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My mother, 72 suffering from chest pain an left shoulder

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Posted on Thu, 7 Mar 2019
Question: My mother, 72 suffering from chest pain an left shoulder pain. Today she had under gone with engiography and 2D echo. Sharing all the reports. Pl. suggest shall we do the engioplasty or by-pass surgery or any other treatment for the same.
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Answered by Dr. Sameer Maheshwari (3 hours later)
Brief Answer:
By pass is better

Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
I went through all the reports you have attached.
Your mother has a blockage in the Left main Artery and two other branches.
In this scenario, Bypass (CABG) is always considered the treatment of choice. As she has a normal heart (normal LVEF) the risks in undergoing the surgery will be very little if done by good hands.
I can understand that people consider Bypass surgery to be more serious than undergoing a simple angioplasty, but in the long run bypass is always considered better than angioplasty.
In such cases angioplasty is reserved for those who are either not willing for the bypass surgery or have some other comorbidity in which doing surgery is risky.
I understand that she is 72yrs, but if done by good hands, she will be absolutely fine.
Thanks and regards
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Sameer Maheshwari (5 hours later)
1.actually my mother is not much willing for surgery as per her age,72.
2.Are there complications with engioplasty,
3.The doctor said that you can go for engioplasty,but since 3 blocks are there,it may not work .
4.How urgent it is to go for bypass or engioplasty
5.Are the medicines prescribed to her are appropriate?
6.If we want to go for bypass then can you suggest some expert doctors inumbai??
We are definately taking second opinion,but let me know whethwr it is or notemergency
doctor
Answered by Dr. Sameer Maheshwari (12 hours later)
Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,
Welcome back.
Let us answer your questions one by one.

1) Now as she is not willing for bypass, angioplasty should be done as she has chest pain and the blockages are severe which might not respond well to medical management.
2) Any left main stenting is difficult and their are complication associated with it. Their may be blockage in the stent or arrythmia during the procedure.
3) As the blockage are severe, the procedure should be done soon.
4) Yes the medicine written are the standard treatment and very good for current situation.

So I think if you can convince her for bypass, it will be good for her otherwise angioplasty is always a option.
It is not like all left main stenting causes problem or can result in blockage in stent. We also do it in our center in XXXXXXX and see many patients with such type of stent who remain good throughout, but this angioplasty is always considered a high risk angioplasty.
Hope this helps.
Thanks and regards
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Sameer Maheshwari

Cardiologist

Practicing since :2010

Answered : 814 Questions

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My mother, 72 suffering from chest pain an left shoulder

Brief Answer: By pass is better Detailed Answer: Hi, Welcome. This is Dr Sameer, cardiologist. I went through all the reports you have attached. Your mother has a blockage in the Left main Artery and two other branches. In this scenario, Bypass (CABG) is always considered the treatment of choice. As she has a normal heart (normal LVEF) the risks in undergoing the surgery will be very little if done by good hands. I can understand that people consider Bypass surgery to be more serious than undergoing a simple angioplasty, but in the long run bypass is always considered better than angioplasty. In such cases angioplasty is reserved for those who are either not willing for the bypass surgery or have some other comorbidity in which doing surgery is risky. I understand that she is 72yrs, but if done by good hands, she will be absolutely fine. Thanks and regards