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Won't Open a 50-60% Blocked Coronary Artery

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Do you have a partially blocked coronary artery, and a doctor who suggests waiting to place a stent until the lesion exceeds 75% or more? To learn more about this heart disease diagnosis, read the comments below for firsthand experiences from patients in similar situations. Share your story, ask questions, and get support from our patient community here.

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Current Postings on This Page (106):

• Vinod in India - Dr. Dean Ornish in the U.S. reports some success in reducing blockages (reversing atherosclerosis) through his program, which is made up of a very stringent diet, exercise, meditation, etc. Also certain statins have shown to cause a small regression as well. A 70% blockage is not going to disappear; however, it may be possible to manage with a 70% blockage, through these lifestyle changes AND the correct medications. This is an excellent topic to discuss with the cardiologist who did your angioplasty.

And ZR in Ohio - a 50% blockage may not actually be causing ischemia. The current best way to measure this is through fractional flow reserve (FFR) which is a thin wire placed across the blockage during a cath. You can read more about this in our article, "To Stent or Not To Stent: Fractional Flow Reserve (FFR) Trumps Angiography in Diagnosing Blockages up to 90%." The bottom line is that if a blockage is NOT ischemic, it is best left alone because the potential complications of restenosis, thrombosis, etc. with a stent would outweight any possible benefit.
Angioplasty.Org Staff, Angioplasty.Org, July 19, 2013

• Just had a cardiac cath. Was a f/u to 2009 LAD stent placement. Two stents looked good. No restenosis. However, Distal LAD had a 50% narrowing before the vessel reached the apex. Doc did not open it up. Is this normal? Why would the doc leave a vessel that is half blocked the way it is? Why not open it while he is already in there?
ZR, Ohio, USA, July 19, 2013

• I am 54 year old, diabetic. I had angina when I walk about half km. My Angiography showed blockages at 3 places. LAD - 99% proximal eccentric lesion LCX - Non dominant & normal. OM2 has chronic total occlusion RCA - Large Dominant & has 70% mid segment eccentric lesion. PDA & PLV is normal My Cardiologist has done successful Primary PCI to LAD on 28th June 2013. Is 70% lesion in RCA can be reversed with Life style changes & exercises. Please suggest.
Vinod M, Pune, Maharastra, India, July 19, 2013

• a case of PTCA ONE STENT. Still having angina and SOB.TMT +VE POST PTCA.100% BLOCKAGE IN DIAGONAL ARTERY. TAKING MEDICINE PAN D, STAMLO 5, DEPLATT A150, TELMA40, ROSUVAS 10, THYROX 100, FROM 18 MONTH. ALSO HAVING PROBLEM IN COPD. I AM TAKING DRINKS MORE OR LESS EVERY NIGHT
KHOKAN, techno, West Bengal, India, June 23, 2013

• Dear Explain in India - A type III LAD is a way of describing the anatomy of your particular Left Anterior Descending (LAD) coronary artery. It means that the LAD artery is long and curves around the apex of the heart to supply a portion of the inferior wall of the heart. Your stent is "patent", i.e. working correctly and open. You have some lumen loss in the proximal part of the stent, meaning that some narrowing has occurred there, but lumen loss does not necessarily have any clinical implications, unless it continues to increase.
Angioplasty.Org Staff, Angioplasty.Org, June 22, 2013

• What is the meaning of type 3 vessel, patent stent in mid LAD with lumen loss in proximal part of the stent?
explain precautions and medical advise, Ex Defence, Hyderabad, Andhra Pradesh, India, June 22, 2013

• Anurajan in Nepal - revascularization means opening us the artery, or the circulation. This can be done with bypass graft surgery or less invasively with angioplasty and stenting. You have two-vessel disease and, assuming both blockages are "significant", would probably be done with angioplasty. Did your cardiologist use FFR to measure the arterial blockage? Also, if you have no history of chest pain or other symptoms, what was the reason your doctor scheduled you for an angiogram? Did a stress test show ischemia (lack of blood flow)?
Angioplasty.Org Staff, Angioplasty.Org, June 21, 2013

• I am 46 yr male. Just had CAG that revealed 70-80% stenosis in mid RCA and 70-80% stenosis in proximal LAD. I don't have a history of chest pain, dizziness. My father had bypass 2 yr back. Doctors have advised for early myocardial revascularization. What is that?? Is it the bypass surgery??
Anurajan, Nepal, June 18, 2013

• Concerned daughter in NL - Your dad is lucky to be sure. The question of whether to open a 70% blockage may be complex, especially given your father's recent experiences. It may be that the arteries are too narrow to begin with and won't do well with a stent. It may also be that these blockages are not the cause of his symptoms. It will be very important for him to stay on the meds prescribed, especially clopidogrel (or equivalent) and aspirin to prevent the blood clotting in the stents he does have.
Angioplasty.Org Staff, Angioplasty.Org, June 7, 2013

• My dad is 64 and has angina - heart disease runs in his paternal family. Last summer he had angioplasty and one stent put in. Last week, he had the dye test because he was experiencing angina attacks. During the test, they put in 6 stents in one branch and then the balloon broke causing a clot. He went into cardiac arrest on the table and flatlined. Today he is good, still in hospital waiting for an ultrasound on his heart. He still has two blockages of 70 percent in the lower branches. The doctor will not be putting in any more stents. He is being released from hospital tomorrow.. Does that sound normal??
Concerned daughter in NL, St. John's, NL, Canada, June 5, 2013

• Wilson F in India -- If you are experiencing chest pain (angina) and have an 80-90% blockage, most guidelines would state that angioplasty would be a valid treatment, although some cardiologists might try a course of medical therapy and lifestyle changes first. But we cannot say since we can't give out medical advice -- and it's necessary to have all the clinical information and angiogram to make a proper recommendation. As for the 40% blockage, normally this is not something that is treated, unless it may have some involvement or interaction with the more significant blockages.
Angioplasty.Org Staff, Angioplasty.Org, June 5, 2013

• I am 37 years old. I had a chest pain. Then I do angiogram. I found 3 blockage. One is 80 to 90 percent, other is 40 percent. Doctor told me to do PTCA with stenting to proximal RCA. Plse tell me what to do.
Wilson F., Margao goa, India, June 3, 2013

• Bubba in Kentucky - Interesting, since a nuclear thallium stress test is usually done prior to an angiogram and, if it is negative (normal) the angiogram is not required. Annual testing is not really recommended in low risk patients. Without seeing all your clinical information, it seems that family history is probably your only risk (but we, of course, urge you to ask that question of your cardiologist). You've done absolutely the correct things in terms of diet. We assume you don't smoke. And we'd only add that exercise (even just long walks) is also important. In any case, a 30-40% blockage may mean nothing. According to the tests, there is no blood flow constriction and you have no symptoms. With the medical/lifestyle therapy you are doing, you are controlling your modifiable risk factors very well and hopefully keeping any disease in check. Again, annual testing for low risk patients is not a recommendation in the guidelines.
Angioplasty.Org Staff, Angioplasty.Org, May 11, 2013

• Due to a family history of heart disease, in April of 2012 and at the age of 53, I had a angiogram performed. This test revealed that I had one blockage and it was a 30-40% blockage in the proximal LAD. After this test was performed, I went through additional testing such as nuclear thallium stress test and echocardiogram to see if the blockage had any affect on the blood flow to the heart. All these test came back normal. My cholesterol has always been near the normal range and have always been a exercise fanatic. My cardiologist issued a prescription for 10mg of Crestor and 5mg of Norvasc and said he see me in a year. Since this time I have also went on a very strict vegan type diet. In January of 2013 I had my annual blood work performed and the cholesterol numbers are HDL-49, LDL-36 and total 99. My question is, can the blockage in this critical artery be reversed by lifestyle changes through diet and medications or will the blockage continue to keep progressing? Also how often should this blockage be checked and what non-invasive procedures are there to tell if the blockage has stabilized of progressed?
Bubba, Lewisburg, Kentucky, USA, May 9, 2013

• Please sign the petition i have started complaining about same thing insurance companies playing doctors and refusing treatment and meds http://www.change.org/petitions/medical-insurence-cover-medications-that-the-doctors-presribe
littledao, Wetumpka, Alabama, USA, May 1, 2013

• Tricia in California - Check out our Forum Topic on carotid stenting and also our interview with Dr. "Nick" Hopkins. How were these blockages measured? Angiography, ultrasound?
Angioplasty.Org Staff, Angioplasty.Org, April 29, 2013

• I am not quite 55. Two and a half years ago I had carotid angioplasty with stent on my left carotid. At that time, blockage on right side was minimal. Now on right side I have three blockages. two are small, 15% and 25%, the third is at 60%. Dr says HMO won't allow stent until 80%. I have a strong family history of stokes on both sides. Are there any other measures, besides Plavix and aspirin and diet?
Tricia, Victorville, California, USA, April 24, 2013

• Sbjohri in India -- We cannot give medical advice about specific cases. This is a question you should ask your father-in-law's cardiologist. Sometimes people function fine with a totally occluded artery, if it's not the dominant source of blood flow, or if collaterals have formed a sort of "natural bypass." But sometimes it's beneficial to try and open such a blockage.
Angioplasty.Org Staff, Angioplasty.Org, April 13, 2013

• What should be done when a coronary artery is having 99% stenosis and rest two are clear - this is a case of my father in law in India.
sbjohri, retired, dehradun, uttrakhand, India, April 10, 2013

• Canadian in Alberta -- Your husband's main risk factor (assuming he doesn't smoke) is his family history. While there's nothing that we can do about genes (yet), we can try to reduce all modifiable risk factors to keep coronary artery disease from progressing. These actions includes taking prescribed medications which your husband has been given. Plavix and aspirin are antiplatelet medications to keep blood from forming a thrombus (clot) in the stent and also to lower the risks of a future heart attack. A heart attack is caused by thrombus forming in the coronary artery and shutting off blood flow. Thrombus often forms at a point of a significant blockage, but not always. These two meds need to be taken for at least six months, but due to your husband's heart attack, his cardiologist might want to keep him on this dual antiplatelet therapy. Side effects are possible bleeding, gastric upset, easily bruised skin, etc. The Metoprolol and Ramipril are two blood pressure meds and may cause light-headedness, sometimes a cough. Finally Lipitor is a statin to help keep his cholesterol down and also has other benefits. Some patients get muscle aches or pains from statins. You can look up each of these drugs on the web and find the exact side effects. But it's also possible that he'll experience none of them. Since they are all helpful, if he does experience any side effects, he should see his cardiologist, possibly switch to another drug or change the dosage. But he should not stop taking anything without discussing it first with his doctor. Diet is very important and the Ornish diet, while difficult to maintain, has shown benefits. Additionally just this week a major study was released showing great benefits from the Mediterranean Diet (30% reduction in stroke and heart attack). And exercise. Exercise not only tunes up the body and circulation, but can actually change the body chemistry for the good. A 40% blockage does not necessarily progress further and, according to all guidelines, is not something you would want to treat with a stent or surgery. Although drug-eluting stent trials have shown lower restenosis rates when compared to bare metal stents, this all depends on many factors and for a wide diameter artery that doesn't have complex anatomical features, many cardiologists feel there's not an appreciable difference.
Angioplasty.Org Staff, Angioplasty.Org, February 27, 2013

• My husband always kept a healthy lifestyle as he feared of Heart disease due to his Dad having the same, yet at 50 he got a heart attack and had to undergo angioplasty to treat the 100% blockage in left branch of an artery. He yet has a 40% blockage on one of his artery. He has a healthy lifestyle, however, what are the chances of the 40% blockage to grow with him as he always had good diet (motivated by Dean Ornish he is now considering plant diet) and medication (he takes Plavix, Metoprolol, Aspirin, Lipitor, Ramipril) What are the side effects of this medications? How long would this medication continue? He has bare metal stent so what are chances of restenosis? Please.
Canadian, Alberta, Canada, February 27, 2013

• Mild Chest Pain in India -- You are describing angina. Although angina is a symptom of ischemia (insufficient blood flow to the heart muscle) it may also be present when there is no significant ischemia. There are patients who still experience angina even after angioplasty or bypass surgery. This can be treated with an anti-anginal medication, such as ranolazine. But the big question is whether you have ischemia, so see your cardiologist and perhaps a nuclear stress test or CT angiogram might be indicated to see if the 50% blockage is causing problems.
Angioplasty.Org Staff, Angioplasty.Org, February 27, 2013

• I am 40 yrs male. Have diagnosed 50% blockage in LAD in the Year 2007. From then I am going on medication continuously. But I am suffering from mild chest pain since 2007 even in rest. Is it risky for me? Otherwise will it be best on operation or Angioplasty?
Continuous Mild Chest Pain Since 2007, India, February 24, 2013

• In response to some of the issues, I had an angioplasty done last Friday. I can tell you that I have and will continue to have a healthy diet along with quitting smoking. I had 99% of blockage in the Aorta, reading some of the responses on this web-site amazes me. Having any type of blockage is a serious matter, and how someone can continue smoking and not get on a healthier diet, amazes me. This is your life and you can take control of it, if you want to continue to live. It is will power, and you should have control of this if it is to make your life better. Good luck to all and Healthy Living! Eve
Evelyn b, Chicago, Illinois, USA, January 14, 2013

• Sonnerts in Philippines -- FFR showed that your blockages are not "ischemic": they are not reducing the blood flow to your heart muscle significantly. The medical therapy you've been prescribed is to reduce or prevent the further progression of any coronary artery disease. But, if you are concerned about side-effects or long-term problems, you should discuss these issues with your cardiologist. For example, Lipitor is a statin which has many beneficial effects, the primary one being lowering your cholesterol. Can you do this with diet alone? This is an excellent topic for discussion with your doctor.
Angioplasty.Org Staff, Angioplasty.Org, January 13, 2013

• Had an angiogram last may. Have a 60% blockage in left coronary artery and 20 percent on my right. I underwent FFR so angioplasty didn't push through. I was given a lifetime medication of micardis 40mg, Lipitor 10mg and aspilet 80mg all once a day. My worry is if i keep on taking Lipitor would it affect my liver? Should I stop taking meds and just change my lifestyle esp my diet? Or having to follow strictly my diet and lifestyle doesn't help me prevent from having a heart attack since I already have a blockage? I am really confused since some meds have side effects.
Sonnerts, Mandaluyong, Philippines, January 8, 2013

• Christina in Alabama - Your 100% blockage is technically called a Chronic Total Occlusion (CTO). Check out our topic on Chronic Total Occlusions. Whether or not they need to be opened is a matter of great discussion among interventional cardiologists. Sometimes the "natural bypasses", a.k.a. "collaterals", are providing sufficient blood supply.

And Bev in Indiana -- If you have had both a Cardiolite (nuclear stress) test and a catheterization and the cardiologist feels that the blockage is not ischemic (not blocking the blood supply to the heart muscle in any significant way) and especially that you are having no symptoms, then you probably are okay. If you have any other risk factors, you might be placed on medical therapy (cholestrol, blood pressure, etc.) -- what symptoms brought you to the cardiologist?

Finally, Pratik in India -- 45% blockage is below the threshold that would indicate stenting. Your uncle already has 5 stents. He should now concentrate on reducing risk factors under his control, such as diet, exercise, smoking (stop it!) and be sure to take the medications prescribed for blood pressure, cholesterol and definitely Plavix and aspirin for at least a year to keep the stents from forming blood clots.
Angioplasty.Org Staff, Angioplasty.Org, January 5, 2013

• my uncle has undergone the treatment on silent Heart Attack, and doctor has done the angioplasty and injected 3 stents (Xing) very first day,and then alternate day they have injected two more stent (all are medicated) now his heart is working on 30% stage. rest two arteries are also blocked 45%.is the procedure is OK or in case someone could advise the next course of action or tell us whether we are on right track or not. please also advise the precautions.
Pratik, Delhi, India, December 29, 2012

• I am a 45 yr old female that just had a stress test and heart cath that revealed that my LAD is 100% blocked with natural bypasses developed already. Dr said that all other arteries are totally clean. Dr said no damage to heart done by blockage and is recommending only medications but everything I have read regarding blockage in this artery is so bad I am very scared to just leave it 100% blocked. I would like opinions on if this is wise. Would also like to know how the LAD could be 100% blocked but there be no other blockages of any kind that seems strange.
Christina C, Mobile, Alabama, USA, December 30, 2012

• I had a Cardiolite test it showed 60% blockage..went for a catheterization ..said it wasn't bad enough to stent ..can you tell me anything to ease my mind about this ..i am 76 years old ..have no other diseases ..i have no shortness of breath or other problems ..what do you think ? ..thanks.
Bev, Muncie, Indiana, USA, December 24, 2012

• One in Pakistan -- A nuclear stress test could show if you develop ischemia with exercise and possibly which artery may be the cause -- or perhaps if the "tightness" is due to something else. Even a blockage at 50-60% is not necessarily recommended for stenting. We would think a nuclear stress test might be a good option to get more information.
Angioplasty.Org Staff, Angioplasty.Org, December 23, 2012

• I had chest pain in October 2010. Angio was positive for about 80 to 90% lesions in LAD and Circumflex vessels. Both were stented with bare metal stents as the lesions were small in length, I am not diabetic and young (age 38. There was also a lesion distal to the stented one in LAD (mid LAD) that was left alone. Since then I am walking, jogging and running for about 10 miles without symptoms. My Cholesterol is controlled (LDL around 80, HDL around 40,TGs around 80). Last week, I had chest tightness (No pain) that lasted 5 to 10 mins. Cardiologist suggested emergency angio. Stents were patent. No new lesion but the one graded 40% last time is still there. Cardiologists are divided in opinion, some say the disease has increased (50 to 60%) the other say it is static as it was 2 years ago (40 to 50%). FFR is not available in this part of the world. My Questions are: (1) how good nuclear stress can determine the ischemia. (2) my symptoms mostly at rest and not on exertion except mild discomfort when I run for more than 20 mins) can Stress test predict the reason for my symptoms. (3) could my symptoms be due to transient cardiac arrhythmia.
One in Pakistan, Pakistan, December 23, 2012

• Shannin -- The fact that your mom has an enlarged heart means something needs treatment: it may high blood pressure or other cause that makes her heart work harder and therefore is enlarged. A blockage in the coronary artery may also be a cause, but has she had a stress test to see if the blockage is actually causing a problem (a 60% narrowing is borderline).
Angioplasty.Org Staff, Angioplasty.Org, September 30, 2012

• hi my name is shannin and my mom has an enlarged heart and she told me that her heart is 60 percent clogged it is worry me can someone live with a 60 percent blockage.
Shannin Green, gw lisk, Clifton Springs, NY, USA, September 14, 2012

• I AM 76 YEARS OLD HAVE NO OTHER HEALTH PROBLEMS SUCH AS DIABETES OR ANY OTHER THING I KNOW OF ....HAD AN ANGIOPLASTY..I HAVE 60% BLOCKAGE IN MY LAD ARTERY THE DR. DID NOT PUT A STENT IN. I WAS SURPRISED...DON'T DRINK ..QUIT SMOKING 20 YEARS AGO ..I HAVE NO SHORTNESS OF BREATH OR CHEST PAIN ..I AM TIRED THO....
Beverly, Muncie, Indiana, September 2, 2012

• I am 80 years...HOSPITAL COURSE; (Last week, angio) Electively presented for coronary angiography that revealed plaque in LM mild to moderate disease 50/60% in mid LAD, mild plaque in the mid Cx, Ectatic RCA with slow flow, but no significant plaque, normal LV. Advised medical management.....Follow up after one week with Cr, Na, K tests. Pls tell me in simple language whether I am clear of disease or require further procedure of any sort. According to my doctor Disease can b managed by medication. Let me your your views and if possible let me know the names of medicines. Presently I am on medicine ASCARD / {2]EXPLENDED [Rosuvastatin} {3} DIOPlus 5/80 mg {amlodipine besilate + valsartan}.Ur guidance will b much appreciated.
Pyarraj, Denmark, August 31, 2012

• Is it normal to have >70% blockage in proximal LAD and no blockage at all in any of the other arteries? The CT angiogram has reported these findings.
CADInfo, India, August 23, 2012

• I'm having an angiogram this Fri.. l have shoulder pain dizzy spells headache and cold sweats i am unable to exercise as i become breathless just climbing the stairs. iv been told if blockage is less than 50% they will do nothing . this is scaring me cause quality of my life is poor since Jan when all this started to happen .
worried 56 year old female, Hull, England, July 25, 2012

• IN august of 2001 i had 2 arteries that were blocked. One was 60% and the other was 55%.My doctor said that he doesn't put a stent in until 65% or higher. I was to quit smoking and change diet. Well i did nothing to help this matter and to be honest i smoked more and my diet got worse. I just didn't listen and now i feel really horrible everyday. My blood pressure is now really high,and it gets low while under exertion?.Is it possible that within a year i could have gotten a lot worse that now i am at 65% or higher?..can that happen within a year?.I have had diabetes since 2000 and it was not controlled for 12 years. I am watching it and controlling it for the most part. My question is can i have gotten worse with my blockage within a year?
Kennydale, Ravenna, Ohio, USA, July 12, 2012

• Sir, I am of about 47. My angiography shows LAD 40 / RCA 60. PLEASE WHAT U ADVISE
DCNP, HEALTH, Peshawar, Pakistan, July 5, 2012

• Mr. Filipino and Rajib and "Doc" from India -- Read our post from May 8, 2012. We cannot give medical advice in place of a physician. But we can give you information that you can use to ask more questions. As FAME showed, a 60% lesion (as seen on angiography) may not necessarily be flow-limiting and may not need to be treated. It is wise to have a functional measure of ischemia (one that measures the oxygen flowing to your heart muscle) as well as a visual test, such as an angiogram. Certainly, we advocate for the use of fractional flow reserve during angiography, if no prior functional stress test has been done. That being said, Mr. Filipino, you certainly should stop smoking ASAP. Smoking is highly associated with coronary artery disease. Also, not sure what you mean by "deadly overnight drinker" but it doesn't sound healthy. Alcohol can be a relaxant, but it's been shown that "binge-drinking" can cause a host of health issues.
Angioplasty.Org Staff, Angioplasty.Org, July 4, 2012

• I'm 41yo from Manila, I just had a "trip" to fully utilize my health card last week and chose to check my heart via angiogram. I am an active person with at least 6hrs work out every week, thin since teens, now 150pnds, not a cholesterol addict, smoke a 5 sticks a day since 26, a deadly overnight drinker once every month respectively and having a religious monitoring of my health specially ecg once every 6months due to my anxiety with long history of family heart diseases. The angiogram found out that i have a 60 to 70% blockage on my LAD. SINGLE VESSEL ONLY. Cardiologist advice me of immediate angioplasty. Is there any other solution? I'm so depressed and i think I'm still too young to place foreign object to my body.
Mr. Filipino, Manila, Philippines, July 3, 2012

• My father's (age 58) Angiogram report revealed LMCA – Normal, divides into LAD/LCX. LAD – Type 3, mild plaquing proximal – mid LAD, 1ST diagonal 50% proximal disease – fair sized. LCX- Non dominant, last OM small caliber totally cutoff seen by grade 1 homocollaterals.RCA – dominant, normal. Please suggest whether he needed angioplasty.
Rajib S., Kolkata, India, May 24, 2012

• First off, Thanks for starting the most informational forum about CAD. My mom in law was diagnosed with various Artery blockage after undergoing Angio. Below are her diagnosis - 60% luminal narrowing in osteoproximal lad 70% luminal narrowing in mid lad50% osteoproximal RCA80% osteoproximal  mid RCA She has cholesterol, High BP and Diabetes, The levels are now within acceptable range. Her cardiologist has assured the blocks can be reversed w/o any surgery or stent ,with the help of medicines and changes in lifestyle (healthy diet,exercise and stress free life) . But people in similar situation have always had undergone stent or angioplasty. Is is possible to cure w/o any surgery? Can you also tell me with the above readings how severe or mild is her blocks? Should we get a second opinion? Thank you for your valuable insights.
Doc doesn't recommend Angioplasty/stent for 80% Blocked RCA. Any thoughts?, Chennai, India , May 24, 2012

• Sharad in Allahabad -- Neither this site nor any web site can answer this question -- it's a complex medical decision that you should be making together with your interventional cardiologist. As far as the U.S. guidelines go, the 30-40% lesion is not singificant and should probably not be done. The 70% lesions in your RCA are a bit of a question. Many, if not most, cardiologists would stent those. However, the FAME study, which measured lesion severity using Fractional Flow Reserve during the angiogram, showed that 1/3 of lesions 70% and greater were not significant and did not need stenting. Another question is whether or not you are having symptoms, significant enough to impact your day-to-day life. And whether or not you have tried optimal medical therapy (modern medications and lifestyle modification) first. These are but a few of the considerations that go into the decision to open a blockage.
Angioplasty.Org Staff, Angioplasty.Org, May 8, 2012

• I am 61 year old male, my angiography was done on 26 Apr 2012, findings are: LMCA: Normal, LAD: Type III Normal, LCX: Non dominant, Distal LCX has 30-40% Lesion, RCA: Dominant, Proximal RCA has 70% lesion, Mid to Distal junction has 70% lesion. LV ANGIO: Not Done Clinical diagnosis: TMT+ve, T2DM, HTN Procedure Detail: Through right radial artery approach, Coronary angiogram done using right and left judkins catheter. Kindly advise us whether we should go for angioplasty with two STENT. Regards, Sharad Saxena Allahabad
Sharad Saxena, Govt. Service, allahabad, uttarpradesh, INDIA, May 8, 2012

• Shani from Pakistan and Angioplasty from the UAE -- Whether or not to place a stent in a blocked artery is "the big question" being asked in many places. There's not much debate about this in unstable patients and virtually none in emergency heart attacks. But in stable patients there are questions as to whether stenting is appropriate or not. Basically, it is very much an individual call, based on the patient's symptoms, clinical status and, importantly, whether or not the blockage (lesion) is ischemic -- is it blocking the blood flow sufficiently to cause a significant lack of oxygen to the heart muscle? This is called a "functional measurement" and can be calculated fairly accurately using Fractional Flow Reserve, during the angiogram. Less accurately, a nuclear stress test may reveal ischemia. Most lesions greater than 90% are ischemic, but when you get down to 50-80% there is some variability. In the FAME study, 1/3 of the lesions measured at 80% were not ischemic and did not need stenting. These are questions to discuss with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, March 31, 2012

• I have had a heart attack two weeks ago. I am 42 year old male and all vitals signs were ok, no BP, no cholesterol (187 mg/dl), not diabetic and 69 kgs weight. Dr. immediately did PCI (stent) to proximal LAD (which was 100% blocked) using 3.0 x 18 mm DES followed by post dilution using 3.0 x15mm non-compliant balloon with residual stenosis. Now other blockages found is that LCX Mid 70%; distal 90%(small caliber vessel) RCA Mid 70 - 80% long segment. Dr. suggested to do PCI (stent) for both LCX and RCA. Please advise if this is necessary to put stent or can it be cured thru medication?
Angioplasty, United Arab Emirates, March 29, 2012

• Hi , my father (58 year old, smoker and hypertensive) just had Angiography. The Angiography reveals LAD-Mid has 90% obstruction, LVG EF 60% and LCX with plaque. After Angiography, The cardiologist who has done my Father Angiography has advice for Angioplasty (PCI with one DES). I have taken a second opinion from another local cardiologist who said that the blockage reveals in Angiography can be cure without Angioplasty with combination of proper Medicines, control diet and regular exercise (Medicines suggest to my father by second cardiologist are (Herbesser (diltiazem hcl) 30 mg 1+1+1 , lowplat (clopidogrel) 75 mg 1+0+0, Concor 5 mg 1+0+0, Disprin CV (once in a day) and Rovator (Rosuvastatin) 10 mg 0+0+1) Based on above two opinion from two different Cardiologist, I am quite confused and unable decide as to whom advise should I follow i.e. should we need to follow fist Dr. advise and go for my father angioplasty or continue with medicines as advice by second cardiologist.
Shani, Pakistan, March 15, 2012

• MSB in Saudi Arabia -- Which artery is your doctor planning to stent? It is true that, if a portion of your heart muscle is damaged, there's nothing to be gained by opening up an artery that feeds that portion. Whether or not surgery or angioplasty is the correct therapy in the artery or arteries supplying the viable portion of your heart is a question that needs to be decided on together by your surgeon, your interventional cardiologist and you.
Angioplasty.Org Staff, Angioplasty.Org, March 6, 2012

• I am a male of 60 years of age. I have a heart attack on 24th Oct. 2003. Then i was on medication & was absolutely yucky did not have any complain. On 26th.of Jan.2012, I had another severe heart attack. I have gone through a an angiogram test. Dr. told me that my main left artery is 100% blocked & 70% other 2 branches are blocked. Right side is absolutely ok. Dr.who has done angiogram has advised me surgery but the other doctors has told me that angioplasty can be done, but echocardiogram is required to see the heart muscles condition. My doubtamine echo stress has been done & another echo also carried out , I will get result tomorrow. My question is that as DR. has told me only one stent will be placed. Then what about other blocked veins? Kindly guide me in this regards.
MSB, Kingdom of Saudi Arabia., March 3, 2012

• Laura from Canada -- Although your question is somewhat "off-topic", we'll try to help. Do you know how long the blockage is? Stents are only made in certain lengths and the longer the stent, the higher the risk for restenosis (reblocking) and other possible complications. Stents certainly can, and often are, overlapped to treat blockages that are longer than the maximum single stent, although again overlapped stents are at somewhat higher risk for restenosis. In your husband's case, since we are talking about the LAD, which is a major artery, your cardiologists are being conservative and are concerned about doing anything that might compromise it. A state-of-the-art hospital may be one that has imaging techniques like IVUS or OCT where the stent placement can be done more accurately. Or perhaps it may be decided that bypass surgery IS the right way to go. Please update the Forum when you get more information about recommendations.
Angioplasty.Org Staff, Angioplasty.Org, January 15, 2012

• My husband had a heart attack over 10 years ago and has a 100% blockage which they have recommended to leave. But he has had a little shortness of breath and tightness of chest again and had an angiogram done which they discovered a 90% blockage (LAD) and a couple of 40% which were irrelative. So we were told that he would be called to put a stent in soon. But now we have got a call saying he has been turned down for a stent as the blockage is too long? and may have to have open heart surgery for one artery! The cardiologist is sending his file to a state of the art hospital with new techniques, but we don't understand why they don't do overlapping stents or some other procedure, in this forum I have not heard anyone mention this, any advice or thoughts would be welcome. And how long is too long before it can get to the point of another heart attack?
Laura Gail, Barrie, Ontario, Canada, January 15, 2012

• I have already had 2 heart attacks and 5 stents total. Two of which were replacement ones. My heart cath on 9-1-11 showed that I have a 60% 3 centimeter blockage in my right coronary artery. In that blockage are two stents that have been replaced once already and can't be replaced again because the artery won't take a larger stent. My doctor said that he wouldn't touch it and I am suppose to see him again the first part of December. I also have a 50 to 60% blockage in my left coronary artery. My question is why is by-pass being discussed at this point. The report said the one is clearly a trapped vessel. Any insight would be helpful. Thank you..
Donna H, Marble Falls, Texas, USA, October 11, 2011

• I just had a chemically-induced nuclear stress test. The cardiologist says I am okay but I am still not sure what the widowmaker is and if the nuclear stress test can show if the LAD is blocked. I am really concerned because I have CHF and I am swelling in my arms and legs even though I take all these water pills and heart medicine. Please advise me on anything else it could be. Thanks!
Florida Gal, Southwest, USA, September 8, 2011

• Is it true that bypass cannot not be performed if blockage is located low? Recently had nuclear imaging performed, indicated issue with blood flow. Next catheterized procedure performed, indicated 100% blockage right side, attempted stent, unsuccessful due to blockage. Now told cannot perform bypass as blockage is too low on the heart and being treated with medicine.
Bob, Center Harbor, New Hampshire, USA, September 6, 2011

• Bonnie in Illinois -- Checkout our Forum Topic on Carotid Stenting.
Angioplasty.Org Staff, Angioplasty.Org, July 30, 2011

• I have 60% Blockage on the right internal Carotid Artery and 39% on the left internal Carotid Artery. I have had a Carotid Doppler Ultrasound and a MRI and MRA test completed. I do not have the results back from the MRI and MRA. Is this all the tests that should be conducted so far with the above listed results? What is the standard treatment with the above findings? I am 47 years of age have excellent cholesterol (tested in June 2011) and do have Blood Pressure (2 1/2 years) that currently is running 140/90 with daily med of Metoprolol, 81 mg aspirin,furosemide, and a potassium pill daily. I have no other health issues I have never smoked tobacco or drank in my life. What other tests should be run? and what are my treatment options with above findings as of today?
BonnIe P., Oswego, Illinois, USA, July 23, 2011

• I had small heart attack 2 weeks ago. Am about 100 pounds over weight, lost already 100 plus pounds. Doc tried to do an angioplasty while in hospital last week, but said RCA 100 blocked. Talked with cardiologist today and they said also center artery 50% narrowing. I am on aspirin, blood pressure medicine, Renexa 500 and Crestor. Is this my life now? I am 58, just retired this year and now a heart attack. Is bypass an option for me. Docs want to treat with medication now. I do not want to be a sleep, tired and bruised all day. Any help or suggestions for me. Very scared and do not want to live this way if bypass can fix or eliminate meds and give me back a quality life I am up for the risk and rehab. Thanks.
Geoff, Pleasant Hill, California, USA, July 19, 2011

• I had a heart attack on 29 April 2011. I had left coronary artery 50% blocked and another left distribution 30% blocked. I had a stent for the 50% blockage. I am on medication to bring down my blood pressure and heart rate. My BP and heart rate is 95/65 and 60. Before my heart attack, my BP is around 115/70. Is my current medication bring my BP and heart rate too low? Should I see my doc to adjust my medication?
Harold, Homemaker, Singapore, May 13, 2011

• A 100% block is also called a CTO (Chronic Total Occlusion). A blockage in the LAD is normally called the "widow-maker", because most people are "left-dominant" and the LAD is the most important artery. But some people are right-dominant.
Angioplasty.Org Staff, Angioplasty.Org, May 12, 2011

• I was wondering about terminology and I guess the eventual conclusion of of what a term means. Is a 100 percent block- of the RCA considered the Widow Maker or does that only apply to the Left? Thanks.
Campbell, New Jersey, USA, May 10, 2011

• Don in Michigan -- the functioning of the heart muscle is usually measured as part of an angiogram -- it's called the ventriculogram and contrast dye is injected directly into the ventricle and the resulting image as the heart expands and contracts yields information about how well the heart muscle is moving. This measurement is called the ejection fraction (EF). This can also be seen to some extent in a echocardiogram. If there has been damage to the heart, one of these tests would show it. The heart muscle can actually withstand an hour or more of complete blockage before it starts to die, which is why it is important during a heat attack to get to a hospital that does angioplasty ASAP.
Angioplasty.Org Staff, Angioplasty.Org, May 7, 2011

• I have read some of the Editor's posts where he/she commented about 'reduced' blood flow to the heart [muscles I assume] as blockage develops and increases. I had a overlap stent(s) put in my LAD which was 99% closed. The doctor said, "I think your heart is ok." I had erroneously thought as long as an artery had any blood flow at all there would be no damage to the heart. Are you able to give us some idea how much heart muscle may be weakened as blockage approaches 99%?
Don in Michigan, Troy, Michigan, USA, May 7, 2011

• HopelessinNC -- Your post here is sort of off topic, but we'll try to answer. It's not clear from your post if your husband had an angiogram done. That would be the only way that his cardiologists would know how much and where the plaque in his arteries is. If there is plaque in many places in several arteries, what is known technically as "diffuse disease", then angioplasty is probably not the recommended therapy. Why they feel bypass is too risky we can't say. Have you talked with a cardiac surgeon? Perhaps a second opinion is warranted. You'll want to make sure to have all his records, including any angiograms. As for Plavix, if your husband is already on Coumadin, then that is a blood thinner -- the addition of Plavix, another blood thinner, would increase the possibility of bleeding complications. And Plavix is not a magical "plaque-preventer". It keeps the blood platelets slippery so they don't clot. We assume your husband has done everything possible to lower his risk factors (taking meds, diet, exercise and stopping smoking, if he does).
Angioplasty.Org Staff, Angioplasty.Org, April 30, 2011

• My husband was sent to our infamous "heart institute" here in NC. Needless to say, he was supposed to have an angiogram or plasty, I can't remember, last september. They prepped him and took him down for his echocardiogram. When he was brought back, the team of cardiologists came in and said there was no way they could perform the angio due to the amount of plaque and come to find out, blood clots. Why can't they perform Bypass Surgery to correct this. They won't even give him Plavix or something to help with the plaque, says its too dangerous. He's 49 had 2 strokes, a heart attack..only we don't know when. They left us with saying he was a "walking time bomb" and to continue taking the cholesterol meds and of course...COUMADIN!!! Does anyone know what would be the problem with a Bypass??? They said his level of oxygen is running between 50 percent in the main arteries and less other places. Can someone help with some information PLEASE!!
HopelessinNC, Jacksonville, North Carolina, USA, April 30, 2011

• Buffaloconcerned -- Sounds like the original angioplasty from 10 months ago was a "kissing stent" situation, where two stents are used at a branch (a.k.a. bifurcation), often the LAD/LADD (Diagonal). Although we obviously can't be sure. Bifurcation stenting is somewhat more prone to restenosis, because it is a complex anatomy. We can't say why the 40% progressed to a 90% in one year but, as you say, the increased lipids may be contributing. Sounds like you are doing everything you can. Did your cardiologist have any further recommendations as to the prognosis of the 90% lesion and any effects if it closed? Yours is a complex situation, both medically and anatomically. Your current cardiologist may be absolutely correct, but you might want to seek a second opinion from either another interventional cardiologist, or even a heart surgeon, to see your options. Let us know.
Angioplasty.Org Staff, Angioplasty.Org, April 27, 2011

• I had angioplasty 10 months ago and had two stents placed below a congenital malformation at the branch of the left anterior descending artery. There was a 40% blockage in the top of the second branch which was considered non eligible for stenting. A follow up angioplasty two weeks ago found a new blockage below the two stented ones. The cardiologist stented it. The previously unstented 40% blockage had grown to 90% and could not be stented. This has occurred despite dietary changes, medications including fish oil, statins, etc... HIV medications seem to have increased lipid and tryglyceride levels but not to extreme levels. I am overweight but losing and did cardiac rehab. What do you suggest? How do I deal with the 90% blockage and do the HIV drugs indicate that I may have a severely shortened life span due to the elevated lipids? Please help.
Buffaloconcerned, Buffalo, New York, USA, April 26, 2011

• had angiogram performed and was told there were 2 blocked arteries that were not repairable mechanically and medicines were the preferred treatment. what does that really mean? i have had 4way bypass done years ago along with followup stents years later. this was done the other day.
Ronchi, Millsboro, Delaware, USA, March 4, 2011

• Sharon from St. Paul -- check out our Forum Topic on "Carotid Stenting". Also read our interviews with Dr. Christopher White and Dr. L. Nelson Hopkins - Part 2.
Angioplasty.Org Staff, Angioplasty.Org, November 21, 2010

• Juniper- I just returned from having an ultra sound done on my right carotid artery. My Left carotid was diagnosed as 100% blocked 2 years ago. What options might be presented to me to address the current levels of plaque buildup (69%) now on the right side under the circumstances.
Sharon from MN, St. Paul, Minnesota, USA, November 19, 2010

• Tina -- If you are not feeling secure with a diagnosis, it's always a good idea to get a second opinion -- if only to feel secure about the recommended course of action. Diabetics are at higher risk for stent restenosis, so drug-eluting stents are the device of choice. Some studies have shown that paclitaxel stents (Taxus) may inhibit restenosis in diabetics better than others -- although this is not a hard fact. However, all drug-eluting stents require Dual AntiPlatelet Therapy (DAPT) for at least a year -- consisting of Plavix (clopidogrel) and aspirin. With the allergy to aspirin and the complication of bleeding ulcers, your relative is at higher risk for bleeding complications -- a definite side effect of DAPT. Is your relative experiencing pain, angina?? The decision not to stent or do bypass may be related to which arteries are blocked. Also how were these blockages determined. Through an angiogram?
Angioplasty.Org Staff, Angioplasty.Org, September 9, 2010

• 75 yr old diabetic relative with 3 blocked arteries: 50%, 70% and 100%. Passed echocardiogram, Nuclear Stress, EKG. Allergic to aspirin: docs decided to not do stents (due to aspirin allergy + history of bleeding ulcers) or full by-pass. Is this conventional care? Or should we ask for a second opinion from another cardiologist??
Tina, Boscobel, Wisconsin, USA, September 9, 2010

• Donna -- This topic is about coronary artery blockages. You might want to check out our Forum Topic on "Questions about Carotid Artery Stenting (Angioplasty)". While we cannot give you medical advice per se, a 30% blockage in a large artery like the carotid is not critical, but you've got warning signs which, with correct medications and lifestyle changes, may be able to be brought under control. Not sure plaque can be reduced, but the progression can be slowed or halted.
Angioplasty.Org Staff, Angioplasty.Org, September 8, 2010

• I just returned from the doctor who confirmed that I have bilateral carotid artery stenoses as shown on the doppler ultrasound. The degree is less than 50% which I take it to be in the 30% range I guess. She continued my cholesterol meds and added a couple of supplements that when together they work to reduce the plaque. I do not have insurance currently so my family doctor is treating me. Does this sound normal?
Donna, Las Vegas, Nevada, USA, August 30, 2010

• blue72 -- Your husband's condition is complex and your question is not something that can be answered long-distance. You should ask his cardiologists to explain fully what they are doing and why.
Angioplasty.Org Staff, Angioplasty.Org, August 30, 2010

• husband had tread mill test done friday, fell down after test had to use paddles twice to bring him back, he has 100% blockage in one artery, 95% 70 % in other two, they want to put in defibrillator in on monday, what are his chances of surviving with this action.
blue72, Independence, Missouri, USA, August 28, 2010

• John in Indiana -- First off, nothing on this Forum should be used as a substitute for medical advice from a doctor. We can suggest that you consult an interventional cardiologist with your records and your angiogram and see what he/she says. Single vessel disease, if that's all you have, is ideal for interventional treatment (angioplasty, stent, etc.). Open heart surgery is seldom done these days for just one blockage. We would guess that your surgeon's plan is to deal with both the blockage and the aortic aneurysm in the same operation. But if your aneurysm has not progressed, perhaps that can be put off. Again this is not advice, but just a suggestion to get a second opinion from an experienced interventionalist. He/she may concur with your surgeon, especially when considering the aneurysm...or not.
Angioplasty.Org Staff, Angioplasty.Org, August 11, 2010

• I recently completed an angiogram after my cardiologist found tissue in my heart was not getting enough blood supply during a tread mill test. The angio confirmed a 60% blockage in the widow maker artery. I am 69 years in age good health, quit heavy smoking 30 years ago, have shortness of breath climbing one flight of stairs and have heart disease as a factor from both parents. Otherwise I walk playing golf and function normally without pain or discomfort in the chest area. I have been treated the last three years for an aorta aneurysm which has not grown according to MRIs on a yearly basis. A consult with a heart surgeon resulted in being advised to have open heart surgery and not angioplasty. My questions are:
1. Is angioplasty possible and safe to reduce the blockage.
2. Would it be advisable to do the bypass and the aneurysm during the same operation?
3.Would you advise additional testing with another angiogram?
4. What are the percentages of having a sudden death if I do nothing and live with my shortness of breath.
5. What would be my estimated life expectancy if I do nothing?
Thank you so much as I don't want to deal with open heart surgery and the risks.
John, Retired Attorney, Griffith, Indiana, USA, August 11, 2010

• Tim -- atherosclerosis can develop and/or progress quickly sometimes. The biology of plaque in vessels is complex and, while more is being discovered daily, the precise answers to your questions are not totally known. When they are, doctors will have come close to actually preventing coronary artery disease. What is known is that heart attacks can be caused by so-called "vulnerable plaques" which may not be large in thickness, but may be at high risk for rupturing. These typically are called TCFAs ("tik-va") or Thin-Cap FibroAtheromas -- they are a pool of lipid-rich material contained by a thin layer of fibrous plaque. If this plaque ruptures, the lipid-rich material leaks into the blood stream in the artery and causes clotting, sudden reduction of blood flow and often a heart attack. Patients who have had a previous MI are often put on antiplatelet drugs, certainly aspirin and often Plavix, to lessen this risk. As for progression of your blockages from 50% to two higher grade ones, it's hard to say. It's possible that the original cath was not accurate or that this artery, which was the cause of your small MI became thrombogenic and more prone to closure. One imaging technology that we at Angioplasty.Org have been writing about, and which many feel is more accurate than angiography alone, is the whole area of intravascular imaging and measurement: IVUS and FFR. You can read about these more in our Intravascular Imaging Center.
Angioplasty.Org Staff, Angioplasty.Org, July 22, 2010

• I had bilateral knee replacement mid March. I had a chemical stress test done and was told everything looked good 4 weeks before. 3 days after surgery I was told I had a mild heart attack in which they did a heart cath and said I had 50% blockage and it wasn't enough to repair. I was told my EKG and everything was back to what it was before the attack. I was told it was as minimum of damage posssible.Four and a half months later while mowing the yard my chest started hurting so upon seeing my cardio doctor he said I needed another heart cath done. My BP was up to 190/100. They discovered the same artery was 90% and 75% blocked in 2 different places. I ended up with 2 stents put in place. I was put on lipitor and BP meds after the first ordeal. My question is how did this all happen after less then 5 months. Believe me my wife is a RN and since we've been together for 15 years, I watch what I eat.
Tim, Cincinnati, Ohio, USA, July 22, 2010

• Ken29410 -- Not sure what your doctors meant by "too narrow for open heart surgery". Open heart bypass surgery, also known as CABG (Coronary Artery Bypass Graft) is meant to provide blood flow to the heart when the artery is too narrow. If there are specific areas of narrowing, they can be opened with a stent, but when the narrowing is diffuse in several vessels, CABG is the recommended procedure. Perhaps they meant that your artery is not suitable for bypass grafting for some other anatomical reason. Our only suggestion is to get them to explain your situation to you more clearly, so you understand, or possibly you could get a second opinion, if your coverage allows it.
Angioplasty.Org Staff, Angioplasty.Org, July 16, 2010

• I was told that my LAD was too narrow for open heart surgery and there were two stents placed. This was done by the Dept of Veterans Affairs Hospital. I don't trust these people but have no choice. What is the outlook for someone like me? Is that accurate or can it be done? I'm 46 yrs old and really don't want to croak yet.
ken29410, South Carolina, USA, July 16, 2010

• Posters to this topic in particular should read today's article about findings from the FAME study. And "Heartbreak" -- you should ask your cardiologist this question, especially in light of these recent findings about FFR.
Angioplasty.Org Staff, Angioplasty.Org, June 23, 2010

• had a ct angiogram a few weeks before i'm scheduled for avr surgery. my surgery is one week from today. cardiologist just called me today saying that an artery in front of my heart is 50% blocked. Wants me to go in wednesday to have a cardiac cath. he said if artery is 50% blocked, they will do nothing, but if more than that, they will do this bypass surgery when i have my avr on friday. do you know why they even have to do the cardiac cath since they already know from the ct angio that it's 50% blocked? what's going on now?
Heartbreak, Virginia, USA, June 18, 2010

• Susan -- one of the downsides of stents is the occurance of blood clots (thrombosis) inside the stent. Your husband's genetic condition (FVL) puts him at higher-than-normal risk for this, so the need for a stent would have to outweigh the risk of having a clot form.
Angioplasty.Org Staff, Angioplasty.Org, June 17, 2010

• My husband has had ALL the coronary tests. His RCA is 100% blocked with collaterals, left anterior descending is 75% blocked, left circumflex 60-65%. Cardiologist performed cath and did not do anything. Case is complicated because of Factor V Leiden (he has had 2 blood clots in knees). Do you know of any studies involving FVL and stenting? They are using a medicine-approach (isosorbide) to try and help his shortness of breath. Thanks!
Susan S, Dexter, New York, USA, June 15, 2010

• Faye -- Sounds like you had an angioGRAM, not an angioPLASTY...an angiogram is a diagnostic test; an angioplasty is where a blockage is actually opened up with a balloon and stent. Most cardiologists would agree with yours -- a 40% blockage should not be treated, unless it can be shown to be in some way a problem. While most use percentage as a guide, this can be misleading, according to some recent studies using Fractional Flow Reserve (FFR) which measures the actual effect of the blockage on blood flow, rather than the percentage.
Angioplasty.Org Staff, Angioplasty.Org, June 12, 2010

• I had an angioplasty on Thurs, June 9th. Doc said there was only 40% blockage in one artery. They would just monitor over time; that they only put a balloon or stent in, for 60% blockage or more. Does that soumd right?
Faye, Magnolia, Texas, USA, June 11, 2010

• See previous responses. A blockage is a sign that coronary artery disease exists, but it may not be severe enough to warrant a mechanical intervention, such as a stent. Optimal medical therapy and lifestyle changes can go a long way to minimizing your risk factors for heart disease. You should discuss a program with your doctor.
Angioplasty.Org Staff, Angioplasty.Org, June 10, 2010

• I have 50% blockage and would like to know what the effects of drinking alcohol are on my condition. I do drink and have all my life drank anywhere from 10-25 drinks on average per week.
Waterloo12, Waterloo, Ontario, Canada, May 30, 2010

• Hi, I am 44 years old and during my regular check up the ekg was abnormal. They sent me to ER and their EKG showed normal. The doctor recommended an angiogram and found 30 percent blockage in all arteries. I am taking crestor for high cholesterol. how can i prevent heart attack and live a healthy life? thanks.
rb1965, Greenville, South Carolina, USA, May 27, 2010

• Pat -- See response below to Brian. Lower your risk factors as much as possible and comply with the prescribed medications. A 60% blockage may or may not be causing reduced blood flow. How was this figure arrived at? Did you have an angiogram? One tool that can be used during an angiogram is an FFR (Fractional Flow Reserve) catheter, which can determine if the blockage has "functional significance" and stenting may help. But treating a blockage that is not causing a problem is actually not recommended -- see FAME study.
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2010

• I had a heart attack approx 10yrs ago. I have had an angioplasty, now the doc tells me there is a 60% blockage in the same artery, which he will treat by medication. Is there a cause for concern.
Pat Mc., Ontario, Canada, May 12, 2010

• Brian -- 30-35% blockage is low. That combined with the negative results on the battery of other tests should rule out problems from coronary artery disease. Do you have risk factors that would make you concerned, such as smoking, weight, cholesterol, and family history? Managing stress better is very good thing for anyone. See if relaxing and not worrying that something is wrong with you helps. Dean Ornish prominently features meditation and relaxation in his therapeutic program for patients who have significant coronary artery disease, so there are definite benefits.
Angioplasty.Org Staff, Angioplasty.Org, April 29, 2010

• For the past month or so have had shortness of breath, dizziness, anxiety (i have a history of anxiety/panic), and chest heaviness. A few years back had very similar symptoms and had ekg, echo, tilt, nuc. stress, reg. stress and everything came back fine. This time they felt we should do an angiogram and found a 30-35% blockage in the front artery and another area of a heart vessel that was slightly dilated. Doc's says symptoms I am having most likely are not coming from what they found. He recommended to just lower cholesterol and take aspirin and to recheck in one year with stress test. I am very worried about what they found and feel like a ticking time bomb. Am I blowing this out of proportion. I have already changed my diet, exercise and am trying to manage stress better. Doc says that most people have plaque buildup by their 40's and do not be overly concerned. I am still extremely worried, would a second opinion be helpful?
Brian, Chicago, Illinois, USA, April 29, 2010

• Mike -- maybe it's stress from life. There are two non-invasive tests that could reveal more: a nuclear stress test and a CT Angiogram. You can read about them in our "Patient Guide to Heart Tests". Sometimes stress is caused by not knowing if you should be stressed! More and more, cardiologists are beginning to think that a CT Angiogram may be the better test in cases of intermediate or indeterminate causes of chest pain. Talk to your cardiologist about these. A CT Angiogram is very accurate in terms of ruling out coronary artery disease. If you do decide to get one, make sure the technicians use dose-reduction protocols. If they don't know what you mean, go somewhere else.
Angioplasty.Org Staff, Angioplasty.Org, April 28, 2010

• Hello, I am a 40 year old male. I have been having chest pressure(not pain) that comes and goes on the left side, and also pressure in the upper left arm area for over a week now. I had the same problem about 10 months ago, and at the time my cardiologist performed a number of tests including a stress test, eco cardiogram, ekg, and everything was fine. In this more recent episode, I went to my cardiologist three days ago, and he performed another ekg, chest X-rays, and it was again negative. I do have a family history of heart disease, and my cholesterol is 230 (LDL is 140). My problem could very well be stress related, as I have a lot of stress and anxiety in my daily life, but I want to rule out any potential problems associated with my heart. What should I ask my cardiologist beyond what he has already done to rule out any heart related problems. Thanks in advance.
Mike, Los Angeles, California, USA, April 27, 2010

• Judith -- Only your doctors can give you "medical advice". A 50% blockage is usually considered the minimum for an intervention like angioplasty -- but it really depends on whether that blockage is actually causing a reduction in blood flow to the heart muscle. The visual size of a blockage does not necessarily mean that this blockage is a problem. Have you had a nuclear stress test, which would measure whether the blockage is causing ischemia (reduced blood flow and oxygen to the heart)? Certainly, reducing your risk factors is number one, so what your doctors prescribed (meds, diet and exercise) seems reasonable.
Angioplasty.Org Staff, Angioplasty.Org, April 25, 2010

• I'm a 63 year old female. I have disabling emphysema, and a 50% blockage of the left coronary artery determined yesterday by catheterization I had all the symptoms of heart attack 4 weeks ago but no heart damage as it lasted 15 seconds. They say the plaque is soft, but the calcium scoring said differently. They suggest exercise, diet and an LDL lowering drug, my total cholesterol was 207 and I have very low blood pressure, and no family history of heart disease. but No guidelines are given for exercise. Do I just wait for the next heart attack? lol This seems inappropriate, wrong in fact. Can you advise me?
Judith R., Honey Brook, Pennsylvania, USA, April 21, 2010

• Jose -- you have small blockages, and taking steps to reduce your risk factors is precisely the right direction -- as for whether or not to take a statin like Crestor, that's something you should discuss with your cardiologist. Some people's physiology just won't go below a certain level of cholesterol -- and statins have been shown to have benefits in more than just lowering the numbers, but each individual is different. Certainly your progress has been very good!
Angioplasty.Org Staff, Angioplasty.Org, March 30, 2010

• I did a CAT. My LAD is between 25 and 50% blocked beginning 1/3 medium. Discrete irregularities in the proximal, 25%. Everything else is fine. I take medication to control my blood pressure. I was able (by losing weight and right diet) to reduce my cholesterol LDL from 153 to 120 within 40 days. My doctor prescribed aspirin and also a cholesterol drug - Crestor 10mg. He wants my LDL to reach 70. Do you think he is exaggerating a little bit? I believe I can reach LDL 100 w/o medication. Wouldn'tīt that be enough? I do not like the idea of taking cholesterol reducing medication. Thanks Joe. I will be 59 in may.
Jose Castro, Brasman, Columbus, Ohio, USA, March 27, 2010

• I wish that I had at least hadn't had my heart attack on Thanksgiving Day. We were one of the lost job, home, and ended up staying a week with our son and his wife, and our 2 year old grandchild. You can imagine the stress. I had been having jaw pain, ear pain suddenly and then it felt like something exploded in my back. I couldn't get warm, i was vomiting every fifteen minutes. Paramedics took me no matter what they gave me it did not stop the pain. The stress test lasted about 7 seconds, my heart was beating over180 . They said I had 30 percent blockage. they said I needed a pace maker and a stent. How long before and also blood pools up in the back wall of my heart. When i stand up my blood pressure goes up and when I sit or lay down it goes too low, I mean up as 240/120. Then when I lay down it drops to 60/40.
Colleen A., Tennessee, USA, February 12, 2010

• Anne from the UK -- we assume you are on other meds as well. Certainly an annual visit to the cardiologist would be wise, although an EKG is not necessarily going to show the extent of any blockage. For that a stress test or possibly a CT Angiogram might be indicated -- if symptoms return.
Angioplasty.Org Staff, Angioplasty.Org, January 7, 2010

• I am a 53 year old woman who had a heart attack 2 years ago. My LAD was destroyed and I had significant muscle damage so that I am on Warfarin for life. My RCA is 50% blocked but my consultant has discharged me. I worry that the RCA becomes more blocked but no-one will know. Other than that - I feel fine with no angina. Should I pursue for yearly/six-monthly echocardiograms?
Anne Howe, Yorkshire, United Kingdom, January 3, 2010

• I just had an Angiogram and am blocked 20% in 2 main arteries and 30% in 2 spots in the main artery.On beta blockers the nitro patch and Crestor. They think I might have Angina.
Carol Loitsch, Paris, Ontario, Canada, January 1, 2010

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