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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain In Arms And Shoulders After A Mild Heart Attack?

hello sir,

my dad is at age of 67 and recently he had sholder pains,so we went to hospital and checked.from cardiogram doctor tell us that he had mild heart attack

Dr. Ahok patil from kolhapur, suggested that you must have to go for Angiography. from Angiography doctor tell us that he has Blockage of 80 % followed by 99% in RCA (right coronary artery). then they attepmted for angioplasty

but was not successful, due to hardning of blockage, so he suggested for "Bipass Surgery". so we take the advice from KLES hospital Belgaon (Dr.MR.Dikshit and Dr.MR. Porwal), Here thay see the angiography CD and suggested that

as previous doctor attempted for angioplasty and was not succesful, there is no need of angioplasty and as it is in RCA we dont need to go for "Bipass surgery also".KLE's doctor gives some medicine and said it will be cure by

medicine no need to take tention and ask to come after one month for checkup again. now 15 Days has been passed.

But still my dad is having pains of Both ARMs and Sholders, he is taking some pain killers like Combiflam.



Please please please suggest the Risk factor and proper guidline to follw i am very much warried about my dad.





Thanks in Advance and wating for your response......





Regards,

Anand kajave

0000

Pune
Fri, 18 Mar 2016
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Critical Care Specialist,  's  Response
Hi, Anand, I understand your concern and I'll try to help you. It is very probable that the pains that your dad suffers should be originating in myocardial ischemia, known as angina.

There are four forms of treatment for patients with angina secondary to blocked coronary arteries:
1- Clinical treatment: Made with medications that reduce metabolism and oxygen consumption of the heart muscle, as well as medications that dilate these arteries.
2- Coronary Angioplasty: It is usually used for patients with one or two obstructions in arteries and consists of placing a stent device at the site of obstructions by facilitating local blood flow.
3- Coronary artery bypass graft surgery: Used for patients with unfavorable obstructions angioplasty, with better results in the long term in relation to the placement of stents.
4- Cardiac transplantation: It is only indicated in extreme cases, when none of the above treatments are possible or effective, associated with significant worsening of cardiac function. It is the least common treatment used.

In the case of your father, he has severe blockages in the right coronary artery, angioplasty tried, but with poor results and persists with angina. In this situation, the first attempt should be to optimize the clinical treatment with medications such as Cardiologist that accompanies doing. However, if these pains become more intense, are not controlled with medications, are compromising their father's quality of life, we must consider the possibility of coronary artery bypass graft surgery.

You said the Cardiologist not think surgery is the best way if only to address the right coronary artery, because studies show better results when the surgery is necessary to treat the left anterior descendant artery with a mammary artery bypass, which it is not your father's situation. However, the case of your dad runs away from what is written in books and if it can not be a good result with the use of medications (optimal medical therapy), surgery should be a very wise option.

Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.
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Emergency Medicine Specialist,  Dr. Mahmoud Hassebo's  Response
Dear Sir , I think the option of Bypass surgery is good as long as your dad is still young with no significant co morbidities , especially he is still suffering from pain with no response to medications prescribed .
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What Causes Pain In Arms And Shoulders After A Mild Heart Attack?

Hi, Anand, I understand your concern and I ll try to help you. It is very probable that the pains that your dad suffers should be originating in myocardial ischemia, known as angina. There are four forms of treatment for patients with angina secondary to blocked coronary arteries: 1- Clinical treatment: Made with medications that reduce metabolism and oxygen consumption of the heart muscle, as well as medications that dilate these arteries. 2- Coronary Angioplasty: It is usually used for patients with one or two obstructions in arteries and consists of placing a stent device at the site of obstructions by facilitating local blood flow. 3- Coronary artery bypass graft surgery: Used for patients with unfavorable obstructions angioplasty, with better results in the long term in relation to the placement of stents. 4- Cardiac transplantation: It is only indicated in extreme cases, when none of the above treatments are possible or effective, associated with significant worsening of cardiac function. It is the least common treatment used. In the case of your father, he has severe blockages in the right coronary artery, angioplasty tried, but with poor results and persists with angina. In this situation, the first attempt should be to optimize the clinical treatment with medications such as Cardiologist that accompanies doing. However, if these pains become more intense, are not controlled with medications, are compromising their father s quality of life, we must consider the possibility of coronary artery bypass graft surgery. You said the Cardiologist not think surgery is the best way if only to address the right coronary artery, because studies show better results when the surgery is necessary to treat the left anterior descendant artery with a mammary artery bypass, which it is not your father s situation. However, the case of your dad runs away from what is written in books and if it can not be a good result with the use of medications (optimal medical therapy), surgery should be a very wise option. Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.