A stemi heart attack involving the LAD is typically more serious than other heart attacks. Left main : Normal Distal LAD appears normal with no significant plaquing or luminal narrowing. They chose intervention as opposed to CABG due to the significant damage and little to no chance of survivability. Anterior ECG leads at baseline demonstrated poor and/or no R wave progression. I am a 59 years old women. According to my doctor, there are no further concerns of additional blockages. What is your hunch on this matter and any suggestion is welcome. A stent wont decrease the risk of a heart attack in those situations. Are his chances of a recurrence of an MI higher than any other individual LAD artery Abbreviation for leukocyte adhesion deficiency. Why would a blockage develop in such a large vessel rather than in one of its subs? The left circumflex was assigned a score of 32. This is why bypass is reserved for critical blockages. Thanks, My CT cardiac score in April 2012 was LAD-19 & I had the same score Nov 7 2016 w/ other findings; mild artherosclerotic plaque burden, mild or minimal coronary stenosis likely, implications for CV risk moderate. rca 100% (proximal ) Diagnols- Diffuse disease 1, Circumflex: Non dominant 75% stenosis at ostium, TIMI 3 dIstal flow He ballooned the two stents and added a 3rd in the gap. He told me that I had a very critical heart disease and need the operation desperately since I could drop dead at any minute, this was very upsetting and let my original DR> know, he apologized for his behavior and said this Dr just treats these things differently, he showed me my ECHO with an EF of 55. Mike has recovered from the stents operation, and is now on Aspirin, Plavix and Metoprolol. About 50% chance of success. The LAD supplies the a large area of the heart and if a blockage occurs, the death could be sudden. My husband had chest pain which we mistook for gastric acidity. During the stress Test three are no symptoms too. My father 52 yrs old, recently got 2 Sirolimus Drug eluting stent placed in his proximal and MID LAD. The small area with significant viable myocardium in the distal septum involves less than 5% of the LV myocardium. If the stress test is low risk and you have no symptoms or reason for an angiogram then one shouldn’t be done. What could that be my mom use to have PVCs before she passed is that the same thing. My mother is 64 yrs old. He has to fly long distances once in about 4 to 5 months. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider. Dr. Mustafa Ahmed. Plan: PTCA With Drug Eluting Stent To LAD /RCA. It means that you have minimal flow only in the artery. doctor put him on aspirin, blood pressure med. My brother in law Mike was recently found to have a 100% blocked LAD, and he had 2 stents (total of 6cm in length) inserted 2 days later in a larger hospital after being airlifted from a smaller hospital (Australia). My questions are- Thoracic Aortic Aneurysm I am 34 I had a massive heart attack my LAD was 98% blocked. I am 72. I mean the maxmimum and minimum pressure. Hi, it sounds like your test showed a small blockage likely only which is reassuring. My ejection fraction was 40% in the hospital. It may need to be addressed Sitemap. You should undergo evaluation to ensure risk factors such as cholesterol, diet, lifestyle, blood pressure, diabetes and so on.. are being treated aggressively. I would need to see the films to comment on the findings. but after few hours he became hypotensive and started shortness of breath. The peak blood pressure during stress was 189/68 mmHg. 1. If you have questions, its very reasonable to have a surgeon review the films regardless. After that he did stress test and echo and it was always good. I have 99% block in my vessel III of LAD in my heart, except this block nothing problem in my heart. Depends on many factors including anatomy, location, complexity of lesion, patient history and operator. Akinesia of the anteroseptal wall extending to the apex is seen. After that the risk of restenosis is theoretically lower than that if an existing stent were present. Has a stress test been performed, are there symptoms? These situations are often very complex and vary hugely from patient to patient. Interpretation: Calcium score of 810 at the 81st percentile. They recommended a bypass which is what he will be having next month. What would be the deciding factor? I know nothing about Internist and whether I should trust anyone besides a cardiologist with my heart. CT coronary angiogram shows mild diffuse irregularities. Cardiac MRI: Function and Viability I can send the actual medical reports if you sent me an email address. The FFR test is another way of checking the severity of a lesion, a negative ffr generally means it can be left alone. In rarer cases an operation may be required. The septal branches of the left anterior descending supply the septum, which is the wall between the left and right main pumping chambers of the heart. Medication: Aspirin 100mg, Twynsta 80/10 and Atorvastatin 40 mg and do 5 x week 40 min moderate aerobic. Occlusion of the LAD It’s just lack of knowledge that puts me at the mercy of others. I am 44 yr old female with only history is insomnia. Its difficult to comment on the LAD without looking at the films, in general if vessels are too small, medical therapy may be preferred to bypass or stenting. Jazak allah Khairan. You should be able to do pretty much as you please in terms of diet this far after the surgery, although your medication timing would need adjustment. Left anterior descending artery: Diffusely diseased. I also have multiple stents in LAD, placed in March 2017. Have read on warfarin and it’s not the best of drugs for a 48 year old. Taking this advocate roll has been therapeutic and helped this life changing event worth it. Is she in a critical condition? atrial fibrillation a. tach. Why? baseline. IPPA. It was unblocked and a stent was put in. Left Coronary artery: Left Main stem (Normal bifurcating vessel), Left Anterior descending Artery {(1) there is 60% eccentric mid LAD stenosis, (2) Moderate proximal LAD calcification. Is it just anxiety? You appear to be in good shape with a good lifestyle. My mother had an Agiography done recently. The report says. Large infarct in the apex and the anteroseptal wall with a small area of viability within it in the distal septal wall. I had two LAD heart attacks last year Aug 2015. I am a 70 year old male ( Australian ) and was wondering if I could get your comment on my CT Calcium Scoring: :/. 81 mg aspirin is likely the correct dose. I am 62 and quit smoking 10 years ago. Everyone states its anxiety but I still get the pain. Is stenting preferred or is it better to consider a Bypass ? Regards Exercise duration : 11.10 min why did the doctor did not think of keeping him on cardiac meds? He also a 100% blockage in one of his carotid arteries and the other carotid was 90% blocked and a stent was placed 2 years ago. Hi was it missed in the reading?? Medical therapy would be advised in most cases and intervention such as a stent only done if that doesn’t work. The last two procedures were radial and the first one by groin. Baseline The mid and apical anterior septum and apical anterior segment are While i don’t endorse a particular treatment, i don’t think we should be entirely dismissive of them. Everything I have read about LAD is this is a major vessel which feeds a big portion of the heart and if this is blocked will cause majoy damage to ones heart muscle. Especially ecospirin ? under 4mm non calcified nodule noted in the left lower lobe. I’ve controlled all factors besides stress. Look up papers on FFR and CFR measurement. February 7, 2016 at 8:47 pm dens eccentric calcified plaque seen in the proximal LAD at he level of origin of first diagonal with blooming artifact and minimal luminal (<25%). End Diastolic Volume: 131 mL (normal: male = 77-195 mL; female = 52-141 mL) I am one month out from the procedure. In two months this will be tested again. PS: Would it be possible to send a copy of your reply also into my Inbox, thanks. Hi Lisa, were you symptomatic before your heart attack? The very proximal LAD Has a very tight stenosis of 90%+ Doctor said the artery was damaged during the procedure. I have many questions but seems kinda hopeless right now. RCA: Is a co-dominant vessel and shows proximal 40% stenosis. Any further tests required? He likely had development of channels that naturally bypassed the LAD that prevented major catastrophe. The vein goes from my feet up into my belly area. Privacy Policy. Hy.doc I want to share angiogram of my brother with u.37 year old non diabetic normotensive.nonsmoker. MyHeart is not a substitute for advice from a doctor. You need to pay attention to lifestyle, diabetes, medicines, follow up, exercise, diet and so on. I later on realized that I was undergoing a heart attack otherwise I was in an impression that I had some digestive problem. I was told by my doctor that had I been a few minutes late, I would have gone. The need for intervention is not typically based on the anatomy alone, rather the presence and extent of symptoms and stability. © 2015 MyHeart. I would recommend some form of imaging stress test such as nuclear stress test or stress echo to evaluate the functional significance of what appears to be a relatively stable lesion. Kim, I am sorry for your loss. Basically the LAD covers a large area! I’m so sorry to hear about your father. Was my condition be called as Widowmaker ? Distal LCX continuous as PDA & PLV which appears normal caliber with no obvious plaquing or luminal narrowing. It is a coronary artery, which is the name given to arteries that supply the heart muscle with blood. my husband didn’t go to the doctor for 12 years. Results sent me for Cath of heart same day. Hi I’m 48 year old female, healthy (so I thought) exercise daily eat well not overweight although have smoked for 20 years. And the survival rate was greater with cabg w/lima then with stents. Significant blockages of the LAD artery can be dangerous simply because the LAD supplies such a large territory. I said wait how critical am I? Will that heal without stenting? The calcium score is 810 and volume 694 mm tube. For LAD we have found 285 definitions. is this thoat tighness while jogging occur due to blockage. Good exercise tolerance. Calcification was analyzed using ScImages’s volumetric calcified plaque analysis software. LMCA – distal plaque The post stress scan image show normal sized left ventricular cavety with mildly reduceduptakein the apexwhich shows reperfusion in the rest re-injectionimages. I have stents 4 of them, went in the hospital a week ago then to my heart doctor he told me i was fine if i was not having any more pain and had been walking for 20 to 30 minutes a day but one Wednesday night we came home and i had a very hard tump in the left side of my chest later that night i had another went to hospital but my doctor thinks I’m ok but i don’t feel well. The LAD Artery What is the function of the heart, are you maximally treated with medicines, have you had a full discussion about the risks and benefits? not sure it was thromosis or temponade. Low Heart Rate – Bradycardia Explained by a Heart Doctor. Peak The mid anteroseptal segment is hypokinetic. * Post- stenting: Excellent result with no residual stenosis. sad with so many questions, I am currently very anxious to know if I am in danger with this aortic aneurysm thank you. Wondering what next step is for me – can’t take meds – diet really not a factor due to my family history. The cardiologist performed a cardiac cath and told us he didn’t put any stents in because he has numerous severe blockages. What age/generation has a better chance of surviving this LAD blockage? These are called collaterals. Global systolic LV function: Poor The body will send platelets to the stent sight to protect the body and encapsulate it. The report says, Left main Coronary Artery : Normal Large diagonal shows proximal 80% stenosis. I have mild cheat pain occasionally and did have a stress test which I passed. Then doctor suggested for TMT and he got tired in 3-4 min. I cant really comment without clinical evaluation and review of the films. I work in a cath lab as a nurse. The first diagonal branch is 100% blocked while there are collaterals from the RCA that fill up to the second diagonal vessel. This decision needs to be made by the treating team with access to you, the clinical picture and the angiography films. As per doctor’s advice; a CT coronary angiography is performed and report says as below – 3. If it is a stable lesion, and the symptoms are stable or absent medical treatment is advised for these intermediate lesions. Im not familiar enough with the topic to intelligently advise you. How serious is this? Read the widowmaker article on this site to get a better idea of what you underwent. I am in Europe at the moment and have presented the CTCA and hospital Angiograms to two Cardiology professionals and after Analysing them they are all reluctant to perform a Stenting procedure on me.My general practitioner here is warning me that something should be done to my diseased Left Ascending artery, even a single stent at the beginning of the vessel, otherwise if it gets completely blocked he says we will be in Big trouble,as they say here? Clinical information a 48-year-old male patient with acute coronary syndrome. I walk 4 Km every day and play badminton on alternate days. In terms of the medications it shouldnt be an issue. I believe I had untreated diabetes for 5 years and was roughly 300 lbs for 10 of the 15 years. The patient is unlikely to benefit from revascularisation. My husband had the MI four moths ago but he i.e. The drs suggestion was to have a single bypass with LIMA. It means Left internal mammary artery(LIMA) to Left Anterior descending (LAD) graft and saphenous vein graft(SVG) to obtuse marginal (OM)artery. Disclaimer: These citations have been automatically generated based on the information we have and it may not be 100% accurate. After 1 week I underwent Troponin test which was positive. God Bless those of us suffering with HD. My cardiologist decided to use meds to treat but at first was going to use stent. I have a active lifestyle walking/fitness, eat healthy, daily herbal vitamins, flax seed & other natural supplements. showing only Military and Government definitions (show all 47 definitions). Stress testing or physiologic testing when doing the angiogram may help to more accurately assess the need for angioplasty and stenting. The baseline rhythm was normal sinus rhythm. Iyman sherman says Here is my concern… I am terrified that even with all of these changes, I should not expect to live a normal life or life span. So we visited Cardiac Specialist and did Aangiographi and found below details. Moderate nonobstructive atherosclerosis Of The mid portion Of The left circumflex artery .4. My question: When is angioplasty not an alternative for an 80% blocked LAD? I would start by going and talking to the Dr that did the case to explain the reasoning so you can have a more clear picture of what happened and why that management plan was chosen. The diagnostic testing nowadays has made it easier to pick this up. Also, AV cusps are thickened and calcified, heart is enlarged (C:T = 13 CM: 22 CM) in traverse diameter. I look forward to your response. © Texas Heart Institute The University of Iowa does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on this web site. I had no symptoms of either it was actually stumbled by by my neurologist and the heart attack was sudden when I got terrific pain in my shoulder. Left ventricular measurements 2. 'Left Anterior Descending' is one option -- get in to view more @ The Web's largest and most authoritative acronyms and abbreviations resource. If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD. Left ventricular measurements I told him I will go home to get things in order and come back Sunday ….As I was leaving the hospital I called my original Dr. and he went nutz on me and asked for the test results…and for me to come to his office tomorrow. She was given medication aspirin, amlodipin and atorvastatin and now the cholesterol levels have gone down. In stable diseases it is not generally felt to be an issue, most would say check with a physician first, some of the donation organizations have rules such as a need for a certain time to have passed since treatment and stable medication over that time. NM REST MYOCARDIAL PERFUSION and MRI CHEST Was done. Language Acquisition Device Sociology, Language, Acquisition. Regards LAD II is caused by mutations of the SLC35C1 gene. I am paying the price for his ignorance now. LAD : Mid LAD 80%, Distal LAD 75%, and Diagonal mid 80%, RCA : Small and non dominant, Mid RCA 85%. The dr discovered that his RCA was 99% blocked and ended up placing 64 mm worth of stents throughout the RCA. [ within 15 days]. 80% calcified, diffuse eccentric lesion in the proximal segment after the bifurcation of the first diagonal branch. Should I start taking some precautions in diet and the mostttt important that should i keep continuing with my pipe smoking ( I dont inhale the smoke ) ? Left ventricle myocardial enhancement Your exercise capacity is good which is reassuring. Often further tests such as viability tests are done in this setting to see if patients may benefit from bypass or stenting, in your case bypass would appear the most likely option with the limited information provided and a viability test would given an idea to see if the tissue is still alive. Sir my may i have your email ? You Are Here: MyHeart » Heart Disease » Coronary Artery Disease » The LAD Artery Is this new discovery not an emergency and should he just opt out of the stent and go ahead and do the bypass surgery? The LAD is considered the most important of the three main coronary arteries and is almost always the largest. Top LAD abbreviation meaning: Left Anterior Descending Curious if you opted for the bypass? Thanks and regards, I currently weigh 205 lbs. Over 99% of people have at least one diagonal branch of the left anterior descending artery. Tell Us How We’re Doing… Is air travel to be avoided? If the clot is there and we have to live with it why do we need warfarin? Thanks for that. Seeing my face, he took no time and dumped me into a wheelchair. There is fibrocalcific plaque noted in the proximal LAD approx 0.7 cm beyond origin causing significantly focal 75-80% narrowing .the involved segment measures approx 0.8 cm in length . LEFT VENTRICLE: Global left ventricular systolic function is normal (LVEF 60-65%). lima to lad is patent . I had a very stressful job but the pot helped with stress. 2. Dear DR Ahmed, The patient’s baseline blood pressure was normal. Not all hospitals are equipped with good interventionalist that can call in a Thoracic surgeon instead of trying to “see” if they can stent it. It hasn’t even been one year and the bipass is 50 percent stenosed and it caused more problems than good. I would recommend being evalauted by the treating cardiologist regarding the chest twinges. I have had multiple stents to LAD, many inside others, once clotting a day after causing an mi. My total score was 233 which is considered at least moderate risk of a heart attack. How long should I take my Plavix after stenting? A focal 75-80% narrowing in the proximal LAD with fibrocalcific plaque. Involving 20 % of the left ventricle anterior myocardial Wall. I understand stents have improved greatly but I was wondering what I can expect.All of the men on my dad’s side of the family died of heart disease in their early 60’s but were untreated and heavy smokers. Obviously, a score of “zero” is optimal, and a score of >300 (or >400, depending upon who you listen to) warrants further work-up, like a treadmill test or nuclear study. Essentially normal symmetrical tracer uptake is notein rest of the left ventricularwalls.The gated SPECT images show normal left ventricular regional wall motion with LVEF of 70%. Inferolateral ECG leads with stress demonstrated minimal (12 bpm). was it missed in the reading?? Prior to the operation he was optimistic that he would be able to also by pass my LAD. Viability test showed minimal results if stented. THANK YOU. please advice on which treatment will be better. HI Dr Ahmed, LAD total cut and CX too. Please do share you suggestions doctor. A lot depends on why the test was performed in the first place. If you are having symptoms and a test suggests you need an angiogram i don’t understand the wait till March. At some point, i will need this stented as well, but may opt for bypass as I’ve heard with today’s technology they are much less invasive. Was This Article Helpful? He also has type I DM. To my dissatisfaction I agreed, here we go 3 LHC’s in 3 weeks! Will 2 stents in LAD cause any latter stage complication in life sir? I mean what is it? The doctor said that my LAD is 60% blocked and I will need open heart surgery. The Cardiologist got me do the Treadmill stress test – achieved 118% of target heart rate, HR 164/94, and perfectly normal ECG. Non smoker ,non drinker , reasonably physically fit, 51 yrs next month ,was asked by office doctor to CT coronary angiogram as a part of annual health checkup . I am currently working on a cardiovascular modelling (CFD) project. This happened twice in the past two years. I ate well and exercised. he experiences no pain after the heart attack. Kind regards I can try to send you the copy of the angiogram if you share the email id. 1.LMS NORMAL being scared wont help you. 30% blocked LAD 5 years ago- Had chest pains 2 weeks ago and they did a heart cath again and said I am 60% LAD 40% RCA and 30% (can’t remember) I am now on angina meds but still get a few pains every day but nothing like what took me to emergency room 2 weeks ago. I was then asked to do thallium stress test : WITHE THE LAD BEING THE WAY IT IS BLOCKED SHOULD I GET AN ANGIOGRAM TO DETERMINE THE EXTENT OF WHAT ELSE. The septal branches of the left anterior descending supply the septum, which is the wall between the left and right main pumping chambers of the heart. I am looking for guidance since I have had multiple procedures done on my LAD and it looks like the trend will continue unless I go in a different direction. he didn’t feel well. Which I’m assuming was the widowmaker heart attack. unfolded aorta is seen. A nuclear stress test fellowed a week later it was normal. he did that and told the block was very hard to penetrate it took two wires to do that. Comparison LAD =left anterior descending, left axis deviation or leukocyte adhesion deficiency, so I think he got the abbreviation not quite right. My EF is in the cellar. And also sometimes I have a feeling like I lose my breath for a sec and I just happen to check my pulse when it happens and it feels like my pulse stops when I feel like I lost my breath. I am starting to feel unwell again. Diagonal lesions alone are typically treated with medicines. Is this an insurance issue where the insurance companies don’t want to pay for it? The 3rd distal blockage could not be fixed. he also had a stress test, ekg and echocardiogram. I like to hear more options and recommendations. The most important thing is follow up, medications, lifestyle, activity, diabetes control, no smoking, and risk factor control. I gad an angiogram two weeks ago, it revealed a blockage. 3) Air travel should be discussed at the follow up appointment and depends on stability of disease. He was put on medication including plavix. The latter result was the reason for going in for a Angiogram in the first place. Left Main Stem >> Normal Bifurcating Vessel, Left Anterior Descending Artery >> Mild Mid Disease, Left Circumflex Artery >> Good Size OM1 Shows mild Proximal Disease. Read by over a million people every year, MyHeart is quickly becoming a "go to" resource for patients across the world. This needs to be determined by the treating Dr. Are these medications doing the same job as an angioplasty but through medication. No exercise induced arrhythmias were noted. Essentially normal symmetrical tracer uptake is noted in rest of the left ventricular walls.The gated SPECT images show normal left ventricular regional wall motion with LVEF of 70%. Also its important to note that although a procedure or operation may be required, you are spot on in that healthy living and medication are at least as important in determining your long term outcome. This needs to be answered by the treating physician with regards to post stent activity. In some circumstances this can restrict blood flow. I also have been pretty weak since hospital discharge and weak tolerance for activity. They told me 3 years ago that there were illregularities just think they should of sorted it then and not let me have a mild heart attack this time. I have never had the CT scan before but what exactly does the LAD score and Plaque score mean? I would discuss with your dr and see if there is any role for intensive risk factor reduction focus. any feedback is appreciated. I was having severe side effects on metoprolol so cardiologist switched me to Atenolol. My father fear from angiography. When my appointment finally came the cardiologist had left and they put me with an Internist/Internal Medicine doctor. He changed me from simvastatin to lipitor and gave me blood pressure med. The resting blood pressure was 100/65 mmHg. Im guessing its at the very beginning of the vessel. 6. What are your recommendations on how to proceed with this diagnosis? The bodies natural instinct is to attack foreign object placed in the body which is why clots are an issue post stent. It has been a year so far it seems OK. Small area of inducible ischemia is noted in the basal infero septum and mid and basal inferior wall With more 75 peer-reviewed medical publications to date, his professional and academic contributions to advancing structural heart care are internationally recognized. the next morning the procedure started and once in the Dr. stopped the procedure about 10-15 mins in to it. Proximal – Small soft plaque is seen in proximal LCX causing approx. Sorry to add another medicine Rosuvas 20 ( 1 tablet daily after dinner). Is there any GENETIC HEREDITARY correlation for my CA score abnormality and possible heart concerns? The blockages are at 80%, 70% and 55%. It was on 8th Jan in the morning, after taking my breakfast , that i started feeling a bit congestion in upper part of the chest. I would ask for a second opinion but please research this carefully.