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  • CT Coronary Angiography questions and concerns.

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    Old 05-03-2012, 05:14 PM   #1
    lamboworld
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    CT Coronary Angiography questions and concerns.

    I am concerned about what my next steps should be. The cardiologist that I saw is recommending that I have Cornary Angiography and stent the OM2 if necessary. Here are the results of my CT:

    Technical Quality: Good
    Heart Rate: 51 BPM

    Findings:
    Heart: Normal right ventricular and left ventricular size. Normal Atria. Normal appearing left atrial appendage. Normal trileaflet aortic valve. No anomalous pulmonary venous connections:

    Pericardium: Normal

    Coronary Arteries:
    Dominance: Right coronary anatomy

    Left Main: Moderate caliber vessel which appears normal

    Left Anterior Descending: Moderate caliber vessel which appears normal. The first diagonal artery is a small caliber vessel which appears normal. The second diabonal artery is a moderate caliber vessel which appears normal. The third diagonal artery is a small caliber vessel which appears normal. The fourth diagonal artery is a moderate caliber vessel which appears normal. The apical segment of the LAD wraps around the apex.

    Circumflex: Moderate caliber vessel which appears normal. The AV groove segment of the circumflex artery appears normal. The first obtuse marginal artery is a small caliber vessel which appears normal. The second obtuse marginal artery is a moderate caliber vessel which appears to have a significant obstructive lesion in the mid segment

    Right: Moderate caliber vessel which appears normal. The right posterior descending artery is a moderate caliber vessel which appears normal. The right posterior lateral branch artery is a small caliber vessel which appears normal.

    Impression: Coronary artery disease involving a branch vessel, potentially.

    I have high cholesterol: 235 and also high Triglycerides: 180
    My BP is slightly elevated at 135/80
    I am not being treated for either.

    I have had the following procedures over the past 5 months:

    Endoscopy: Normal
    Tests for H Pylori, Lyme disease, B12, Vit D, Folic Acid. Vit D was low
    CT of Lungs: Normal
    Stress Echocardiogram: exercised for 10 minutes and results were normal
    MRI of Brain: Normal
    EKG: Normal
    Blood tests during physical: Normal except for high cholesterol

    Here are the background of my symptoms that started in late November 2011. My symptoms have gotten slightly better but are certainly still there. This is my posting on the GERD board because that is what I thought I was dealing with.

    Over the past few weeks I have noticed that I started to experience GERD symptoms. I was diagnosed with GERD many years ago and took PPI's for a few years. After a while it got better and I went off the medicine. I haven't taken any PPI's or antacids for the past 5 years.

    During exercise I have noticed the following and I am pretty sure that it is symptoms of GERD but I wanted to ask the question:

    Burning from my upper stomach up to my jaw.
    Jaw burning on both sides.
    Both arms burning.

    I am a 38 yr old male in pretty good health. I might be 10lbs over weight but other than that I am healthy. I don't take any meds.

    Obviously, I am concerned because some of my symptoms are the same symptoms of heart issues. At, rest all of these symptoms go away except for the typical heartburn symptoms.

    Also, 2 weeks ago I was able to run a 9 minute mile on the elliptical and since these symptoms have started I can barely go 5 minutes until the burning gets bad enough that I have to quit.

     
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    Old 05-03-2012, 09:29 PM   #2
    Vyking
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    Re: CT Coronary Angiography questions and concerns.

    Have the Angiogram done it could save your life.
    Your burning is Angina.

    I had burning in the throat, I also thought it was GERD.
    I ended up having a triple bypass in 2009.

    My angina has gone now and I feel great.

    Good Luck.

     
    Old 05-20-2012, 04:58 PM   #3
    lamboworld
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    Re: CT Coronary Angiography questions and concerns.

    Okay, I had a heart cath completed.

    They found a 95% blockage in the LPL1, 100% blockage in the MARG3 and 50% in RCA. Some other small 25% blockages were found in secondary arteries. The LAD was 100% clear. Both the LPL1 and the MARG3 arteries have collateral arteries that have formed.

    My cardiologist said that the normal protocal is to treat the blocked arteries that I have with medicine first. They started me on 40mg of Pravastatin and 50mg of Metoprolol. I have tolerated those medicines very well with little to no side effects. He originally also put me on Isosorbide mononitrate but I just could not take it. I can now do all of the things that I used to do with little or no Angina. However, I am wondering if I would feel better if I had those arteries stented.

    I am going to have a second option with another cardiologist at Duke to see what they have to say but I am wondering what everyone else thinks.

    I am male and only 38 yrs old. I don't smoke, drink and my BP has always been around 130/80. No diabetes or any other ailments. I am also not overweight. At most, I could drop about 10 to 15 lbs. I do also have mild Sleep Apnea which is untreated. I choose not to treat with CPAP because it doesn't really make me tired during the day. However, I have dealt with high cholesterol most of my life. My HDL is usually around 40 and my LDL tends to be over 150 when not treated with statins. My Triglycerides are usually around 200.

    My father and his brothers and sisters all take cholesterol and BP medicine. My father and my uncle both have stents. My father had stents put in after a heart attack at 58 and my uncle had stents put in after chest pains in his 60's.

    So, I realize that I am going to be a statin and BP medicine patient the rest of my life and I will also have to make significant lifestyle changes. Do any of you think that stents will improve my longterm outcome.

    My guess is that my arteries have been narrowing since I was about 20 but that is just a guess. Is there any research on how long it takes a coronary artery to go from 0% narrowed to 100% closed?

    Last edited by lamboworld; 05-20-2012 at 05:03 PM.

     
    Old 05-20-2012, 07:42 PM   #4
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    Re: CT Coronary Angiography questions and concerns.

    They normally stent them if they can during the cath proceedure, I'm surprised that they didn't.

    What did your Cardio say they would do if the meds have no effect?

    If the blockages don't respond to meds and they are un-stentable you might need bypass surgery.

    Normally anything under 70% ~ 75% they won't touch anyway.

    Last edited by Vyking; 05-20-2012 at 07:44 PM.

     
    Old 05-21-2012, 12:10 AM   #5
    lamboworld
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    Re: CT Coronary Angiography questions and concerns.

    Quote:
    Originally Posted by Vyking View Post
    They normally stent them if they can during the cath proceedure, I'm surprised that they didn't.

    What did your Cardio say they would do if the meds have no effect?

    If the blockages don't respond to meds and they are un-stentable you might need bypass surgery.

    Normally anything under 70% ~ 75% they won't touch anyway.
    He said that they would stent them if the meds do not respond. I have read a lot of studies and it appears that there is a lot controversy on this topic. All of the studies indicates that stenting does not increase life expectancy but most generally say that stenting will reduce or eliminate Angina if meds don't work.

    Last edited by lamboworld; 05-21-2012 at 12:11 AM.

     
    Old 05-21-2012, 02:22 PM   #6
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    Re: CT Coronary Angiography questions and concerns.

    lamboworld,
    If the meds don't work and you have the option, go for the bypass surgery.
    I know it sounds scary but it really isn't as bad as you think and if you look after yourself the new arteries can last 30+ years.

    My son in laws grandfather had bypass done in 1984 and he's still going strong.

     
    Old 05-21-2012, 03:39 PM   #7
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    Re: CT Coronary Angiography questions and concerns.

    Met with duke cardiologist and he agreed with my cardiologist. He said for my situation that i should only consider doing a stent if I was not able to control my symptoms with medications. He suggested that I give it a month to 2 to see how am I able to exercise and to consider doing a stent if I am not able to get back to normal exercise routine. The duke cardiologist said that my blockages were fairly basic and they would be no problem to stent if i decided to.

     
    Old 05-21-2012, 06:58 PM   #8
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    Re: CT Coronary Angiography questions and concerns.

    That's good to know.

    Good Luck.

     
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