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Angiography, CAD, left main disease, ostial LAD disease, 75% stenosis, revascularization of LAD, ischaemia. Meaning?

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Hi Dr my age is 47,hight of 175,weight of 80 kg,i just went Anjiogram and the result was showing like this:LMCA Distal left main 40% stenosis,
LAD Ostial LAD 50 - 75% stenosis,
One diagonal (2 mm in size)is totally occluded,fills retrogradely (best seen in LAO cranial veiw)
Ramus:Small vessal,appears occluded & fills retrogradely
LCX/OM : Normal
RCA : Normal
Diagnosis : CAD,Left main disease with ostial LAD disease and occluded diagonal,
Recommendation: Consider revascularization of LAD & diagonals after assessing ischaemia (stress thallium/TMT)
Please advice me whether the block can be treated by medication or need anjio blast or oper surgery?
Thanks & Regards
Posted Thu, 3 May 2012 in Hypertension and Heart Disease
Answered by Dr. Rakhi Tayal 3 hours later
Thanks for writing to us.
We cannot predict the prognosis of such blocks found on Coronory Angiography. We need a more detailed evaluation. You have not mentioned why did you get a Angio in the first place. Do you have any symptoms or not?
The coronary artery which has got blocked cannot be reversed with the help of medicines. There might be some improvement if there are a few clots. Thickened arterial walls cannot be reversed. One can only help in preventing the further damage by keeping a good control on serum cholesterol. Some cholesterol lowering medicines like statins are cardioprotective.

75% stenosis is a major stenosis and any small clot might cause the complete arterial blockage causing a heart attack. So I think the best next step should be to undergo Stress Test / TMT.
After that your doctor should be able to decide if it is best to get the revascularisation done.
I hope you have found my answer and recommendations to be both adequate and helpful. Should you have additional questions I am available to address them.
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