How do the doctors measure a blockage In arteries?

I posted a journal a while back and got no response to date. I am in real need of some help about this issue. I was told by 3 previous doctors I had a 70% blockage, LAD, but nothing was done for this. I have recently gone to a New doctor who preformed a catheterization and he came back to me with a 40% blockage LAD. I have had a heart attack in June 06, So how could this be. I am confused, scared, and have no where I can turn for information . I have scheduled a appointment with yet another card. doc. but NOW dont trust what any doc. says. I am wondering if anyone has had this happen to them? I also dont understand how a blockage is measured during a cath.? Is it up to the doctor to estimate the blockage , or is a computerized machine doing the calculations for them? Please help me to understand any of this . Thank you, Terri

Report post

7 replies. Join the discussion

Hi Terri,

Sorry to hear you had a heart attack. This is a wonderful place to help you find all kinds of answers, no matter what the questions.

You are asking very good questions. If I'm understanding you correctly, you had an LAD blockage of 70% at time of heart attack that has now shrunk to 40%. This is a GOOD THING. Reversal of blockage size is life saving!!! You didn't mention a stent implant during heart attack, so I'm assuming you've been on a drug therapy regimen of heart medications (anti-coagulants, thinners, statins?). If you have been doing nothing else, the medications are already assisting in decreasing blockage 'gunk'.

Google 'cardiac lumen' for links on how artery diameters and blood flow (perfusions) are tracked.

Cardios have a number of options when dealing with blocked arteries. My LAD and RCA stents were 70% blocked 3 years after heart attack...the cardio chose to back out and do nothing beyond continuing drug therapy because the blockages were scar tissue, not heart disease lesions. 10 years later, they are a little more than 70 percent blocked and there is ischemic tissue surrounding old dead heart muscle but the dr told me that it would be better to wait it in, each year brings us closer to more sophisticated levels of cardiac repair for women.

Very few cardios will intervene with blockages under 70%. They have the options of doing nothing, stenting or bypassing more fully blocked arteries. I had 2 blocked and their location made them accessible to stent deployment....which spared me bypass surgery to open 2 arteries which them reclogged somewhat within probably 6 months. But it was scar tissue, not disease this time.

I know this is an overwhelming, confusing issue so stick around and be sure to enter specific topic words in the Find It search box on this site. Sorry I missed your first posting.

Glad you are here. Again, 40 percent less blockage is quite amazing in such a short length of time. You are doing something very right!! (smile)

Take good care,

Report post

Hi, Thank You so much for responding. I had no idea that a blockage could shrink in size. Every doctor I have gone to said it usually gets worse not better. This is why the 4th cath. was done on me. I only take a asprin a day, nitro (when needed) Dilitizem. I do have a bovine aortic valve put in in June 06, so I am wondering if this has something to do with the difference in the blockage numbers. Yes , I am Smiling, about this news, but am still having severe angina, so I am not convinced the blockage has shrunk a whopping 30% in less than a year. I will be going to a pulmonary doc. tomorrow , so I will ask him about this also, and take the copy of the CD I asked for with the pictures of this cath. on it. Thanks So much Terri

Report post

Smart of you to ask for the CD! I didn't realize you are still recouping from a valve replacement....those can take longer to cover from than bypasses.

Please let us know about the true state of blockage percentage....Sorry to hear about the continuing chest pain. Blockages and lesions can come and go...according to some experts, this is happening constantly and our body just takes care of if without our noticing. Cancer cells pop in and out of existance too. Your 30 percent wider opening could be a reversal of damage from your immune system tidying up, tacking things down a bit tighter. (smile)

Let us know...You've got me very curious about all this now Terri


Report post

I recently had a chat with my cardiologist about the pros and cons of treating new blockages medically (with drugs) vs. angio and implanting another stent.

Turns out that apparently when looking at five-year outcomes (docs are very big on 'outcomes') there is actually a slightly higher mortality rate with angiography vs meds only for blocked arteries. This almost defies logic until you consider that, just as in every invasive medical procedure, there is a certain baseline risk in just going through angiography itself.

Most patients, however, seem to prefer the pro-active 'just do something' approach rather than what seems like doing 'nothing' but taking medicine.

Also, remember that the longer blockages are in place, the more effectively those wonderful collateral arteries can begin stretching and growing to continue bloodflow to affected heart muscle in a sort of detour around the blockage - do-it-yourself bypass surgery!



Report post

Dear scholastic,
I do not know anything about scar tissue changing the readings on a cath, because I have not had a heart attack. I was told that the blockages do not change, but if you had different cardiologist reading them they might have a different reading. I don't think you would go from 70% to 40%. Maybe it would be good if you could get a cardiologist to explain this to you.

Report post

Dear Mermaid,

Thanks for the "cardiac lumen" clue Mrs. NASA. A regular lightbulb went off in my head. You may have answered some questions for me, as well. I will be doing my research but love having our resident lady scientist on board.

Kennie: Yep--I've developed my own bypass. The 3-D photos from my calcium scan show that I've practically grown an entirely new right coronary artery in addition to collaterals. Pretty amazing considering at one point I was quite dead.

Interestingly enough, the 5-year cancer survival "outcome" is also statisticaly the same whether patients underwent chemotherapy, or not. Something to think about . . . I have the tendency to not trust statistics because they are always based upon the "average." I am a living testimony to beating the odds.

Terri: I would also be interested in hearing more about your treatment options and where they lead you. You have a unique combination of factors that could teach us all, including doctors, a thing or two.

I don't know much about valve replacement, but where CAD, specifically, is concerned, some people, including doctors, are of the school of thought that it is a progressive incurable disease. Others claim that CAD is reversible through diet, exercise, and life style changes, and they have the research to document it. I use particular vitamins and herbs known to clear plaque from the arteries and, for me, I think they are working. But even the die hard naysayers are beginning to discover that some of the newer statin medications are actually reversing plaque formation.

Just this morning I read an article in the paper about a new statin about to begin clinical trials. It's called ETC-1002 (Esperian) and right here in Michigan was discovered and developed by one of the scientists who discovered Lipitor--the largest selling medication in the world. It says that ETC-1002 greatly increases good cholesterol, decreases bad cholesterol, decreases tryclycerides, and is touted to be the best statin yet to be discovered.

New medical breakthoughs in heart disease are being made every day. There is always something new to learn, and medical "opinions" can change in a heartbeat.

Welcome to our group.

May the Blessings Be!


Report post

Hi, Thank You all for the replies to my question. I went to a new doctor on Thursday. He also said plaque does not shrink and in my case each of the 4 doctors who have done my caths. came up with a different percentage of blockage in my LAD because each doctor reads it differently. Hum!! I said so I still donot have a answer as to how much of a blockage I have. He said a good estimate for me to live by is the first 3 docs. said a 70% block, and the other said a 40% block. then I could probably only have about a 50 to 60 % block. Yipee!! I said, and feel like I can breath better now. He did put me on plavix, because I am allergic to all statins, I have mialiga (severs muscle cramps and muscle loss from them). so I use fish oil now and blood thinners. I am eating right, low fat, no salt diet. Hopefully this will help as well. I was also told that the bovine valve is another factor in different readings, because no doc is going to do a complete angiogram on me for fear of the high risk. Thats ok by me , because I feel like I have had enough of them already , and the second one I had done, the nurse in the room knocked over the IV pole onto the doctor and caused a iliac artery disection into the acending aorta. A Stent was put in and i am ok. I Look forward to learning from all of you. Smiling now in Va. Terri

Report post

This journal entry is closed to replies. We close all journal entries after 90 days.

If there's something you'd like to say, here are some things you can do:

Things you can do