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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Exertional Chest Discomfort, Breathlessness, Abnormal Stress Test, High BP. Is It Due To Narrowing Of Blood Vessels ?

I am experiencing exertional chest discomfort, breathlessness, abnormal stress test, high blood pressure , dyslipidaemia since May 2012. A coronary angiogram was done on 23 August 2012. The result / Coronary angiography: Left main: ostial 30% narrowing. Distal 30% eccentric narrowing in continuation with ostial LAD 30%. Left Anterior Descending: Ostial 30%. proximal tubular 30% around smaller D1. Larger D2 normal. Circumflex Artery: Mild proximal narrowing. Distal 20% narrowing. Right Coronary Artery: Dominant vessel; diffusely diseased. proximal mild narrowing. Acute margin tubular 30%. Ostial PLSA 30/40% narrowing. Dr., based on the result, how serious is my heart disease? Is it life threatening? Are the chest discomfort, breathlessness, etc due to the narrowing of the blood vessels? What should I do now? I am on medication for high BP , high cholestrol. My email address is: YYYY@YYYY Thank you, AAAA
Thu, 25 Oct 2012
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Cardiologist 's  Response
Hi
70% narrowing is generally needed to cause symptoms. The bigger blood vessels do not show significant obstruction - that does not rule out risk. Smaller vessels and spasm could contribute. Typical symptoms and positive stress test are strongly supportive of the diagnosis. High blood pressure and dyslipidemia are strong risk factors. Strict control of pressure and lipid is a must.
A thallium stress may throw additional light - till then - amy be subsequently too - treatment as ischemia is preferable
Take care
Good luck
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Cardiologist Dr. Aslam Lalani's  Response
Hi
you have mild disease in almost all vessels supplying blood to heart , from your history your chest pain and breathlessness looks to be related to your heart problem
you need to do now is take regular medication with out missing any single dose of any medication adviced by your Dr. ,
life style modification like low cholesterol diet , avoid dhee ,butter, fried ,junk foods , take good quntity of green leafy vegetables , fresh fruits , quit tabacco use in any form (if using), limit alcohol intake ,
regular follow up with your Dr. and regular monitoring of your Blood Pressure and cholesterol level .

any amount of heart problem we cant neglect , we need to take it seriously ,dont panic but dont neglect also
take care
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Exertional Chest Discomfort, Breathlessness, Abnormal Stress Test, High BP. Is It Due To Narrowing Of Blood Vessels ?

Hi 70% narrowing is generally needed to cause symptoms. The bigger blood vessels do not show significant obstruction - that does not rule out risk. Smaller vessels and spasm could contribute. Typical symptoms and positive stress test are strongly supportive of the diagnosis. High blood pressure and dyslipidemia are strong risk factors. Strict control of pressure and lipid is a must. A thallium stress may throw additional light - till then - amy be subsequently too - treatment as ischemia is preferable Take care Good luck