DEAR DR. GOTT: My 58-year-old husband who is never sick was preparing for a hernia-repair procedure but did not pass the EKG pre-op test. They had him do a stress test, which he also flunked. They did a cardiac catheterization and found the right coronary artery is 100 percent blocked. Another has a 60 percent blockage, and another has two 30 percent blockages. They said they don’t do anything unless a blockage is 70 percent or more and gave him Crestor and metoprolol tartrate.
I guess I assumed with a 100 percent blockage, they would have to do a bypass but that doesn’t appear to be an option. He said they do this for a living and have standards they have to follow and that it is a little artery and a big blockage. Other vessels seem to have taken over for it. Does this sound reasonable to you? I’m worried, and he is still in shock that he isn’t the healthy man he thought he was.
Thank you for your help.
DEAR READER: Unfortunately, as you discovered, some disorders may not reveal outward symptoms and aren’t found until something like hernia repair or other unrelated conditions occur. For example, coronary-artery disease affects millions of Americans — yet they have no symptoms and may even remain unaware of the problem until they suffer a heart attack. Symptoms of coronary-artery disease (CAD) include chest pain or discomfort that occurs when the heart muscle fails to get an adequate supply of blood rich in oxygen. Silent CAD is just that — silent.
Your husband had a completely blocked artery. Fortunately, another nearby artery took over the work of the malfunctioning one and your husband remained unknowing. This is a common occurrence. Simply put, this can be compared with a detour on the road. You may have to take an alternate route to get where you are going. But you do get there, nonetheless.
Blood flow within arteries can become either partially or totally blocked because of plaque, a material that builds up within arteries. Partial blockage is known as stenosis, or narrowing. One treatment option might be to simply test the artery yearly. Another might be to provide an anticoagulant or a medication to lower cholesterol levels. The latter is what your husband’s physician chose. Invasive methods of opening an artery might be accomplished through angioplasty.
Crestor should lower your husband’s cholesterol level and reduce his risk of developing stroke and related cardiac conditions. The metoprolol is a beta blocker used to treat angina and hypertension and to help prevent or treat a heart attack.
In this situation, a cardiologist weighed the pros and cons of surgical repair, using a 70 percent blockage as one guideline. I personally know of one patient who was unconscious and not expected to survive. He was sent via ambulance to a large cardiac center where he was monitored closely, placed on medication, and sent home to recuperate. He wasn’t bad enough for surgery! Much to my surprise, the patient survived and did well. He continues to be monitored on a regular basis.
To provide related information, I am sending you a copy of my Health Report “Coronary Artery Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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