Angina and a single coronary artery blockage

I have a 80% blockage of my ramus branch of the coronary artery. I was initially hospitalized in the Kaiser Permanente Hospital in Sacramento in 1/1996 with chest pain and it was determined I had a LBBB. Since that time I have had 5 heart protocols after complaining of chest pain. My Dad, a patholgist, kept telling me to keep after it because it appeared nobody was believing me. Finally, in 11/2011 I was catheterized and a 80% blockage was found. Due to its small caliber it could not be stinted or survive angioplasty. I have been on Ranexa. I am not getting worse, nor am I getting better. I have type 2 diabetes totally controlled. I also have myasynthia gravis also controlled and Low T. My whole family is doctors. I was a USAF pilot and I also lettered in HS and College Football. Altough my height and weight is out of proportion, I look exactly like my Dad and Uncles look and none of them were athletic nor did any of them die of heart disease and all lived into their mid 80s. I have never smoked or used illegal drugs and was always acive. Unfortunately perhaps, I have a high pain threshold and on several occassion I have continued to function with serious wounds and disease until forced to stop. I trust my current cardiologist, and he has indicated that no other method would have found my blockage. He also has told me that my prior heart protocols were invalid as my LBBB would have made them inaccurate. I also went over this data with my first cousin,  the senior pathologist at Cincinnati General or whatever it is called now, and he also confirmed this. My problem is that being a former veteran and exposed to Agent Orange, the VA is giving me an Effective Date of the day of my heart catheteriztion in 12/11. Their definition of cornonary heart disease specifially includes angina which I have been complaining about for many years. Nobody called it angina until the catheterization. My first question is, with a small caliber artery blockage, what are the chances of a heart attack?, and second, why can't my complaint of chest pain be called angina? My dad passed away 10 years ago or I would be asking him. He also was a VA consultant. I feel sorry for vets who have do deal with the VA without help.  

An 80% obstruction of the ramus branch of the circumflex coronary artery means you have coronary artery disease, but not  necessarily that your chest pain is angina, caused by this blockage. For that, other tests such as a stress test are necessary. Considering this lesion was discovered in 2011 and the ramus is as small as described by you, the volume of blood that flows through is also very small and therefore unlikely to cause much trouble even now, and an even less likely reason for angina since 1996. Meanwhile, you should review your cardiac risks and look into what you can do for a heart healthy life style. You can also calculate your cardiac risks and your optimal treatment.

Blockages can be found by a number different methods besides catherisation:
Treatment not only depends on finding a lesion but more specifically on the effects of insufficient blood supply to your heart. I cannot comment on Agent Ortange or the VA system.
Hope this helps,
Dr T



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