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What causes type III LAD with proximal lesion?

Answered by
Dr.
Dr. Shuba Hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

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Posted on Mon, 6 Jun 2016 in Heart Attack
Question: what is type III LAD mild proximal decease? what is the risk
doctor
Answered by Dr. Shuba Hariprasad 3 hours later
Brief Answer:
Mild but reversible risk for heart disease. Need lifestyle modification

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Please bear with me while I try to explain.

The heart has 4 chambers - 2 left and 2 right (separated by a septum) These are further divided into atria (above) and ventricles (below) (separated by valves)

Deoxygenated/venous blood from the body except lungs return to the right side of the heart. This is then pumped through the pulmonary valve into the lungs to oxygenate it.
The oxygenated blood then comes into the left side of the heart and is pumped to the body (Including heart) through the aorta.

The blood supply to the heart arises from the proximal portion of the aorta, just above the aortic valve. This then divides into branches that supply different parts of the heart.

The Left anterior descending artery- LAD (a branch of the left main coronary) supplies the anterior wall of the heart and the interventricular septum.

There are anatomical variations to the length of LAD and consequently it's area of supply.
Type III LAD indicates a longer artery which supplies a larger area (to include part of the inferior wall and apex of the heart as well).

Theoretically & physiologically, this is an advantage as it acts as a back up blood supply to the apex and inferior wall, should their original blood supply get compromised.
However if this type III LAD is diseased, it is a disadvantage as more of the heart muscle gets compromised. (as that part of the muscle gets used to being supplied by it).

A coronary artery is said to be diseased when the inner wall of the vessel is damaged (due to hypertension, diabetes, smoking, high cholesterol, inflammation) and plaque deposits are formed- atherosclerosis. Extent varies between mild to severe.

These areas exacerbate the blood flow turbulence and act as a nidus to form blood clots. These clots can severely compromise blood flow to the heart and result in a heart attack.

Mild disease is the starting phase and can be reversed or controlled, in the least, with lifestyle modifications and medicines. Based on your report, the initial (proximal) or beginning part of the LAD has few plaque deposits with no compromise in blood flow. This is a good time to attend to it

If you are a diabetic, hypertensive, have high cholesterol, thyroid hormone imbalances, or you smoke, abuse alcohol, or are overweight and have a sedentary lifestyle, your risk of developing a severe vessel disease is high.

You would need a combination of strict diet and medications to control any Coexisting diseases (mentioned above).

I would:
- do a complete physical exam and get detailed family & personal medical history and habits
- do blood tests (complete blood count, ESR, lipid profile, thyroid hormone levels, blood glucose levels, kidney & liver function tests)
- ask for a urinalysis, ultrasound abdomen (if indicated), electrocardiogram, echo cardio gram and an exercise stress test.

Based on the reports and clinical findings I would formulate a course of action. Close & regular monitoring will be required either way to keep disease at bay.

Diet and exercise plays a vital part in this. Exercising for a minimum of a half hour of cardio exercises is necessary (has to cleared by a physician first).
Diet-
- avoid fatty, oily, fried salty foods
-avoid whole grains and food made outside home
-eat veges and fruits as fresh & raw as possible.
-stay away from refined grains. Stick to whole grains.
-Use healthy oils- canola (good for XXXXXXX cooking) , olive oil, gingelly oil. Avoid butter, ghee.
-hydrate yourself adequately.

I recommend you see your physician and go for regular follow up and check up to make sure all is going well

Hope this helps.

I would be happy to answer, if you have any further questions.
If not, please close this discussion and rate my answer.

Wish you good health.
Regards,
Dr. Shuba Hariprasad



Above answer was peer-reviewed by : Dr. Naveen Kumar
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