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Need for BYPASS SURGERY with OCCLUDED LAD in ANGIOPLASTY.

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ended up with emergency angioplasty after 2 and a half hour of cardiac pain.
doctor found totally occlude lad. opened it to 50 percent with angioplasty.
recommends bypass surgery and am waiting to see cardiac surgeon on 15 may. am concerned with diagnosis which were almost non existant. government hospital and not very open but very dictatorial.

i was discharged from hospital with the following meds
BEFORE BRKFST
omeprazole 1; antiacid

AFTER BRKFST
losartan 1; angio ll
aspent 1; aspirin
spironolactone 1; diuretic
ismo 2, vasodialor

AFTER DINNER
losartan 1; angio ll
ismo 2, vasodialator

8pm
flomax 2 tamsulosin
sennakot 3

BEFORE BED
semvistatin 1 40mg; statin
lorazepam 1; relaxant

i am concerned thaat he did not enclude a beta blocker and a calcium channel blocker. i have variant angina which is quite severe at times.

i also am not sure as to the ability of my heart to function and whether i am in danger of pulmonary edema or having liquids around the heart.

i will not be able to have surgery for another 2 to 4 weeks and am wondering of my prognosis until then and is it possible to exercise like riding a bicycle at this time.

i have encluded copies of angiogram and echogram for you study and comment.

thank you
carl bethell

Category: Cardiologist

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Category: Cardiologist
 26 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I sincerely apologise for the delay in reply.
Ideally when the ejection fraction of the heart is reduced, in your case it's around 35%, so the treating doctor has rightly started losartan and diuretics. Beta blockers has to be started starting with a low dose and gradually stepped up.
Once ejection fraction comes down following an attack and the artery is opened up early, there is a chance that it will improve. But whether it will be completely normal, it's difficult to say because may be some amount of damage of heart in your case.
In your case without complete revascularisation, the will be a chance of pulmonary edema, but can be minimized by restriction of fluids to 1000 ml per day and gradually adding beta blockers and avoid exertional activities.
I will request you to share the angiogram cd ( through dropbox ) or you may also share the link if possible, and the video image of the ECHO if possible. That will help me comment better on what procedure is best suited for you.
Till your heart is completely treated by either CABG or Angioplasty, I would suggest you don't do any exertional activities like cycling.
Feel free to discuss further,
Regards.


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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