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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Possible To Have Blockage Even If ECHO And ECG Are Normal?

Hi.I am diabetic. My ECG and ECHO reports are normal and I don t have any pain in chest as well. I can walk properly and climb stairs without fatigue. But my TMT was positive and I underwent angiogram. In that it shows around 90℅ blockage in LCA. Now docs have advised me for CABG. Is it alright? Is it possible to have so much blockage even if my ECHO and ECG are normal?
Fri, 7 Aug 2015
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Cardiologist,  's  Response
Hello. Thank you for your question and welcome to HCM. I understand your concern.

Yes. It is possible. EKG is a test that reveals the ad hoc, at the moment, state of electrical system of the heart. If there is some acute ischemic process going on, it is captured by the EKG, because these problems, in acute setting, are reflected in it. Echocardiogram is a very useful tool to asses the status, movement and function of the heart wall, valvular system and other. It is very sensitive and specific if you had a recent or remote myocardial infarction, but it cannot depict blockages in the coronary arteries.

Diabetes does significant changes to arteries of various diameters, in the body. It does not spare the coronary arteries either. I do not have your angiogram report to tell you more, but if coronary artery bypass grafting was recommended to you, then it must have been at least two-vessel disease and/or coronary blockage in a critical site, where stent placement carries a lot of risk.

I hope I was thorough with my answer. Good luck with the procedure.

Best regards,
Dr. Meriton
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Is It Possible To Have Blockage Even If ECHO And ECG Are Normal?

Hello. Thank you for your question and welcome to HCM. I understand your concern. Yes. It is possible. EKG is a test that reveals the ad hoc, at the moment, state of electrical system of the heart. If there is some acute ischemic process going on, it is captured by the EKG, because these problems, in acute setting, are reflected in it. Echocardiogram is a very useful tool to asses the status, movement and function of the heart wall, valvular system and other. It is very sensitive and specific if you had a recent or remote myocardial infarction, but it cannot depict blockages in the coronary arteries. Diabetes does significant changes to arteries of various diameters, in the body. It does not spare the coronary arteries either. I do not have your angiogram report to tell you more, but if coronary artery bypass grafting was recommended to you, then it must have been at least two-vessel disease and/or coronary blockage in a critical site, where stent placement carries a lot of risk. I hope I was thorough with my answer. Good luck with the procedure. Best regards, Dr. Meriton