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Was admitted for Hysterectomy surgery but failed in the Cardiac fitness test. Done angiogram. Suggest?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 424 Questions
Dear Dr.,
I'm writing this for my mother who was recently admitted for Hysterectomy surgery but failed in the Cardiac fitness test. I am attaching the angiogram report here, could you please check and provide an expert advise on the observations?
Posted Thu, 10 Oct 2013 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 16 hours later
Brief Answer:
Needs CABG (Coronary Artery bypass Graft) surgery but little tricky situation

Detailed Answer:

dear thanks for query.

though in your question as to what you are looking for I understand that you would be wanting to know what to do next. most important issue would be what are your symptoms and at what stage and work load your TMT was positive. If you are very symptomatic or TMT is strong or low workload positive you need to go for revascularisation and CABG is best option though they mention lad distally is small which may give some technical challenges. if you don't have major symptoms and TMT is positive at high workload than there is always role for medical management.

if you have any other queries please get back to me.
Above answer was peer-reviewed by
Follow-up: Was admitted for Hysterectomy surgery but failed in the Cardiac fitness test. Done angiogram. Suggest? 1 hour later
dear Dr. there were no symptoms of heart issues except for throat discomfort while climbing stairs. TMT showed positive in around 6 mints of tread milling. we have consulted two doctors, the first dr asked for surgery while the second said surgery is not required. would you like to see the video?
Answered by Dr. Prabhakar C Koregol 48 minutes later
Brief Answer:
Medical management is acceptable

Detailed Answer:
As advised by second doctor it is reasonable to go on medical management and see how symptoms respond. If she becomes a symptomatic until such time of recurrence of symptoms no need to go for surgery. Survival is same with both while symptoms relief is more complete with revascularization.

Above answer was peer-reviewed by
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