http://www.vitamincfoundation.org/forum/viewtopic.php?f=11&t=12113&start=60 Just an update, I had another heart cath on 12-17-15, if you recall there was a nuclear stress test done in October that indicated that there may have been a small blockage in the bottom of the heart and the doctors suggestion was to do a heart cath then. I elected to continue with the medications I was on and added an extended release nitro. After several weeks it became obvious that the ER nitro was not enough to eliminate all the chest pain symptoms without adding another regular nitro pill. It also became obvious that the trend was heading downhill even though I was still on PT and vegan diet. (with a little oil) So I decided that I would take advantage of the fact that my insurance deductible had already been paid for the year (and several other factors)and decided to have the heart cath.
Fortunately, they did not find any glaring issues so the doctor is just increasing the dosage of the ER nitro. Unfortunately, I was unable to have a discussion with the doctor after the procedure but was able to talk with his PA who also arranged to get me a copy of the catheterization report. I was unable to discuss the specifics in the report with the PA as I really didn't get a chance to read it till I got home (200 miles away) Needless to say, I am not "up" on my heart related terminology so a great deal of the info in the report I don't understand. I will say though that the somewhat rosey outcome of the heart cath results gave way to some distress when trying to pick this report apart.
Thus the reason for the current post. I thought the group could help enlighten what the report is actually saying and make suggestions as to if PT is indeed helpful in my situation and if it should be modified in anyway in attempt to get the best results.
The report lists the Hemodynamic Data which I will leave out unless someone feels it would be useful.
Left ventriculography:
Ejection fraction is 62%
Anterior hypokinesis is noted.
Coronary angiography: A right dominant system is present
Left main coranary artery: Gives rise to the LAD, circumflex, and ramus intermedius arteries. Luminal irregularities are present.
Left anterior descending coronary artery: The left anterior descending artery is a large vessel reaching the apex of the LV, wrapping around the apex, giving rise to the first diagonal to the second diagonal and previously placed stents in the LAD are patent.
Left circumflex coronary artery: The circumflex artery is a medium sized vessel which gives rise to the first obtuse marginal, to the second obtuse marginal and distal circumflex is providing collaterals to the right coronary artery. The mid-circumflex artery showed a 40% narrowing. The ostial Obtuse Marginal 3 has 100% occlusion. Collateral to the third obtuse marginal are provided by the distal LAD
Ramus intermedius coronary artery: The ramus intermdedius artery is a medium sized vessel. Luminal irregularities are present in this vessel.
Right Coronary Artery: The mid-right coronary artery showed 100% occlusion. Occlusion occurs just past the marginal branch. Collaterals are being provided by the distal left anterior descending artery.
Grafts: Saphenous vein grafts t the right coronary artery and the left anterior descending artery are 100% occluded.
Conclusions:
1. Three vessel coronary artery disease.
2. Patent stents in the left anterior descending artery.
3. Diastolic dysfunction and systemic hypertension.
4. Normal overall ejection fraction with regional wall motion abnormalities.
5. EF= 62%
6. Occluded SVG to the LAD and the RCA
Recommendations:
1. Maximize medical therapy
2. Risk factor modification
3. Prompt evaluation with recurrent chest pain
For me, the mention of collaterals is encouraging but the discussion of occlusions and narrowing is disturbing. Trying to put my head around the whole picture and I'm coming up with a Salvador Dali painting!
Just to add, after reading the many posts about getting off of statins, I weaned myself off of them in October of this year. Since that time my cholesterol number has increased to 300 from 180.5 in July 2015. Here is some additional data taken while in for the cath compared to July.
July / Dec 17,
Cholesterol 180 / 300
Triglyc 206.1 / 204
HDL 42.2 / 50
LDL Calc 97.1 / 209.2
VLDL Cal 40.8
CARD Risk 6
From the posts I read cholesterol increase when dropping statins and on PT is normal although I'm not sure how long.
I have posted this cath data at Owens suggestion in hope that I and others may gain some insight and knowledge. I look forward to comments, suggestions and recommendations from the group.