Cardiac catheterization. With this procedure, a wire is passed into the coronary arteries of the heart and X-rays are taken after a contrast agent is injected into an artery. It's done to locate the narrowing, blockages, and other problems.
Nuclear scanning. Radioactive material is injected into a vein and then is observed using a camera as it is taken up by the heart muscle.
This indicates the healthy and damaged areas of the heart. Modification of risk factors. Risk factors that you can change include smoking, high cholesterol levels, high blood glucose levels, lack of exercise, poor dietary habits, being overweight, and high blood pressure. These decrease blood clotting. Aspirin, clopidogrel, ticlopidine, and prasugrel are examples of antiplatelets. These lower lipids fats in the blood, particularly low density lipid LDL cholesterol.
Statins are a group of cholesterol-lowering medicines, and include simvastatin, atorvastatin, and pravastatin, among others. Bile acid sequestrants--colesevelam, cholestyramine and colestipol--and nicotinic acid niacin are other medicines used to reduce cholesterol levels.
These lower blood pressure. Several different groups of medicines work in different ways to lower blood pressure. Coronary angioplasty. With this procedure, a balloon is used to create a bigger opening in the vessel to increase blood flow. Although angioplasty is done in other blood vessels elsewhere in the body, percutaneous coronary intervention PCI refers to angioplasty in the coronary arteries to permit more blood flow into the heart. There are several types of PCI procedures, including:.
People can also take medications that lower their blood pressure and cholesterol levels. However, it is important to speak with a doctor before starting any new medication, even over-the-counter drugs, such as aspirin. Newer studies have shown that low dose aspirin may not be beneficial except in people who have already had a prior heart attack or stroke or those who have specific risk factors, such as diabetes. A widowmaker heart attack occurs when a blood clot or cholesterol plaque completely blocks the LAD artery, which supplies oxygen-rich blood to the front of the heart.
The total blockage of the LAD artery is a serious problem that requires immediate treatment. Delayed treatment for a heart attack can lead to significant tissue damage and scarring. It can be life threatening or lead to permanent disability. Not all heart attacks start with crushing chest pain or arm numbness.
Some heart attacks come on slowly, causing only mild discomfort or no symptoms of chest discomfort at all. Some people may not even realize that they have had a heart attack. As the symptoms of a heart attack vary from person to person, it is vital to learn as much information about them as possible. People can start by asking their doctor about their heart health and how to reduce their risk of cardiovascular disease. When someone is having a heart attack, they will have raised cardiac enzymes, in addition to other symptoms.
A cardiac enzyme test allows for a doctor…. The symptoms of a heart attack and a panic attack can feel similar, especially if a person has not experienced either before. Here, learn how to tell…. Some people take a blood pressure change without other symptoms to mean that a heart attack is occurring. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
In Nov , I had another heart attack in my PDA posterior descending artery they placed 1 large medicated stent. Curious if you opted for the bypass? After Nuclear test and imaging two months ago my Cardiologist said that there is a small blockage in the left descending artery and we will do an Angiogram in March of next year. I feel uncomfortable that he did not do it then. My Doctor is a good Specialist and he is thinking that it is small, so we can wait.
However, he says always, if you feel shortness of breath or Angina, call immediately and we will do an angiogram. What is your hunch on this matter and any suggestion is welcome. Hi, it sounds like your test showed a small blockage likely only which is reassuring. It all depends on your symptoms and why the test was done in the first place. I would ask your Dr. There are very few times i would schedule an angiogram to be done in 3 months time.
Sorry to interrupt the thread. My mom just had a stent for LAD blockage. Doctor said the artery was damaged during the procedure. Then they said they had to put a longer stent to cover the tear and rupture. I just want to know is there anything we need to worry about this rupture vessel.
Will she need CABG? We are very worried now since the stent procedure had rupture complication. Thanks in advance. It sounds like she may have had a dissection of the vessel and or a perforation that was taken care of by covering the affected area with the stent.
Hi dr, My dad is 59 years old. This needs to be determined by the treating Dr. I cant really comment without clinical evaluation and review of the films.
Sir hello i had a angioplasty after inferior heartattack and stent in lcx i have 70percent blockage in lad disall end. Hi Doctor , I am 45 years old , I had a myocardial infarction two months ago , I went to a small unequipped hospital 30 minutes post chest pain , I recieved dinitra tab beneath my tongue and Aspirin mg …after one hour I went to a big hospital and the cardiologist advised me to perform angioplasty ASAP , I did it 5 hours post chest pain , tlhe cardiologist told me that it is a diagnostic angipoplasty , no need to put a stent.
I work in a cath lab as a nurse. The stent itself can cause problems with blockages so we really only want to use a stent when the blockage is severe. The bodies natural instinct is to attack foreign object placed in the body which is why clots are an issue post stent.
The body will send platelets to the stent sight to protect the body and encapsulate it. Meanwhile, the platelets are causing a blockage. It sounds like your dr is trying to be conservative which is a good thing. I ask this because my grandfather was just diagnosed with severe 3-Vessel CAD. He was in the hospital having surgery to remove colon cancer and had a heart attack a few days later. They recommended a bypass which is what he will be having next month. Why would a blockage develop in such a large vessel rather than in one of its subs?
Is there something going on in the whole of the system that is causing a blockage to form in the LAD? Something dietary or behavioral or genetic? Thank you. A blockage occurs in specific areas and severe, rapid onset of symptoms most often results from a rupture in the plaque lining the vessels that attracts platelets.
Platelets are a component of the blood that responds to the site of percieved injury. If a blockage slows or stops blood flow a clot can form, but the hear attack itself is not often caused by an actual clot as much as the collection of platelets.
There are some conditions where a clot can travel into the coronary ateries though. My Father had a heart attack , he was admitted in hospital and was on medicines for two days. Doctor had no idea what is happening and he was dead within few hours.
He could have been alive.? Very sorry for your loss. I would start by going and talking to the Dr that did the case to explain the reasoning so you can have a more clear picture of what happened and why that management plan was chosen. These situations are often very complex and vary hugely from patient to patient.
My husband had chest pain which we mistook for gastric acidity. Two days later we went to hospital he did an ECG which was abnormal and triponin levels were up at An angiogram was done which showed a LAD occlusion. The doctor regarded it as late presentation and immediate intervention to the LAD was now considered inappropriate.
Large infarct in the apex and the anteroseptal wall with a small area of viability within it in the distal septal wall. Left ventricle myocardial enhancement Delayed enhancement is seen in the anteroseptal wall and apex with evidence of microvascular obstruction. Non-cardiac findings: No relevant findings are seen. The patient is unlikely to benefit from revascularisation. Do you think opening the totally occluded LAD artery would be of much benefit or would leaving him on conservative line of treatment be better.
As there is a small area of viable myocardium. Would performing angioplasty to open up the LAD artery be of any benefit as the reports seem to suggest a very small area of viable myocardium in the infarcted anterior segment. In the situation described, medical treatment would be typically advised over any type of intervention. My surgeon managed to by-pass just one of the occluded again! Prior to the operation he was optimistic that he would be able to also by pass my LAD.
However, he could not isolate or find my LAD!! Is this possible? Are there any techniques to locate an LAD? I am 55 Asian man with normal blood pressure and cholesterol level. I have been relatively fit slightly over weight and never smoked or drink. I do have family history of heart problems. I had abnormal EKG and stress test 2 years ago. With my stubbornness, I believed that I could keep my current status through healthy living and medication. Finally, my doctor convinced me to do a catheterization.
No damages to the heart muscle through. I like to hear more options and recommendations. Thank you very much. Its difficult to comment without seeing the films, however in any such situation i feel that opinion should be sought from both surgeon and interventional cardiologist and an appropriate decision made with the pro and con of either approach being considered.
This is known as a heart team approach and should be standard in all centers of excellence. There are may situations in which there is a clear preference between the approached, dependent on the clinical situation.
Also its important to note that although a procedure or operation may be required, you are spot on in that healthy living and medication are at least as important in determining your long term outcome.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at MustafaAhmedMD. I survived a massive heart attack in I expect it was missed due to my age 36 , health, non smoker, vegetarian and the lack of any family history. They chose intervention as opposed to CABG due to the significant damage and little to no chance of survivability. I am at maximum therapeutical dosage on applicable medications.
As in my case sometimes CABG may not be an option depending on the patients condition in acute conditions. I would also like to mention that my MI was stress related, which is seldom mentioned as appears to be the case in this forum.
I have witnessed far to many stress related heart attacks during my nearly 17 years of being a cardiac poster child. Nearly a decade ago I witnessed a fatal heart attack of a 19 year old male. I would like to see the opinion of a Cardiologist and or healthcare provider opinion on age trends and stress. I also feel incumbent as a cardiac patient and heart attack survivor to try to share my stories with other in hope that it might make a person proactive rather than wait and spend their life as a statistic.
Taking this advocate roll has been therapeutic and helped this life changing event worth it. I am at a crossroad myself, I am 56 years old and had a first heart attack in in the RCA area , I recovered quickly and the Dr said it was mild and was started on statins at that time. On October 6th I went to the hospital with chest pain that went away while in the emergency room.
Since the hospital and my long time Dr. So a new Dr. I was admitted to the hospital and later that day a stent was placed in the RCA and I was sent back to the room to recover.
The last two procedures were radial and the first one by groin. The next morning the Dr. He came to my side and said I needed bypass surgery and a surgeon would come to my room to consult me. I was devastated….. The confident surgeon came to my room and said I was critical and needed the surgery right away and I could stay in the hospital a Tuesday and I will schedule Monday. I said wait how critical am I? I told him I will go home to get things in order and come back Sunday ….
As I was leaving the hospital I called my original Dr. I ran for 9 minutes with no symptoms and a normal EKG. I received a call from the Open Heart Surgeon since I cancelled the surgery. I have two very qualified Dr. I am seeking a 3rd opinion in Austin Texas later this month after the stress test.
I feel strong no symptoms but this has affected my mind thinking I am going to drop dead at any second……. Many thanks Jazakallahu kheir for your answer however kindly advise 1. Can he lead a normal lifestyle other than watching his diet and being physically active with exercises. Are his chances of a recurrence of an MI higher than any other individual 4. At what level should we work at getting his ejection fraction be?
What preventive measures should be taken? Hi I am 71 year old male I had heart attack 10 days ago. LAD total cut and CX too. Cabg or stent apex totally necrosed.
Often further tests such as viability tests are done in this setting to see if patients may benefit from bypass or stenting, in your case bypass would appear the most likely option with the limited information provided and a viability test would given an idea to see if the tissue is still alive. Viability test showed minimal results if stented. Medication was my choice. I also have an aneurysm. No symptoms or pain, I guess I am lucky, Dr.
I never realized I had a heart attack. I began a year long course of Keladine cream…snake oil, I know but you tend to grasp at staws. They recommend exercise, but I am apprehension. You always hear about athletes collapsing. So I am taking it easy, God willing I will survive. Trust GOD shows long lead of life to you. Can u say what are all the medicines u take in a day. Mustafa Ahmed. LAD stands for left anterior descending artery.
Heart Blockage — Explained With Pictures! What Is A Stress Test? Reply Belwady Murthy says December 27, at am After Nuclear test and imaging two months ago my Cardiologist said that there is a small blockage in the left descending artery and we will do an Angiogram in March of next year.
Reply Dr. Mustafa Ahmed says December 29, at am Hi, it sounds like your test showed a small blockage likely only which is reassuring. Reply David Boulton says January 4, at pm Why would a blockage develop in such a large vessel rather than in one of its subs? Reply uday says January 25, at am My Father had a heart attack , he was admitted in hospital and was on medicines for two days.
Mustafa Ahmed says January 26, at am Very sorry for your loss. Reply Iyman sherman says February 28, at am My husband had chest pain which we mistook for gastric acidity. Mustafa Ahmed says February 29, at am In the situation described, medical treatment would be typically advised over any type of intervention. Reply Iyman sherman says February 29, at am Many thanks Jazakallahu kheir for your answer however kindly advise 1.
Type out your question here if you are comfortable and i advise you keep personal identifying information private. Dear Dr I have paraxysmal atrial afbrillation. Sometimes manage symptoms at home other times I go to ER I have mild dilation of heart and mild mitral,atrial and pulmonary regurgitation.
I exprience severe fatigue not sure what causes that. I also have Hashmotors disease. I am 64years old. How would you personally treat a patient like me. My husband had a stent fitted 1 month ago and was also diagnosed with mild LAD disease.
His job requires a lot i heavy lifting and is very physical would this pose a problem with the mild LAD. Many thanks Sharon. This needs to be answered by the treating physician with regards to post stent activity. The mild LAD disease is unlikely to be related to any decision making. Difficult question to answer. What does the following statement mean? It means that you have minimal flow only in the artery. I am not having any angina or chest pain.
I just have some headache on the back side of my head if I brisk walk for more than 30 minutes continuously. I have a history of hypertension for last 15 years. Hi, To advise you accurately i would have to see the angiogram. Essentially it depends on the characteristics of the lesion which would dictate the the suitability for stenting. Also why was the angiogram done in the first place? Angiogram was done as my TMT was positive for reversible ischaemia.
I have had 3 TMTs so far and all of them were positive for reversible ischaemia. I can try to send you the copy of the angiogram if you share the email id. I only feel exhausted when walking hills and up slopes.
Can I get by medications only. Jazak allah Khairan. It honestly difficult to say without seeing the films and knowing more details of the history, and the heart function etc. He was put on medication including plavix. What would be the deciding factor? Im guessing that your husband has been placed on the Xarelto for either very poor heart function or the presence of a clot in the heart.
The MRI will likely be to see if the clot has resolved or not and if the blood thinner can be stopped. The xarelto is due to the clot On th L AD which was there since the MI on 23rd Jan but we were initially put on plavix and a month later on xarelto.
Why were we not put on xarelto immediately. Are these medications doing the same job as an angioplasty but through medication. Extensive predominantly non calcified plaque throughout the right coronary artery with multi focal areas of severe stenosis.
An angiogram was done which showed a LAD total occlusion. Are these medications doing the same job as an angioplasty whilst I have accepted angioplasty is not an option but through medication. I can send the actual medical reports if you sent me an email address.
He is on xarelto od, Aldatone od, bisiprolol od, ramipril od ivabradine od, Lipitor od, aspirin od and Lipitor od. Pandocid od. We are to do an MRI of the chest to decide whether xarelto did the job or we have to go to warfarin and I have a lot of reswrvations for warfarin. Why are we on xarelto and not plavix like the first month of treatment? What is the deterring factor as to whether we will move to warfarin? If the clot is there and we have to live with it why do we need warfarin? If you need the echo results and all other results I can send them to you via email if you give me your address.
My husband had the MI four moths ago but he i. Overwhelmed by fatigue and religiously watches his diet and walk 30 minutes on the treadmill. Jazakallahu kheir. My mother had an Agiography done recently. My mother is 64 yrs old. No stent or Bypass performed.
The patient exercised for 11 min and 24 sec, to stage IV of the exercise protocol, achieving The double product achieved was The resting heart rate was 70 beats per minute. The baseline rhythm was normal sinus rhythm. There were no arrhythmias. ST segments or T waves were normal at baseline. Left ventricular segmental wall motion is normal. The primary reason for test termination was fatigue. The blood pressure response to stress was normal.
The heart rhythm during stress was sinus tachycardia. Inferolateral ECG leads with stress demonstrated minimal 12 bpm. Blood pressure returned to baseline within 3 to 5 minutes. Abnormal exercise stress echocardiogram at an adequate cardiac workload demonstrating a small LAD territory infarct without obvious ischemia.
Good exercise tolerance. Blood pressure response to stress was normal. ECG findings are not suggestive of ischemia. No exercise induced arrhythmias were noted. Other Study Information: Not intubated, no pacemaker or central lines. Ideally there would be a detailed analysis of your wall motion on the echo during the stress portion. Global left ventricular function increased appropriately with stress. No new segmental wall motion abnormalities were seen.
All remaining scored segments are normal. Peak The mid anteroseptal segment is hypokinetic. Not all LV segments were well visualized. Recovery The mid and apical anterior septum and apical anterior segment are hypokinetic. It looks like there are no new abnormalities on the stress portion of the echo which may mean no further treatment other than current is required.
He also says bypass not viable. I am now worried as still getting angina. Is he right or should I seek 2nd opinion. If there is no viable tissue then stenting is not likely to be of benefit unless there is truly persistent pain despite optimal medical treatment of angina.
I had two LAD heart attacks last year Aug I have 4 stents and ICD implanted on Sep 30, I am on heavy medication. Regular workout. I am 49 years. Please advise how do I manage this in future to avoid another heart attack. How regularly I should have my heart tests.
Would my EF be normal in future? Thanks, Amir. Best thing is to be compliant with medical regimen, pay attention to risk factors, lifestyle and symptoms, regular follow up, and keep active. I have had multiple stents to LAD, many inside others, once clotting a day after causing an mi.
Last week I had 3 more stents in the LAD during which it was ruptured and scented also. Also says bypass would not be viable. I am already on multiple medications but still getting angina. Now home and worried. I also have multiple stents in LAD, placed in March Worry about them all the time. Just checking in to see how you are doing.. I have had my bypass surgery done 7 weeks ago with no complication other than incision recovery, is fasting ok now or not?
You should be able to do pretty much as you please in terms of diet this far after the surgery, although your medication timing would need adjustment. I understand stents have improved greatly but I was wondering what I can expect. I am 62 and quit smoking 10 years ago.
I had been having a very high resting heart rate but my Bp was overly high……. I had been having problems with 2 large varicose veins, one in each leg…. The vein goes from my feet up into my belly area. The symptoms of a widowmaker are essentially the same as those of any type of heart attack. And as with other heart attacks, you may not notice any symptoms until the heart attack begins and sometimes not even then. Seek emergency medical attention immediately if you have any heart attack symptoms.
Some of the warning signs and symptoms of a percent LAD blockage include:. Women are more likely to experience many of these symptoms without having chest pain. A widowmaker heart attack is caused by a complete block of the left anterior descending LAD artery. The LAD transports a large amount of blood into your heart, so without blood passing through the LAD, your heart can quickly run out of oxygen and stop beating.
The LAD most commonly gets blocked up with plaque from cholesterol. Plaque can cause blood clots that obstruct the artery. In some cases, the clots can build up quickly and instantly cause a percent blockage even if your LAD was only partially blocked.
The risk factors for a widowmaker heart attack, as with any heart attack, are primarily lifestyle choices or genetic factors that affect your cholesterol levels. Also, your risk of having a heart attack increases as you get older.
Genetic factors that can make you more vulnerable to a heart attack or other heart conditions include:. The more quickly a widowmaker is addressed and treated, the higher your chance of recovery. The most common emergency treatment for a percent LAD blockage consists of the following steps:.
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