HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For New Onset Angina

default
Posted on Tue, 22 Apr 2014
Question: I had bypass surgery last January and they did 3 bypasses but I had 4 blockages. Surgeon used 1 bypass to bypass 2 blockages. I started having angina in February of this year, Dr. ordered a radioactive stress test. My regular cardiologist told me I have part of my heart "not working". The radioactive XXXXXXX did not light up in this area. He said I would not be a candidate for another surgery. He prescribed Ranexa and said they would do a heart catheterization as a last resort and after that if I had a heart attack, I would just have to have it. I am willing to go through another surgery If that will help. I get out of breath and tired very easily. This limits what and how much I can do. I am 63, will be 64 in XXXXXXX of this year and I have diabetes and am on an insulin pump. I had a heart attack and a stent in 2005. I'm thinking I would at least like a second opinion.
doctor
Answered by Dr. Prabhakar C Koregol (3 hours later)
Brief Answer: If you a new onset angina go for Cag Detailed Answer: If you had no angina after surgery and after sometime you have angina than it's worthwhile going for angiogram even if your stress is negative. But if you only have breathlessness and weakness it could be due to heart weakness due to prior damage. In my opinion the choice of treatment - stent, surgery or medicines - can be determined based on angiogram. Discuss about this option with your treating doctor. To comment further, please clarify what are the predominant symptoms?
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Prabhakar C Koregol (8 hours later)
I have had angina, starting in February of this year. None before since the surgery. Jaw pain mostly which I had before my previous heart attack. Also having episodes with waking in the middle of the night with numbness and pain in my hands and arms to the point I cannot use them for awhile. Not sure if it is angina or something else. I did take some nitroglycerin and it seemed to help but it just might have gone away for another reason. If I have to live with being out of breath and tired with very little walking then I will, but if I have yet another blockage I want to get it taken care of before another portion of my heart is damaged. Is this solid thinking??
doctor
Answered by Dr. Prabhakar C Koregol (24 hours later)
Brief Answer: Not exactly Detailed Answer: yes your jaw pain especially it is similar to your previous pain it is likely to be angina. as for as numbness it may or may not be cardiac. breathlessness and weakness will be part of your heart weakness. As far as your other block is concerned it likely to be left unattended to it likely only for two reasons 1. it's too small and no major significance 2. there was no treatment option surgically. in either case there is nothing much any one can do about it anything. but you need to discuss with your doctor. but if you had complete relief of symptom which had recurred now it's likely to due to new block and you need an angiogram. . of course still there can be major role for optimisation of meds.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Prabhakar C Koregol

Cardiologist, Interventional

Practicing since :1998

Answered : 427 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For New Onset Angina

Brief Answer: If you a new onset angina go for Cag Detailed Answer: If you had no angina after surgery and after sometime you have angina than it's worthwhile going for angiogram even if your stress is negative. But if you only have breathlessness and weakness it could be due to heart weakness due to prior damage. In my opinion the choice of treatment - stent, surgery or medicines - can be determined based on angiogram. Discuss about this option with your treating doctor. To comment further, please clarify what are the predominant symptoms?