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Angiogram Showed Plaques In The Distal LMCA And Significant LAD Ostial Stenosis. Any Solution?

Posted on Tue, 28 Aug 2012

Question: I am 40 years old and I went for a normal check up and ended up to do an angeogram. And, the findings are Plaques in the distal LMCA extending on tp LAD.
LAD: 70% OSTIAL lesion. Rest of the LAD apperas normal
Lcx: No Significant lesion. Dominent vessel
RCSA: No-dominant vessel: Normal

Final Diagnosis:
Significant LAD Ostial Stenosis

Answered by Dr. Sourav Ganguly (3 hours later)

Hi,

Thanks for your query.

For Predicting the prognosis, blocks found on Coronary Angiography is not enough; we need to know the symptoms you have.

70% stenosis in LAD in asymptomatic patient can be treated with medication if he/she is cardiologically stable. If he/she adheres to doctors prescribed medications strictly though coronary artery blocked cannot be reversed with the help of medicines, he/she can lead a normal life.
One can only help in preventing the further damage by keeping a good control on serum lipid profile; by some cholesterol lowering medicines like statins, antiplatelet drugs like aspirin, clopidrogel etc. and anticoagulant like warfarin, heparin etc. Most of the patients are doing well with those medications without increasing the block.

But if the patients is symptomatic (chest pain, respiratory distress, unconsciousness etc.) or poor drug compliance then revascularization is the best procedure for him. The revascularization is done by angioplasty and stenting.

Consult with your cardiologist and follow his advices for further management.

Hope I have answered your query. If you have any further questions I will be happy to help,
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish you good health.

Thanks,
Dr Sourav Ganguly

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sourav Ganguly (16 hours later)

Sir,

Thank you very much for your quick response. As you mentioned on top, I have been taking these medicines.

1. Clopidgogel
2. Aspirin
3. Repace 2.5
4. Avas 40MG
5. Concor

The doctors says since the blockage in the distal LMCA extending on tp LAD, graft will be better than angeoplasty.

I never had any chest pain but I went to the doctor for difficulty in breathing. Eventhough, I am taking these medicines now, I have difficulty in breathing and I had to take a XXXXXXX breath ( 2-3 tims) every minute.

Please advise.

XXXXXX

Answered by Dr. Sourav Ganguly (3 hours later)

Hi,
Thanks for your query.
I told you earlier that if the patients is symptomatic (chest pain, respiratory distress, unconsciousness etc.) then revascularization is the best procedure for him. As now you have symptomatic with 70% LAD blockage so you need a revascularization procedure. What your doctor said is absolutely correct that since the blockage in the distal LMCA extending on top of LAD, graft will be better than angioplasty.
So please follow his advice. Please don’t wait so much time in taking decision.
Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion and rate the answer and write a review.
Wish you good health.
Thanks,
Dr Sourav Ganguly

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar