Checking your heart for blockages?

Checking your heart for blockages?

Author
Discussion

andygo

5,447 posts

200 months

Saturday 24th August
quotequote all
I am in the MK area with surgery etc carried out at the John Ratcliffe hospital.

ikeepbuyingd5s

6 posts

25 months

Saturday 24th August
quotequote all
Andygo

I'm a Consultant Cardiologist who does mainly cardiac MRI and happy to discuss on phone if it helps. Message me if needed.
In essence though - the implications of coronary disease are spectacularly variable from entirely silent (that causes you no symptoms and you die from something else in your 90s) to serious life-limiting problems. For this reason weighing up the options is critical.

There are 2 reasons to consider a (or any) procedure (i.e. surgery or stent)
1) It makes you feel better
2) It reduces the risk of something bad happening in the future - i.e. hopefully makes you live longer

It sounds as if you are likely to have a chronic total occlusion in the LAD ("CTO"). It appears that the muscle supplied beyond the blockage is scarred. Trying to open the blood supply to a scarred area unlikely to make things better but it can be nuanced and is needs the information weighing up. The analogy I sometimes use is that the water supply to the field has been interrupted and the crops have died - re-opening the blood supply won't bring the dead crops back to life. Without further information/seeing pictures I can't comment specifically but we often suggest medical therapy (i.e. pills, no procedure) in this situation - i.e. whats been proposed doesn't sound unusual. Nevertheless we've had some patients who have felt better after having a blocked artery opened even when we thought the muscle supplied was dead and scarred.

Ignore the "widowmaker" term - a sudden blockage of the LAD isn't great - can't argue with that - but this is a different scenario in that you are alive and kicking despite the problem. i.e it isn't just the location of a blockage, its the clinical scenario.

The important thing going forward in this situation is often meticulous control of BP/cholesterol/risk factors. You need to know your left ventricular function as if impaired there are specific pills you should be on and the evidence for this is good.

It is a complex area - lots of data, but extrapolating to individual patients is challenging. My patients often leave the clinic room with a piece of paper in which I've drawn (badly) the different options and the possible pros and cons together with uncertainties. They sometimes return with a bigger piece of paper having been on google - but this is all good.

Like I say - happy to discuss so please get in touch if it helps - and I'm sorry about the delays you've had - a reminder for me of how difficult it is for people to carry on whilst uncertainty in their health exists.

I don't post on here much, but the light relief of readers' cars, property pawn, steak a la man and people kind enough to post pictures of their takeaway has been much valued over the last few years, even if I go and buy another volvo d5 every time - so keen to "pay back" and help if people have cardiac issues.


andygo

5,447 posts

200 months

Sunday 25th August
quotequote all
ikeepbuyingd5s said:
Andygo

I'm a Consultant Cardiologist who does mainly cardiac MRI and happy to discuss on phone if it helps. Message me if needed.
In essence though - the implications of coronary disease are spectacularly variable from entirely silent (that causes you no symptoms and you die from something else in your 90s) to serious life-limiting problems. For this reason weighing up the options is critical.

There are 2 reasons to consider a (or any) procedure (i.e. surgery or stent)
1) It makes you feel better
2) It reduces the risk of something bad happening in the future - i.e. hopefully makes you live longer

It sounds as if you are likely to have a chronic total occlusion in the LAD ("CTO"). It appears that the muscle supplied beyond the blockage is scarred. Trying to open the blood supply to a scarred area unlikely to make things better but it can be nuanced and is needs the information weighing up. The analogy I sometimes use is that the water supply to the field has been interrupted and the crops have died - re-opening the blood supply won't bring the dead crops back to life. Without further information/seeing pictures I can't comment specifically but we often suggest medical therapy (i.e. pills, no procedure) in this situation - i.e. whats been proposed doesn't sound unusual. Nevertheless we've had some patients who have felt better after having a blocked artery opened even when we thought the muscle supplied was dead and scarred.

Ignore the "widowmaker" term - a sudden blockage of the LAD isn't great - can't argue with that - but this is a different scenario in that you are alive and kicking despite the problem. i.e it isn't just the location of a blockage, its the clinical scenario.

The important thing going forward in this situation is often meticulous control of BP/cholesterol/risk factors. You need to know your left ventricular function as if impaired there are specific pills you should be on and the evidence for this is good.

It is a complex area - lots of data, but extrapolating to individual patients is challenging. My patients often leave the clinic room with a piece of paper in which I've drawn (badly) the different options and the possible pros and cons together with uncertainties. They sometimes return with a bigger piece of paper having been on google - but this is all good.

Like I say - happy to discuss so please get in touch if it helps - and I'm sorry about the delays you've had - a reminder for me of how difficult it is for people to carry on whilst uncertainty in their health exists.

I don't post on here much, but the light relief of readers' cars, property pawn, steak a la man and people kind enough to post pictures of their takeaway has been much valued over the last few years, even if I go and buy another volvo d5 every time - so keen to "pay back" and help if people have cardiac issues.
I have pm'd you.

dickymint

16,968 posts

203 months

Sunday 25th August
quotequote all
^^^ what a nice guy clapclapclap

andygo

5,447 posts

200 months

Sunday 25th August
quotequote all
I thought that.