary Heart disease are:
1. Family History
2. Increasing age
3. Being a male, we cant do any thing for these 3 factors
4. Heart disease like Hypertension
5. Diabetes
6. High Cholesterol and triglycerides
7. Low good Cholesterol (HDL)
8. Smoking
Calculate the risk factor you have present.
Now there is question of Coronary angioplasty. There is fifty fifty chance of it. If the block or lesions in the artery are small than it may be treated by medication and life style changes only but you have to take lot of precautions. If lesions is such kind that it may cause Heart attack in future than angioplasty is required. It is better to do angioplasty immediately after angiography because patient feels comfortable and pain will not be caused again and again for inserting the cannula for angiography and angioplasty. Same cannula are used for both the procedures.
Coming to your last query, there is no alternative of this. If you has Ischemic ECG changes, TMT positive, Chest pain (may be absent in diabetic patient), Chest discomfort and shortness of breath on exertion than you have to go for the above said procedure.
My last advice to you is that go for angiography and than for angioplasty if needed and advised by your cardiologist.
Best Wishes
Dr. Dinesh Kumar Bhatia
Health Care Magic
Answered: Sat, 14 Jul 2012
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Diabetologist Dr. Pratap VGM's  Response
Dear sir/madam

Usually in diabetes there will be triple vessel disease, that means you need to proceed with the angiogram but angioplasty is not a good option for diabetes because of incidence of restenosis.
Instead of it you can undergo bypass surgery because it carries good prognosis and less incidence of restenosis.
So discuss with your cardiologist once.

Answered: Tue, 27 Aug 2013
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