Any doctors here? Heart related query


starchazer

Well-Known Member
Disciple
Hey guys,

I know this is a tech forum, so apologize for posting this here. However, since I like and trust this forum I am going ahead with this thread. Hopefully we have some doctors here who can help/advise me.

Here's the situation.

Just a few days back my uncle felt pain and numbness on the right side of his body. He went to a doc and the doc wrote some medicines that eased the pain. Next day he got ECG done and doctor told him that he suffered a heart attack and was advised to get CT Angio

But they delayed the test because of his high/fast heart palpitations. Finally after 2 days of wait he got the CT Angio done. But they took nearly 3 days to present the report (they said doc. is not available etc.)

Now yesterday he finally got the reports and doctor told him that he has 80-85% blockage in one of his artery. And was advised to get bypass surgery done immediately. But they also prescribed some medicines for a course of 10 days. This is to see if the medicines can clear the blockage and if the bypass surgery can be avoided.

These are the results to his CT Angio:

lm - normal
lad - 32-35%
RCA - Normal
LCX - 82-85%
Sugar - 250
blood pressue - 120/80

He's going to scan and send me the complete report. I can share it here once it's with me. Would actually appreciate if someone (who knows the deal) can take a look at it.

Now, I am not expert, but there are some things which I am unsure of:

1. He mentioned pain and numbness on his right side, how important it is that it's a symptom for heart attack?
2. If he suffered a Heart attack, shouldn't he be hospitalized? Can medicines really ease the pain in an instant?
3. He's a non-smoker. He's 6ft and not obese. He's alcoholic but not a heavy drinker. 1-2 pegs every alternate days. :p. Could this lead to 80-85% blockage?
4. Doctor said he's not sure of whether the scan truly shows blockage of artery or it's something else. So they asked him to get another CT Angio done. Now he already spent 15k on this scan. Why would they need another test? Shouldn't he be treated with utmost importance? Since according to them he suffered an attack and should go through a surgery. Aren't they being a little careless with their approach?
5. Now he's also been given some medicines for 10 days to dissolve the blockage, How would they know after 10 days if the blockage is gone? Will another CT Angio be required?

Now, please don't think that I doubt their intentions. They may be doing their job honestly. But I am a little skeptical because they want to get CT Angio done twice. And anyway. they say to always go for 2nd opinion. And that's what I seek here. Since he's in Delhi and I am in Bombay, I can't be with him, but I can at least try to help him from here. If anyone (preferably docs) can help me on this matter, than I will be really really thankful. If none of you can help, then I will go to a heart specialist and have him see the reports.

Thanks in advance!
 

red dragon

Justiceforall
Veteran
Probably he had a subendocardial MI,transmurals are mostly painful.
MI can present with any type of pain.
Patient can even complain of toothache during an attack,and right sided pain is not rare at all.
But why your cardiologist did a CT angio?
Is your uncle having renal problems?
CT angio is not at all a replacement of the conventional coronary angiography,and unless it is absolutely impossible to do a cath angio no Cardiothorasic surgeon will do a CABG(legal issues are there)

Get a conventional angiography done from a competent interventional cardiologist first(non invasive cardiologists are useless in any serious cardiac case)
 

pratikb

Well-Known Member
Veteran
And as red dragon Said why ct angio ?
On ct angio you can't decide on grafting.

Please see a doctor who is trained for all this and do coronary angiography before deciding about bypass.
 

pratikb

Well-Known Member
Veteran
More than that, they are not doing justice to him.
Get normal Coronary angiography done where they pass catheter to heart and check each and every major artery
 

sumchamp

Well-Known Member
Adept
I would surely advise to consult some good cardiologist, if ECG shows cardiac arrest. He must not delay it by taking some medicine or doing CT angio.

Coronary Angio should be done asap if ECG/TMT reports are positive. It will surely help them/you to understand how much blockages are in arteries and what should be done.
 

pratikb

Well-Known Member
Veteran
ECG showing cardiac arrest.

OP won't be here to discuss with us.
Cardiac arrest means heart is stopped.
 

medpal

Resident Medic
Adept
the way reports are presented I feel something wrong around it.

You need to get your uncle examined by a good cardiologist thoroughly, the tests include a few blood test (as cardiology is not my speciality cant precisely say which ones), TMT, 2D echo and coronary angiography. As CT Angio is a newer non invasive investigation there are few limitations around it so it cant be 100 percentage perfect.

The way blockages are written he can benefit from angioplasty rather than bypass surgery.

hope this information helps you, and well wishes for health of your uncle.
 

pratikb

Well-Known Member
Veteran
tests would be
1) complete blood count
2) sr.lipid profile
3) liver function tests
4) sr.creatinine and BUN
5) sr.homocystein level
6) vit.D level
7) HbA1c

followed by coronary angiography,
that angiography will define whether we can go for angioplasty or bypass.

whether legion is long segment or short,wehther legion is ostial or other
whether lesion at junction.
so many factors.
 

Top