
Heart Attack. Done With Angiography And Having Mild Chest Pains. Is It Necessary To For Surgery?

Question: Dear Dr,
My dad (56year old) had a heart attack. Angiography was done and has confirmed:
1) There are two arteries blocked. (a) Left Artery, just below the LAD, and (b) Right, quiet low down (after almost 3 intersections).
2) The Left atery is not significantly blocked and that right is the culprit.
3) The right artery is at least 90% blocked.
4) There is no evidence of muscle damange. The inferior wall is a bit lazy, but still alive.
The concern for Dr is that the blockage in the right artery is quiet low, and a challenging place to reach, and therefore conducting Angioplasty and placing stent(s) is a risk. CABG is not recommended because only one blockage is significant.
He has been on medical treatment (cholesterol control, BP, Blood thinning (tablet and claxane twice a day) for the past 3 weeks, and feels relatively stable. He was discharged for a few days. While he was discharged, Dr did not give any claxane. He had very mild chest pains after two days.
He is not diabetic nor hypertensive.
I can email Angio stills and Mibi report.
Would you suggest that he remain on Medical treatment or go through surgical treatment?
Thanks...
Regards
My dad (56year old) had a heart attack. Angiography was done and has confirmed:
1) There are two arteries blocked. (a) Left Artery, just below the LAD, and (b) Right, quiet low down (after almost 3 intersections).
2) The Left atery is not significantly blocked and that right is the culprit.
3) The right artery is at least 90% blocked.
4) There is no evidence of muscle damange. The inferior wall is a bit lazy, but still alive.
The concern for Dr is that the blockage in the right artery is quiet low, and a challenging place to reach, and therefore conducting Angioplasty and placing stent(s) is a risk. CABG is not recommended because only one blockage is significant.
He has been on medical treatment (cholesterol control, BP, Blood thinning (tablet and claxane twice a day) for the past 3 weeks, and feels relatively stable. He was discharged for a few days. While he was discharged, Dr did not give any claxane. He had very mild chest pains after two days.
He is not diabetic nor hypertensive.
I can email Angio stills and Mibi report.
Would you suggest that he remain on Medical treatment or go through surgical treatment?
Thanks...
Regards
Brief Answer:
Yes - he should go for CABG (bypass)
Detailed Answer:
Hi friend,
Welcome to Health Care Magic
He should go for bypass surgery ...
The aim of an investigation is to modify the treatment based on the result....
90% block / inducible ischemia / and symptom are indications for intervention.
Since angioplsty is a risk, bypass is a must... even otherwise, bypass is better anyway
Earlier the better – the aim is to prevent infarction
Aggressive management of risk factors is a must till then..
Take care
Wishing speedy recovery
God bless
Good luck
Yes - he should go for CABG (bypass)
Detailed Answer:
Hi friend,
Welcome to Health Care Magic
He should go for bypass surgery ...
The aim of an investigation is to modify the treatment based on the result....
90% block / inducible ischemia / and symptom are indications for intervention.
Since angioplsty is a risk, bypass is a must... even otherwise, bypass is better anyway
Earlier the better – the aim is to prevent infarction
Aggressive management of risk factors is a must till then..
Take care
Wishing speedy recovery
God bless
Good luck
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar

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