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ct results, scared and confused

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Posted 3/18/2006 8:58 PM (GMT 0)

53 yr old female, former smoker, cholesterol 118, HDL 27,Trig 99,VLDL 20, LDL-CAL 71, overweight, cannot exercise due to shattered bones in foot.  Had new 64 slice ct coronary angiogram.  Cardiologist that read the report stated that he is new at reading this (hospital has only done the tests on paying patients for 1 week).  He reported RCA; technically a dominant vessel which is free of significant disease in its proximal course.  in its mid course it tapers off into small vessel that give off a right ventricular branch.  Immediately after right vent. branch, right coronary artery appears to be completely occluded.  The PDA is seen to fill PROBABLY via left sided collaterals especially the first obtuse marginal branch.  He did say that he is not certain of the blockage and may be seeing muscle.  Calcium score was 3 - small degree of mild sof plaquing along with specks of calcium in LAD - proximal to the takeoff of the first diagonal brnach.  Sof plaue is nonocclusive.  Rest of LAD is small but free of significant disease.  All other vessels/arteries free of soft plaque and calcium.

Cardio doesn't feel angiogram is warranted at this time.  Patient on Toprol 50mg 1 x day, asprin 81 mg 1 x day, Lipitor 10 mg 1xday.  ER cardio suggested that this blockage may have happened years ago. Patient is non-symptomatic.

What tests do you think would be warranted for an total blockage?

What risks is this blockage for future heart problems?

How unusual would it be for a calcium score of 3 to have this significant blockage?

Any other information you could add would greatly relieve my anxiety.

Posted 3/18/2006 10:06 PM (GMT 0)
Tomah welcome to the HW. Are you seeing a cardiologist? If not i would. Or get a second opinion. You don;t need the stress and anxiety. Their are no good blockages, and it's always better to be safe now by seeing the cardiologist than sorry later for not checking out. I'll keep you in my prayers. DELTA
Posted 3/18/2006 10:39 PM (GMT 0)
Thank you for your reply.  Yes I am seeing a cardio - he is the one that said no angiogram was needed at this time.  I can't get another dr. to read the 64 slice ct coronary angiogram, they only want to read ones done by their own machines.  I am so disappointed - I paid $1,000.00 out of my own pocket for this test, and now, because they didn't have enough experience reading them, I am left with all these unanswered questions. I am scheduled for an echocardiogram on Monday, and then return to the cardio on April 12th.  I think I may have to ask for the angiogram - I can't live with the uncertainity.  I have no idea if I would be able to live a full life with a 100% blocked coronary artery.  Right now I am afraid to DO anything, - I don't know how well veins hold up taking over for the artery.  I feel so depressed!

Posted 3/18/2006 11:32 PM (GMT 0)
Hey and welcome :) Sounds like you have been treated by the Keystone Cops. Silly doctors will kill you. With what you wrote about your test results, and ONLY if you HAVE SYMPTOMS, that are ANGINA, or pains related to coronary artery blockages, would I ask for an angiogram. Otherwise I would wait a while.

I have a left dominant heart. Only 9-10 percent of the population are like myself. If your RCA is truly dominant, you have future problems if the interpretation of your test was correct. How can you trust the interpretation of the test when the doctor says he is new at it? This is a first for me to hear. Usually "new" doctors go out of their way to hide the fact. I really don't believe you heard this from the doctor that interpreted your test. Maybe from a tech or someone else.

I can tell you one thing for sure, if you do not lose weight and heal your wheels so you can exercise, you are doomed.

Best of luck and health to you.

Rj
Posted 3/18/2006 11:42 PM (GMT 0)
Dear Tomah, Try not to worry too much. The stress in definately damaging. Did I read right that you are not having any symptoms? Why did you have a 64slice CT done? I had one done in January. However I have recurring chest pains and not sure exactly why. My cardio thinks he caught a coronary artery spasm on my last nuclear stress test. I take a low dose Calcium Channel Blocker for that but still have almost daily chest pain. That is why I had a 64 slice CT scan done. My cardio said it was very good but I did not see the report. He never gives them to me; he just tells me what they say. ?? I'm suppose to have no blockages or other structural anomolies. My regular doctor suspects I have fibromyalgia because of other things. So that could explain some of the chest pain. I have a very difficult time knowing if it is the coronary spasms or the fibro so I worry ALOT. You can take some consolation in the fact that your cardiologist does not think you need an angiogram but ask him why so you can be clear and reassured about it.
Posted 3/18/2006 11:45 PM (GMT 0)
Rj - thank you for your reply.  I wish I could "heal my wheels", as you suggested, but that foot is held together by screws, nails, and pins and it deteriorating more due to arthritis.  The dr. that read my scan told my PCP directly that they are new at reading these tests - they have only been doing the tests for a week (although they were using volunteers before that), and my physician passed that info on to me.  You said if the test is correct, I am in trouble for the future.  Could you explain further, please?

Posted 3/19/2006 12:43 AM (GMT 0)
First you should DEMAND that your test results be reviewed elsewhere. Ask one of your doctors to give you the name of someone, or some hospital that can properly review your test results. There are many hospitals that can. This is rediculous that you were told what you were. You never know, your Pcp, or whomever told you this, could have just been trying to make you feel better.

After having heart disease/cad, strokes, etc, my cardiologist asked me "how was I sure that it was my heart hurting me"..... This, mind you was after many years of cad and already having 2 stents.

As far as trouble in the future, it probably will be your weight, but your dominant coronary artery is somewhat deformed.

Rj

Post Edited (Aldo) : 3/19/2006 7:52:40 AM (GMT-7)

Posted 3/19/2006 3:30 PM (GMT 0)
Tomah, I must apologize for trying to scare you into compliance :( yesterday. Coronary artery disease (CAD) can be very aggressive and as you know, it is a killer. I had two stents inserted on August 29th, 2005. One was in my left anterior descending artery (LAD), and the other was in my obtuse marginal. On February 2nd, of this year I had a rotoblational procedure in my very proximal LAD, followed by a large stent placed there, and another stent on down toward the distal end of my LAD. The blockage was 95% occluded. I could not have survived complete closure of this artery. I was having extreme angina.

This is barely 5 months between receiving 4 stents. I am a bit bitter at the medical world. I know how fast these blockages can develop, but I think I had at least one blockage overlooked, 5 months ago when I had 2 stents placed. The apparatus came apart during my rotoblational procedure. They worked for a good while in retrieving the wandering part....I would have had emergency bypass, if they had failed. This all has really "frayed" my nerves. Enough of my troubles :)

I hope that you know, and I forgot about this last night, that women often do not have symptoms of heart disease/heart attacks like men do. Women sometimes have vague aches not directly over their heart, and become nauseous and break out into a cold sweat. I think both genders can have "silent" heart attacks but I believe that they are more common in women, from what I have read.

So, whatever you and your doctors decide, should be a very cautious decision. Have you asked about a nuclear imaged stress test? I know your foot has shattered bones in it, but they can give you a drug that speeds your heart rate so as to obtain the nuclear images. If your instinct tells you that you probably need a cath, then push for one. I have had 6 and am still here (I think) :)

Please let us know what you decide. All my best :)

Rj
Posted 3/19/2006 4:16 PM (GMT 0)
Rj - thank you so much for your post today.  I must admit, you had me pretty scared! LOL.  I'm sorry for all your problems - I know you must be scared, too.  This heart stuff is all too much, and I am somewhat bitter about cardiologists, too.  My husband had a heart attack with 5 stents a year ago December.  I don't think cardios realize how scared and nervous we get, it is just all so routine to them.  I have yet to meet a compassionate one that will actually sit down and talk to you.  At least in our cardio's office, the nurses run interference for the drs., and you hardly ever get to talk to one.  The cardio that I saw said that he didn't think a nuclear stress test would be beneficial, because he thought it would be abnormal.  I would like to have one, because if, by some chance it did come back normal, we would definately know that the heart was getting enough blood to that area.  This just has me confused, and because I tend to suffer from "heart phobia" anyway, this is just making my anxiety worse.  I would rather KNOW some for certain, than to guess - I can deal with whatever it is - it is just the unknown that is scary.  The ER dr. that I saw said that he thought the blockage had been there for a long time, but the office cardio said we would have no way of knowing.  Once again, Rj - thank you so much for posting your replies - and I hope we both will be better soon!

Posted 3/19/2006 4:58 PM (GMT 0)
Thank you Tomah :) I agree with every word you said!!! I just hope that you get some answers soon. It is very easy to get neurotic from the wonder of what lies ahead and how far away it is....

Rj
Posted 3/19/2006 6:27 PM (GMT 0)
Hi Tomah,  I wanted to welcome you to Healing Well forum.  I am sorry that you are having so many problems with your cardiologist.  I see that you have already received some excellent advice thus far.  I too would recommend a second opinion as soon as possible.  Please keep us updated on what happens and continue to post we would love to hear more from you....

Posted 3/19/2006 8:23 PM (GMT 0)
Hi tomah, I agree I would definitly get a new cardiologist.Its rediculous for you to have to worry over these tests. I had quad bypass surgery in 2002,I was 44yrs.old,I had 5 blockages,they fixed 4. The reason they didnt fix the 5th one,that was 100% blocked is because it grew its own arterys back to my heart,which they said is not uncommon.I,m not trying to scare you, I just wanted to share my story. I know how scary heart trouble can be,and I wish you all the best.Please get another opinion.Take care and welcome to HW.
Posted 3/19/2006 8:59 PM (GMT 0)
Hi Hope.  You didn't scare me at all - that is what they are saying happened to mine - grew a new blood supply.  At least I know you can live if that happened - I've been afraid that I will drop dead any moment! LOL  Have you ever been told what the long term prognosis is for your 100% blocked artery?  Are they just going to let it be?  I guess I will know more after I see the cardio again on April 12th.  I am certainly going in with a very long, long list of questions, and won't leave until I get some answers.  I am going to try to get a second opinion on the ct scan - may be tough, though - no one wants to do it unless they are the ones that administered the test.  Thanks to everyone on this board - everyone seems so nice and supportive!

Posted 3/19/2006 9:26 PM (GMT 0)
Tomah please keep us informed , as you can see their are members in this forum who will be here for you. We are connected by the heart. Not medicaly, but heart and soul. I think we all agree that a second opinion or demand more from your doc who is treating you now. This is worring you and you will continue to have anxiety until you get more answeres. From my to yours DELTA
Posted 3/24/2006 8:45 PM (GMT 0)
Hello everyone, I have searched long and hard for a forum just like this. I have type II diabetes diagnosed just over a year ago, and just last September was diagnosed with CAD, I too have I think? 100% blockage in the largest artery and my body made it's own bypass. I'm so scared that I'm just going to keel over dead, and I can't stop thinking about it! I just want to break down crying all the time...and my husband quote says "its not life threatening"!! I just need to let it out and find support. From what I have read I'm in the right place. I'm at work right now, so can't stay...but I will be logging in when I get home. Hope to hear from anyone.Thanks for listening (reading)!!

Post Edited (sharplle) : 3/24/2006 1:54:49 PM (GMT-7)

Posted 3/24/2006 9:23 PM (GMT 0)
I totally understand how you feel. What tests have you had? Are you seeing a cardio? I'm sure you've read my post, I'm not certain about my blockage, but I am still scared. I haven't had much luck trying to find another dr. to read my cat scan! Would love to talk to you! Hugs,
Posted 3/25/2006 3:07 AM (GMT 0)
Hi, thanks for the reply! I have left my email and yahoo ID, I would like to talk to you too. I have had a cardiolite and stress test which came back positive....I then had a heart cath which apparently showed a total blockage?? of the large artery, however, my body made its own bypass and on the other side I have an artery which didn't properly form from when I was born, it has some slight damage, they didn't want to put a stent in for fear of rupturing it. I wasnt told all this though, the doc thought I was too doped up "NOT" I was totaly aware of everything that was going on...all he said to me was, I found a blockage, I'm going to change your medication!!??? then spoke with my husband and showed him the film of the cath. sad
Posted 3/25/2006 6:33 PM (GMT 0)
Lesley - I have e-mailed you!
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