Chest Pain

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Aortic Dissection Type B complications

Question: 
My 78 year-old active mother was flown to an out of town hospital last week after she was diagnosed with Aortic Dissection Type B. She is being managed with medication in order to keep her blood pressure under control.  There was no surgical intervention. Tests (CT scans, blood work, sonogram) did not show that any of her organs or limbs were involved.  However, since this has happened her mobility has been affected in that she cannot walk very far. Both of her legs are weak from her knees to her hips and she can barely walk 20 feet without having to sit down.  This has greatly affected her quality of life and activity level.  We are wondering if this is some type of claudication as a result of the dissection, if it’s something temporary, something permanent, or something entirely unrelated.
Hi Carol,
Her symptoms (if new since the diagnosis of Aortic Dissection was made) should be re-evaluated for further treatment The initial therapy was correct but only for as long as no other complications occur. The dissection may well have ‘cut off’ the circulation to her legs and she should be re-tested!
Hope this helps,

My stents failed within days after treatment for a heart attack

Question: 
I had a heart attack 2.5 weeks ago. Next day 3 stents were placed in right coronary artery. Pressure became constant. Went in for more stents in left coronary and was told the right stents had totally closed up. Dr was not able to penetrate any of the 3. He did not place more in right side. So now I am on additional medicines. What can I expect as far as my recovery? Never knew I had heart problems until heart attack. Only other thing I have is hypertension. Dr said diet and exercise will reduce if not cure this problem along with additional arteries growing above blockage and trying to reattach to right artery below blockage. Have you ever heard of that happening?
 

The right coronary artery is totally blocked, but its downstream portion is filled backwards from the Left coronary artery’s major branch, the LAD.

Optimal treatment of coronary artery disease

Question: 
I am having 90-95 % of block in both branches of LAD and 60% of block in RCA. Also have medically controlled normal diabetic,hpertension and cholestrol. Dr. sujested angioplasty; should it be cured by medication ? I have under gone EDTA  chelation therapy and took 20 days (twice a week-EDTA+VIT-C,etc;)
 

Comments 3

  1. Post
    Author

    Hello,

    My mom had a quadruple bypass in 2011 (4 blocked arteries). Ever since then, she was doing better but had some discomfort here and there which doctors said might be due to surgery. She’s also had regular stress tests, every year or in 2 years.
    This year in June 2017, she was having some pain and we took her to ER. They did an angiogram and found 2 of the bypasses not working anymore. Docs placed 3 stents in one of them, the other one was small so it is being treated with medication.

    3 months later now, she has been feeling the same way again. We called the cardiologist but she does not think its heart related but rather just menopausal symptoms (mom complained of hot flashes) but she does have tightness in her back and her nose is always dry, which causes probs breathing. For the past week, she also suddenly having a bruise in her arm, which doctor says is internal bleeding from her blood thinner (brilinta).

    Either we can wait for her next cardiology appointment, but her doc always think shes “fine” even in her last appointment before the stent procedure. Or we can go back to ER and request for another angiogram.

    Is it too soon for another angiogram since it was this past June? Any advice is appreciated. It worries me to think there is something going on with the heart again.

    1. Recurrent chest pains in a patient with known coronary artery disease like your mom is an absolute indication for another investigation, that might include a cardiac stress test, cardiac CT scan or catherization. Her cardiologist needs to evaluate potential chest pain causes and not assume anything until she has evaluated tests that have excluded or confirmed recurrent blockages!
      Hope this helps,
      Dr T

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