• 10 months ago

    Proximal and mid LAD stents

    Hello, first time posting here. I'm looking for some support on my recent heart health issues. I'm a 43 y/o male nonsmoker. I have significant family history of poor heart health on my mothers side. I won't go into all of the specifics unless to keep this as short as possible. Here's my story:

    Around the first of this year I noticed some occasional dull achy chest pain. Was very sporadic and could happen at any time. This eventually became more and more frequent. In March I was sitting at work and was feeling the dull ache when I had an episode of sudden intense chest pain that doubled me over and caused SOB, nausea, and extreme sweating. A couple of weeks later I had some extreme SOB after moving a heavy object. My PCP did a work up (chest xray, holter monitor, ekg). All was normal except for ekg shows bradycardia (I exercise frequently). Cardiologist was not impressed but offered to order a stress test or CTA of Heart for my peace of mind. Being and xray tech, I opted for the CTA and it was positive for LAD stricture. On May 30th a Heart cath revealed an 80% "widow maker" stenosis in the mid LAD. Stent was placed and after increasing my workout routine I felt like a new man after a couple of weeks, all symptoms gone. Afterwards I correlated extreme fatigue and dizziness.

    Fast forward a couple of months and the dull achy pain starts coming back along with fatigue. On 9/27 I was jogging and had some pretty intense chest pain along with nausea and sweating. A trip to the ER and a heart cath later in the day and they find another 75% stenosis even more proximal in the LAD. Another stent was placed. F/u with my cardiologist was interesting. He doesn't feel that either stenting explained any of my symptoms and he couldn't explain why the other blockage happened so quickly. I'm still having the dull achy pressure/pain along with dizziness and sporadic SOB. On 10/16 I was also having some sharp stabbing type pain as well so I went to ER AGAIN. Nothing was found, troponin was ok. Was kept overnight for observation. Eventually the pains stopped in the night.

    My PCP is not satisfied that what has been done is sufficient. Based on the location of these blockages, he's concerned that maybe a bypass was the correct option from the start. Both interventionalists mentioned the possibility of by pass before each stent. My cardiologist says I need to be seen in a tertiary facility and I have an apt to see a specialist on 11/9.

    It's hard to correlate all of the things that I'm experiencing, but I know that something is not right with me. Any information or ideas would be very welcome. Thanks in advance to anyone who took the time to read all of this.


  • 7 months ago

    RE: Proximal and mid LAD stents

    I took the time to read it all, even tho' I have no answers for you, I do wish you the best in finding out what is wrong. I have been having chest pains that are getting a little worse, but nothing like what you explain. I had a stress test that showed a "slight darkening" and the Dr. gave me the option of a CT or an angiogram. I opted for the latter, but am still not sure which would be better and may just change my mind. I would agree with you - that something does not seem right with you and I believe you need to find the right Dr. to go through it all with you and find the answer. Again - good luck!!
      • 7 months ago
        Proctorb, thank you for the only response. I wish you the best of luck as well. I understand your uncertainty about which test to do. The cardiac cath is the “gold standard” and might give you more piece of mind than the CTA. In my case I had both, and have yet to have a stress test. I would like to know your outcome if you don’t mind sharing later.

        Since this post a few months ago I have been through another heart cath (3 in one year) on 11-2-18 at Barnes Jewish in St. Louis. I was told it was normal and that my heart was not the reason for the continued chest pain, dizziness, and shortness of breath. It was recommended that I have an EGD done to check my esophagus, this was normal and the pain continues. I had a follow up at Barnes on 1-18-19 and the cardiologist there continued to tell me that my heart was fine and that’s he didn’t know why I was still having pain. He offered to refer me to a colleague who runs the facilities clinic for people who have chronic chest pain. I saw him on 1-22-19 and after reviewing my chart, history and doing a physical exam he confidently diagnosed me with 2 types of coronary microvascular disorders-Coronary Slow Flow and Prinzmetal Angina. I had researched these types of things extensively and in my mind I thought this was the problem. A confirming diagnosis was extremely relieving, even though it means my heart has problems-but I already knew that in my gut. So now it’s a matter of getting the right combination of meds for me that will help control the spasms and open up the arteries. It’s a bit too soon to know for sure, but I think they are helping already.

        I highly recommend that if anyone who reads this and has continued, hard to explain chest pain, keep searching for a doctor who will listen to you and take you seriously. Microvascular disease is not a “made up” diagnosis. There has been a lot of literature coming out of late about the seriousness of the problems this can cause. Best of luck to anyone who reads this.
      • 7 months ago
        So glad I found this article. xrayguy we are the same age with the same problem. I had a 99 blockage stented in my widow maker. Two other stents after that. One of my cardiologist suggest my symptoms "extreme fatigue, chest pains, random feel dizzy" were spasms caused by the stents not allow for natural contraction of the arteries. Are you able to say what the medication they prescribed?
      • 7 months ago
        Sligamer, sounds very familiar. Hope you get the right help. I’ve been on many different meds in the past 9 months in several different combinations. What I’m on now that is working is Diltiazem 24 Hr Er (Cardizem) 240mg twice a day along with Isosorbide Mononitrate Er (Imdur) 60mg once a day. I also take sublingual Nitro when then pain is really bad, but I’ve only done that once since put on this new regimen. I also take aspirin, Plavix, and Crestor. The Imdur does give severe headaches that do gradually go away with time. I was taking a couple of Tylenol in advance to help with that before the headaches let up. The Cardiologist that finally diagnosed me said it’s all about getting the right drugs and dosages for each patient, but he said that Cardizem works best for most. Hope this helps and best of luck to you. I know exactly how you feel and it really degrades your life.