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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Precautions Are To Be Taken After Getting A Stent?

My husband (age 60, 2 generation paternal cardiac history, regular medical care including ekg s, but not medicated for high blood pressure or cholesterol) suffered a 90% blockage in his Left Anterior Descending Artery and blockage in the diagonal. The cardiologist says he probably had a 40% blockage and an unstable plaque event brought on a sudden major blockage. Excellent care avoided the big one but he suffered a procedural heart attack when the diagonal collapsed as a stent was put in place in the LAD. 1. Please clarify how the diagonal may have been lost. 2.Could one regain that 10% lost function? 3. What could be ongoing consequences? 4. Is his risk of another event now elevated? Thank you very much.
Wed, 17 May 2017
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Pulmonologist 's  Response
Hello
Welcome to HCM.
The diagonal is a branch arising from the LAD. They may be single or multiple. It is a common complication during angioplasty of the LAD that the diagonal origin gets pinched off and the vessel shuts down. This causes lack of blood supply to the area supplied by the artery leading to heart muscle damage and a minor heart attack. The intensity depends on the diameter of the diagonal which varies from person to person. In some people its very small and its closing off doesn't cause a problem . It can be moderate or large sized also. Since heart muscle is damaged with the diagonal shutting off some amount of the hearts pumping function is lost. Usually since the diagonal supplies only a small portion of heart muscle, it does not lead to much drop in pumping function and in most of the cases the normal lv pumping function is achieved in about three months. It happens with about 10-15 % of patients undergoing an LAD angioplasty and does not have significant consequences.
Also it does not raise the probabilities of further adverse events.
Hope I have answered your query satisfactorily.
Wishing you good health
Regards
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What Precautions Are To Be Taken After Getting A Stent?

Hello Welcome to HCM. The diagonal is a branch arising from the LAD. They may be single or multiple. It is a common complication during angioplasty of the LAD that the diagonal origin gets pinched off and the vessel shuts down. This causes lack of blood supply to the area supplied by the artery leading to heart muscle damage and a minor heart attack. The intensity depends on the diameter of the diagonal which varies from person to person. In some people its very small and its closing off doesn t cause a problem . It can be moderate or large sized also. Since heart muscle is damaged with the diagonal shutting off some amount of the hearts pumping function is lost. Usually since the diagonal supplies only a small portion of heart muscle, it does not lead to much drop in pumping function and in most of the cases the normal lv pumping function is achieved in about three months. It happens with about 10-15 % of patients undergoing an LAD angioplasty and does not have significant consequences. Also it does not raise the probabilities of further adverse events. Hope I have answered your query satisfactorily. Wishing you good health Regards