Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
I believe your tendency of getting your normal coronaries, stented arteries and grafts getting block faster than others because of your Diabetes and perhaps genetic predisposition. Normally, after a successul CABG it is unusual for graft or native artery occlusion as early as 3 years. Therefore, among please keep tight control on your modifiable risk factors. Like your HBA1c value for control of diabetes ought to be always below 8. Other factors which you ought to take care of are :
1. Good cholesterol (HDL) > 40 mg
2 Bad Cholestrol always low i.e LDL <100 mg%, Triglycerides <150 mg %, and total below <190 mg %)
3. Blood Pressure always controlled.
4. No Smoking
5. Fair amount of slow steady frequent exercise to cover small distances each time as per your doctor's advice.
6. Philosophical attitude towards stress which; stress is universal it is reaction which matters.
7. Weight contol.

Chest discofort during your morning walk is angina equivalent symptom. Please take a tablet of sorbitrate sublingual rest for 10 minute and then walk. As it is, Diabetics do not get typical chest pain. Please ask your cardiologist he may want to schedule another coronary angiography as you have not mentioned whether you went in for revascularisation in 2011.

Other thing I am tempted to correlate is your symptom of swallowing with enlargement of one chamber of heart, when was your last echocardiography, Doppler examination done? How much was your ejection fraction and whether there was any leakage of mitral valve written as mitral regurgitation.

The course of coronary artery disease after surgery and stenting (the methods of revscularisation) vary from person to person, there is nothing to be disheartened about you will have to fight it out. Therefore, be on follw up with your cardiologist, he is the best judge of a particular situation. One thing is sure, howsoever, severe a situation may be everything has potential treatment in cardiology.Good luck.

If there is further query which you might have I will be most happy to answer. Good Luck.

Regards

With Best Wishes:
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW

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Thanks for writing back.
The part that restenting was done in 2011 was missing.
Heaviness in chest means there is disparity between demand and supply of blood to the heart. Therefore, sorbitrate and rest. One can take as many as 5 tablets a day. But that would mean frequency of demand outstripping the supply for 5 times. Meaning, an indication for coronary angiography of graft and native vessels both.
No, in the setting of accelrated atheroclerotic coronary artery heart disease, thinking of other cause will not be prudent, it is cheating on oneself.
Please, restrict to two small pegs that is 60 ml of total of Whisky, Rum or Vodka or one glass of wine. Anything beyond that is positively harmful. Habituation is not an excuse for fatal attraction. You ought to have resolve.
My suggestion is to choose a cardiologist, there are some very good cardiologist in Mumbai. Depends on which part of the city you live. Let him guide you through this difficult phase of your life. Promise to yourself that you will follow his/her every suggestion and approach your cardiologist in what you perceive as an emergency how trivial it may seem. You will do well. Good Luck.
With Best Wishes.

Dr Anil Grover
Cardiologist

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Thanks for your kind words.
Please close the query with comments and stars.
It was a pleasure interacting with you.
Thank You

Anil Grover

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