Doctor insights on:
Exercizing After A Cardiac Stent In The Lad
Can stent be used to open 100% blockage in an artery such as LAD during cardiac catheterization procedure. Cons and pros please. Thank.
Yes, if needed: Total blockage may occur suddenly - this is what causes a heart attack. Then the goal of the procedure is to get the blocked artery open asap (<90min) to save otherwise dying heart muscle. If the blockage is chronic, then it should be opened if the supplied muscle is alive and the patient's active lifestyle brings out symptoms. Stress scanning may be helpful to determine this. ...Read more
My 60 y dad had coronary stent placement in LAD artery for incidental finding of coronary block (80%)at 53 yr of age. Am I at risk for CAD in future?
Can only Plavix be taken after coronary stenting? I have erosive gastritis, take Protonix (pantoprazole) 40mg and a DES in LAD post heart att. Need 3 more DES or BMS.
There may be options: Plavix (clopidogrel) is a platelet inhibiting drug. The purpose of the medication is prevention of future myocardial infarction and death following acute coronary syndromes and prevention of stent thrombosis. There are other medications besides Plavix (clopidogrel) that are platelet inhibitors ...Read more
Is it possible to take only Plavix (clopidogrel) and not Aspirin after coronary stenting? I have erosive gastritis and DES in LAD after heart a, need 3 more stents.
Anti platelet Rx: We use dual antiplatelet therapy for at least 6 months to minimize stents occluding after placement. Usually either aspirin or plavix (clopidogrel) is continued later if no contraindication to that. The erosive gastritis is a significant problem and the appropriate step (s) in this case need to be considered with risks and benefits to the treatments by those with the most information about the patient. ...Read more
I had a DES placed in my LAD 30 days ago. How long does it take for the endothilial cells to cover the stent cage in this type of stent?
Atleast 1 year: In order for struts of stent to be fully endothelialised and before one can even consider altering dual amtiplatelet therapy, a full 12 months ought to pass. There are other features such as lesion length, and angulation that may warrant even longer DAPT - discuss with ur interventional cardiologist. Data suggests outcome curves continue to diverge, so benefit upto 18 months post DES for dapt. ...Read more
Had a heartattack a few weeks ago and had a stent placed in her LAD, Wondering if it was safe to ride roller coasters at the great escape.?
No: I would avoid this, personally. Ask your cardiologist for a more definitive reply. ...Read more
Husband has artherosclerosis, stent in rca in nov, 2012, left main 60%, LAD is 70%, on medications, ef43%, feels fine, is it ok to gym and do weights?
3 weeks ago, stent placed due to 95%+ blocked lad. Since then, I often feel a bit of pressure or pinching like feeling. Not pain...Just discomfort. Is this normal?
Yes: Yes it's very common to have a pinching pain in your chest after a stent is placed. However, the pain should be stable, if it changes, get to an er otherwise I would call your cardiologist and follow up as an outpatient. ...Read more
I'll let MDs reply: On the rx issue, I must allow mds to reply. But - whatever they say, i'll strongly recommend that you also look into techniques that will help with all of the symptoms, including the cardiac ones. Any of the following: mindfulness meditation, stress reduction, relaxation exercises, yoga and/or targeted cbt will help a myriad of symptoms and probably make you feel more alive and happy too. Best! ...Read more
Is it safe for a cardiac patient with 2 stents in LAD to use lithium.....also well controlled type 2 diabetic with oral med....sreatine 1.1?
Ans: I assume you are on your medications for the stents. Lithium is metabolized through the kidney so you kidney function is monitored and so far your creatinine seems ok. Now the diabetes can cause a problem for you and lithium if you kidney function is compromised due to the diabetes CSI be sure to keep your blood sugars as perfect as you can. Monitor closely. Your hardy issue is affected by the dm ...Read more
My boyfriend is an avid triathlete and ended up with a 95% block in the LAD and had a stent placed. Why would he still have chest pressure and sob?
LAD stent: Your friend should not be having chest pain and shortness of breath if the LAD block was stented successfully and it was the only problem. It is necessary to report these symptoms and be re-evaluated for other problems e.g. Silent heart attacks, congestive heart failure, failure of the stent, blood clots and other problems. It is wise to see the doctor frequently and meanwhile follow directions. ...Read more
Should I get a stent, have bypass surgery, or try medicines for 100% blocked lad? If medicines, what are the most effective medicines for that. Thanks
Need to see films: I would have to see coronary angiograms, echocardiogram, complete history and physical, pulmonary function test, hemoglobin a1c, cbc, chem 12, as minimum to advise anything. If the LAD territory is viable and the LAD vessel a good surgical target, and there is an internal mammary artery suitable, even if no other vessels require revascularization, no comorbidities would strongly advise lima-lad. ...Read more
Which is safer in an average dose -klonopin or ativan-for a patient with cardiac disease -that is 2 stents in lad?
Both safe: Both drugs are safe for coronary heart disease. But they have somewhat different indications. You should use the one that best suits your needs. Let your provider help guide you. ...Read more
If my lcx and LAD are less than 50% blocked (lcx due to stenting) but my ramus gets totally blocked, can this cause a heart attack?
If at LAD there is stenonis 80% at proximal, RCA there is long stenosis 60% at mid & stenting has not be done, whether AF ablation can be performed?
1st things first: Ablation can be done but why wasn't the LAD addressed? If you're in an area with expertise to do AF ablation, there must be someone who can dilate your LAD - why was it not done? IT would make sense to do that first unless there is a good reason not to - (like a negative stress test?) ...Read more
Mid LAD Shows chronic total occlusion with faint filling of distal LAD seen through collaterals, (LMCA, LCX, OMs, RCA are normal) Pls suggest Stent/Med?
Cannot stent: You prob can't stent your mid-LAD as it is already 100% occluded. Good that you have collaterals to feed that downstream muscle. You should be on a statin med (pravastatin, etc) to prevent further atherosclerosis. Add a blood pressure med like Lisinopril if you have high BP. And use meds for angina, but only if you trigger it w/ activity. A daily aspirin is recommended. Any heart attacks? ...Read more
Middle LAD & circumflex artery are 100% blocked. Blockages, while severe, short in length. Both arteries receive collateral. Can angioplasty/stent help?
Failed stress test. EF 33%. Poss. Blockage both RCA and LAD. Will be doing angiogram. What are chances this can be resolved with stent vs. Surgery?
Angiography: When the clinical indication for an interventional procedure in addition to medical therapy is present, one needs to first see the coronary anatomy to determine what is the best procedure for the patient. When multivessel disease is present in such a patient, often surgical intervention is preferable to stenting but not always. After the angiogram discuss the choices with your Dr. ...Read more
HDL is 122...LDL is 93...VLDL is 13. I have a heart stent in my LAD from 4 yrs ago. Exercise everyday and eat good...is the LDL too high?
Have you had any patients who got a sudden blocked LAD artery, MI, and SCA, and who survived despite stent failure (permanent total blockage)?
I had a heart attack and a stroke 10 months ago. 1 stent in LAD, 3 more to add in the future. Can I catch a two-hour flight?
Best: To get clearance from your Cardiologist. Make sure to take your medication with you. ...Read more
I am a cardiac patient with 2 stents in lad. Problems breathing in cold. Below 35 degrees and in heat. Is this common. Can it be med related?
Problems: This kind of problem is not unusual but you should consult your cardiologist to see if something untoward is going on. There may be steps your cardiologist can take in evaluating and treating the symptoms. ...Read more
Due to a heart attack in 2005 I had a stent to my LAD. I also have diffuse atheromatous disease to my RCA. So, what is the reason of Ramipril 1.25.
Heart attack in 2005: Ramipril (& its family, the ACE inhibitors) have been shown to reduce the risk of heart attacks & vascular events (strokes) in pts who have had prior vascular events. Your greatest risk factor for another stroke or future heart attack is the fact that you (claim you) had one in 2005. To reduce future risk, you should take Ramipril & also aspirin, statin (RCA disease), & beta-blocker (an "-olol"). ...Read more
Have relatively short 100% blockage in mid LAD &100% posterolateral branch of circumflex artery (both relatively small targets).Will stent help or ris?
Stent: There are technical factors in deciding whether stenting is possible and physiologic predictions of whether successful stenting will yield benefit. Your doctors including interventional cardiologist are best to advise you regarding your specific situation. ...Read more
Have CAD stent cto LAD 17month ago. Cbc shows mpv12.4. read higher mpv could up risk for cv events. Take asp.81mg, no more effient. Am concerned. What todo?
No new therapy: I believe your MPV is so close to normal range that additional therapy aimed specifically at that would not convert to any meaningful change in outcome. Certainly keep taking your aspirin 81 daily. Good luck ...Read more
No: With a Xience you need at least 6 months of DAP. No compromises on that PLEASE, until unless your doctors have told you something otherwise. ...Read more