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Diabetic. Had By-Pass surgery. Complaining of chest pain. Advised for angiography. Blockage removable by medications?

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Hello Doctor,

This query is regarding my mother who is a diabetic heart patient. She had her By-Pass surgery in the year 2005.

For the past one year she has been complaining of infrequent dull pain in her chest, shoulders and armpits. Even though the pain is dull, her ECG revealed no major cause for concern in the past year. However, for the past few weeks the frequency of dull pain has increased. We got the ECG done once again and this time the doctors suggested that the ECG is not normal and advised her to go for either an angio-graphy or a CT Coronary angiogram. We got the CT Scan done and I am attaching the report of the CT Scan along with this query. The results tell me that Radial to OM is blocked. Seeing the results, the doctor has advised her to go for a Angio-plasty.

My question to you is -
Can the blockage be removed by medications? We basically want to avoid another surgery.
In case the surgery is unavoidable, is it safe to get angio-plasty as she had already had one by-pass done in year 2005?
After seeing the report, how many arteries do you think are blocked? Is the main artery also blocked?
During the bypass, one artery was bypassed. So the bypass artery is still unblocked? Is there a way to tell from the attached report?

Thanks in advance.

Posted Thu, 30 May 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 38 minutes later
Hi friend,
Welcome to Health Care Magic

The blockage can not be removed by medication / it is a mechanical problem and needs mechanical means for relief...
Surgery is the best option – it is far more superior than stent in diabetics, stents get blocked frequently and earlier
One branch is certainly blocked / there may me a surprise at times - the gold standard is direct angiography only...
The old block is obvious (nothing has been done to it - it is bypassed) – but the bypass is working well
It is wiser to opt for surgery / earlier the better, because she is symptomatic and there are ECG changes...

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Diabetic. Had By-Pass surgery. Complaining of chest pain. Advised for angiography. Blockage removable by medications? 11 minutes later
Thank you for the quick answer doctor. I really appreciate it. I have a couple of follow-up questions -

1. Do you mean to suggest that Angio-Plasty would also not be a good option due to her being a diabetic?
2. By surgery did you mean a Heart By-Pass? If yes, a second by-pass is advisable for someone who has already got one?

Best Regards,

Answered by Dr. Anantharamakrishnan 10 minutes later

Yes, angioplasty is not the first choice in diabetics...

Yes, The surgery she needs is Bypass.
Second, even a third bypass surgery can be done, if needed, as here...

All the best
Above answer was peer-reviewed by
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