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MRI showed blockage but do not have symptoms other than arrhythmia. What should I worry about?

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General & Family Physician
Practicing since : 1995
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About three years ago in my annual exam, I had been referred to do a stress test measurement. I think my results of the measurements during the huff/puff period were OK, but the quick afterward "pictures" of my heart suggested I had some right-side blockage. I then went in for a cardiac MRI, and that confirmed that I have that blockage, and then was recommended to get a catherer lookaround, which confirmed that I have a 100% block about halfway down that area, and indicated that I had some accumulation of other "junk" lying around in there. Given all that, I do not experience any "symptoms", other than some arrhythmia (I do take some metoprolol) and I do take a little extra Vitamin D3 to help prevent any hypothyroidism effects). I seems that my body has worked out some alternate path(s) to insure that plenty of blood comes in, then all gets pumped out with no complaints. So... what should I worry about?
Posted Wed, 25 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Pragnesh Vachharajani 54 minutes later

Thanks for posting your query.

You are right, human body has great adaptation potential and it always tries to find alternate as when needed.

There are 2 major vessels in the heart left and right. From this two main vessels various branches are spread across the surface of heart.

This vessel gets blocked by deposition of fat in them either completely or partially blocked.

As seen in your case in most of the cases there are developments of alternate channels above the blockage area and circulation is taken care off, so that you remain symptom free.

You need to take care of following to avoid future complications,

1. Keep your blood pressure under control.
2. Get tested for lipids on regular basis and keep them under strict control
3. Regular follow up with your physician is must.
4. Do regular exercise and control your weight and take healthy diet consisting of good quantity of salads, fruits etc.
5. Quit tobacco in any form.

As long as you are asymptomatic and do not have any problems nothing else in required in most of the cases unless your doctor advises and feels that there is need to open the blocked artery.

I hope echo cardiogram was also done to see that things are fine.

Please maintain good healthy life style.

I hope this answers your query, I will be glad to reply any follow up queries that you have.

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


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Follow-up: MRI showed blockage but do not have symptoms other than arrhythmia. What should I worry about? 21 minutes later
Again, speaking about common heart-related "symptoms"... I don't experience any. I do occasionally experience some minor side-effects of metoprolol (no "feeling" in my hands or feet). I do not "experience" anything about arrhythmia, but I can immediately check my pulse rate and detect a few commonly harmless "double-ups" in my pulses.
Answered by Dr. Pragnesh Vachharajani 24 minutes later

Good to hear from you again.

I think this is fine.

As long as your EKG does not show any significant rhythm abnormality and you do not experience symptoms like giddiness, chest pain, difficulty in breathing etc. this can be ignored and considered harmless.

What you might be feeling is premature beats.

Other wise metoprolol is well tolerated drug and good drug also to prevent cardiac problems.



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Follow-up: MRI showed blockage but do not have symptoms other than arrhythmia. What should I worry about? 2 hours later
This is to summarize & correct a couple of things I had said earlier.

re: Keep your blood pressure under control. - my current common blood pressure is what has been so always - normal blood pressure.

re: What you might be feeling is premature beats. - yes, that's what goes on, but I don't feel them unless I go looking for it with my thumb pressing against the major artery in my neck. I just couldn't remember the technical name, i.e. premature beats. Those are very common.

re: EKG's I've seen have shown no significant rhythm abnormality.

re: did what I called a cardiac MRI was in fact an echo cardiograph/cardiogram? If that's so, then the one done before the catherter was done showed my total block.

re: smoking... I used to be a more or less chain smoker of cigarettes (3+ packs/day), but I finally completely stopped maybe 7+ years ago (and I haven't cheated, but I still occasionally get teased to sneak of a cig)

re: lipids ... I generally avoid trans-fats and saturated fats, and mostly use unsaturated and some polyunsaturated, and Omega-3.

re: my weight... it fluctuates, but I'm now down to maybe 195.

re: metoprolol - I am somewhat concerned about metoprolol. I have had a few occurances with my blood pressure below 100/70 and pulse rate under 50/min. Based on info about such potential side-effects (including the occasional numbness of my hands and/or feet) I have chosen to cut my metrolol intake level in half. I'm not really sure how metoprolol is supposed to protect me from cardiac problems. Unless I get a convincing explanation, I will continue at one 25mg/day, not two. I might even stop taking it.

I'll shut up now... thank you for your support.

Answered by Dr. Pragnesh Vachharajani 1 hour later

Good to hear from you again. You are an informed patient and that makes the job of physician easier.

The test done by inserting catheter is known as coronary angiogram.Echo is just like ultrasound and it is a non invasive test.

You are already adhering to healthy life style and it is good that you quit smoking long back. You are cutting the down the risk factors and that is the most important thing to do.

Apart from this please do not adjust the dose of metoprolol on your own. Your blood pressure is under control that is good; still you should not stop the drug without advice from your physician.

Metoprolol is a drug which belongs to beta blocker class of anti hypertensive drugs. This drugs work on heart and by various mechanisms they protect the heart. This drug is the drug of choice in patient having problems of blood circulation in heart. They reduce the heart rate and reduce blood pressure by dilating blood vessels.

Unless you have some specific problems with the drug, please do not stop the drug without consulting your physician.

I hope this helps.


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