Questions re: heart attack, blockage, no stenting

Hi all: Newbie and this is my first official post. My mild heart attack happened 8 months ago. I have a 90 percent blockage, but it's way down at the end of the LAD, so stenting was not deemed possible or necessary. Medications/lifestyle management are my treatment. I've completed the cardiac rehab, I feel pretty normal, and my ejection fraction is basically back up to 60%. They say you can just barely tell that anything happened at all. Also, when I had my cath done, they said all other arteries were clear.

Does anybody else out there have a blockage that's still there, untreated? I find myself wondering odd things, like -- could this be affecting me somehow? Should I be alert for particular things that could happen because of this? Or is it really just all about taking meds and maintaining healthy lifestyle in hopes that it doesn't happen again, somewhere else? It's odd, too, because I thought I already had a healthy lifestyle. (Weight under control, active lifestyle, no smoking or diabetes, etc. I'm also under 50, pre-menopause).

I may just be obsessing. I am a teacher who went back to work less than 2 weeks after the incident. Now I have some time off, so I may be having some delayed reaction/processing. But I don't see very many references to non-stented blockages, so I'm curious if others out there have one like this. Thanks in advance for any thoughts!

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Hi Anne,

My situation is very similar. I had a heart attack 8 weeks ago on
a distal branch artery. The blockage was at the very end and too tiny
to stent. They tell me the damage to my heart was very minimal
But like you, I am dwelling on the 'what ifs.' I did ask about the
blockage still being there, and if it could cause more problems;
what I was told is that the damage has been done and that is what
caused the heart attack, those areas fed by that artery not getting
oxygen. Like you, all arteries were clean except for that one
Little area and I don't smoke, or have any risk factors. In fact, I ran
four times a week!

I'm so sorry this happened to you; it's definitely life changing!
It helps me to read about others in my situation, and how far they
Have come. You are not alone.


Cindy

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I also had a heart attack 18 months ago. I had 3 stents placed in the right coronary artery. They said I had minimal heart damage, but that I had other small blockages which weren't stented. I of course worried about them, but I had to deal with a severe reaction to statin drugs and couldn't start rehab for 6 months. Within 2 months I started having chest pain, which was angina. 2 months later I was in the hospital for bypass surgery. I had four bypasses done, and was told there were no other visible blockages. However, with such severe coronary artery disease, I still worry that I have a ticking bomb in me. I try and eat right, and I walk, and take my meds. I can't take statins, so that is also a concern. Who knows, all we can do is trust our doctors and take care of ourselves. Hope you are all doing well.

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Thank you for your reply. I'm sorry that you had to deal with more surgeries and medication problems! But you are right: All we can do is take care of ourselves and hope for the best. Wishing you well, too.

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Thanks for your reply. It IS comforting to see others in the same boat. I was a runner, too! (But not as consistent as you. I am walking instead, for now, partly because it feels safer, but mostly because I can sustain it better than running). We'll see how it goes, I guess. Thanks again; I will be wishing you the best as well.

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Thanks! I will be switching to walking as well
I just need to do the cardio rehab first. Did you do rehab, and if so, how was it?


Cindy

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I have stents plus blockages too small to stent. I currently have unstable angina, which is a pain, but I am learning what to worry about and what not to worry about. I do get spasms which cause me pain, but I keep the nitro with me in case it gets bad. I take the meds carefully and on time each day and currently am in cardiac rehab. The rehab is helping a LOT, especially in building my confidence during exertion. Time will help me cope and should help you too. I watch my diet and hope to never have to have bypass. The education classes at the rehab are very helpful too. I am learning that by doing what I should, I may be able to reverse some of the small blockages. I hope you can too!

DJ

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Hi Cindy: Yes, I did the cardiac rehab. I found it very helpful (see DJ71's comment, too). I had more to learn about diet/exercise/lifestyle than I expected. I also felt much more secure about exercise with somebody keeping an eye on me. And the group support element was nice. I would strongly recommend it to anybody.

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I enjoyed the cardio rehab as well. I took it the first time last summer after my heart attack, and then again after my bypass surgery, finishing up in January. Since then it has been hard to stay on track but I keep moving. I liked the group support, and the fact that the therapists and nurses were monitoring my health while exercising. I got nutritional advice, and an exercise plan to work with after my rehab was completed. I can still contact them if I have questions too. Well worth it! Thanks for all the support here, we all won't feel so alone in this.

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Stents are not treatment for blockages actually. They stent because it helps reduce angina. You say untreated, but actually the treatment for blockages is medication, it is not necessary to stent. My cardio told me this after my heart attack but I did not believe him at first. I did end up getting a stent, when I had angioplasty. But I could have just as easily gone the medication route without stent. I also had one blockage, no other plaque buildup. Why, who knows. There is a newer thought in the medical world that far too many angioplasties and stents are being done, and that stenting does carry some additional risk factors, one of which is the long term use of dual anti platelet therapy. And it is putting a foreign body in the heart. So medication is increasingly being used as the only treatment. Your heart has this wonderful, magical ability to build collateral arteries around the blockage. The medication helps with that, as does exercise. This is actually a better route than stenting, it is better for your body. In some ways, we are coming back around to what was done before stenting. I have met heart patients in their eighties who are thirty years past their heart attack, without stents. I think of one in particular, many I wish I could keep up with her. You recuperated well and are doing what you need to do. You may live the rest of your long life without ever having problems again. None of us know what the future holds, there is little point in worrying about whether or not this will happen again. Best we can do is do what we can to prevent it, but live our lives. When they come out with the new biological stents that are absorbed over time by the body that will be kind of cool too.

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Very interesting, Threesacharm. Thanks for the info!

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I was told by the doctor who did my cardiac catheterization that stents would not work for me because the coronary artery disease was too advanced. What he said was, "you have a chestful of coronary artery disease." A bit blunt. Two days later I had quadruple bypass surgery, and they told me that I also had some tiny blockages that didn't need anything. I may need a stent someday but in the meantime I am eating well and exercising hard five days a week. I read that 20% of bypass patients need another "procedure" at some point, whether stent or surgery. I also have diabetes. I am learning to walk past the dessert table at church without looking at it, which is darn hard. I have had three desserts in restaurants in the last ten months. At first after the surgery I was afraid to eat anything. Now there are no more ribs, chicken wings, etc., but a lot of fish. I also lost 37 pounds and want to lose 10 - 15 more, because it will help with the diabetes, which is under good control.

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Hey good going, always nice to see someone with big success.

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Thanks!

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My husband was on statins for twenty years (Lipitor) after quadruple bypass surgery in 1993.

Last week he had an episode of acute coronary syndrome (next step:full-blown heart attack).

And here is the "kicker": angiography revealed that three of his four coronary arteries are totally blocked, and the fourth is 70% blocked.

So will somebody please explain to me what is so great about the Great God Statin? All it did for my husband is bring his kidneys one click away from failure, cause nocturnal leg and foot cramps, and take away from muscle mass.

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Wow, Notsurprised, that is impressive. Way to go!

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Well, threesacharm, I quite agree with you about stenting, and would consider myself very lucky not to have any at all. After having a mild heart attack in 2007, six Cypher stents (now discontinued) of various sizes were placed in one artery when it was found that the artery had "collapsed". There was no sign of plaque, and all the other arteries were pristine. Again, like many of the posts I have read here, I was very fit, slim, non-smoker, in my early 50's, etc., but with a fair bit of stress. Naturally, three and a half years later I was no longer on dual anti-platelet therapy and suffered a stent thrombosis at one of the stents. I am one lucky lady to be here today! And, with virtually no heart damage, thank goodness. It seems that the high incidence of very late stent thrombosis is the reason Cypher stents have been discontinued. Now I have been on blood thinners for over two years and who knows how long I will have to stay on them and endure the side effects (landed up in the hospital with a GI bleed last October). I would give anything not to have these stents, which have become the problem and not the cure!

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Hi Anne, I had a 90% blockage in my right artery and the doctors said they didn't have a stent big enough..Discharged me and gave me pills , after 2 years had passed...Just last Monday on the 26th August ..I went to Bergen Hospital in Omaha and had Doctor Agarwal put 3 stents in for me..My artery was now 100%closed...I live in Michigan and heard such good things about this doctor I decided to go there...He is excellent.. It was worth the trip and one night in the hospital..I feel great..their phone number is 402 398 6781 if you should decide to get some more info..I sent my previous cath cd in to them and they told me I needed to get there immediately..Good luck..

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Condoline, 20 years without an incident is pretty good! No one can say whether this would have happened 10 years ago without the statins. I have a love/hate relationship with them, but especially for men, they seem beneficial. But plenty of people on statins still have heart events so I don't think there's any guarantee that one will be fine forever, unfortunately.

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Wow! I could have written your post, including being a teacher! My blockage is in the same place and was not stented. I am being managed with medication. I was active and leading a fairly healthy lifestyle and was 40 when my heart attack happened this past April. I still have days when I obsess about it... a day has never passed without thinking about it. I've decided that thinking about it is ok as it reminds how important balance in my life is. However the obsessive days are tough.

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threesacharm, I also agree with you about stenting.
I have three stents so far and had a lot of problems>>>all in 2004. First thing, 10 hours after first stent, major heart attack. My body did not like the stent. That was followed by deep vein thrombosis due to emergency angioplasty. Two months later: in-stent restenosis.
I have had a few angioplasties since. Had my last heart cath in May of this year. No stent though. Cardio said 2 main blockages in LAD---60 and 70%. One is inside one of the stents. Fortunately for me, I am on Medicare and they do not pay for a stent unless the blockage is OVER 70%.
In the meantime I live very healthy; eat right, exercise every day, etc.
I know that my cardio does way to many heart caths and stents.
But what are we to do if the cardio has this serious look on his face and says: Your nuclear stress test showed, a, b and c and you need a cath.

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