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Medical Forum / General / Cardiology / May 2008questions on angiography
I'm getting information second hand about my mother-in-law, but this is what I know. She's 85, and a few days ago she felt odd,and she was taken to a local ER where they said she had some kind of arrythmia. Atria and ventricles were not coordinated, apparently. So she had an angiogram yesterday, and at most, a vessel was 75% blocked, and one was 50% blocked. However, the report I get from one of her daughters (who is freaking out BTW and I'm having a difficult time getting reliable info from her, because she is feeling sorry for herself, and NOT her mother - that's another story) is that my mother-in-law has some kid of anatomical malformation of her coronary arteries. She has two, where the cardiologist expected three. First of all, the cardiologist claimed he had never seen a patient with only two coronary arteries, but a review of the web indicates that this not uncommon (so I wonder about his experience ??, or the veracity of the web). So they want to do a ACV angiogram? What is that. I've had enough angiograms to know that if an artery is blocked you won't see it. So how can they determine if the lack of proper contrast dye is due to an antomical malformation, or a 100% blocked artery. The info I get is that EKG apparently is fine (how can it be fine with an arrythmia?), as well as other blood and functional workup I'm hoping I can get on a 3-way call with my sister-in-law and her mom's cardiologist so I can get some unfiltered answers. I want to know if the apparent anatomical malformation is the cause of the arrythmia. And what tests/procedures are really necessary. Jerry > I'm getting information second hand about my mother-in-law, but this > is what I know. She's 85, and a few days ago she felt odd,and she was [quoted text clipped - 24 lines] > > Jerry Bill says in third person. What ....... Don't fear the reaper! Who thinks you are a nut case. http://en.wikipedia.org/wiki/Life_expectancy  SignatureGarden in shade zone 5 S Jersey USA neighbor Jerry (jerry.ra...@pioneer.com) wrote: > I'm getting information second hand about my mother-in-law, but this > is what I know. She's 85, and a few days ago she felt odd,and she was [quoted text clipped - 11 lines] > uncommon (so I wonder about his experience ??, or the veracity of the > web). So they want to do a ACV angiogram? Suspect what they heard was "a CT angiogram." > What is that. A computed tomography (CT) angiogram is doing a coronary angiogram using newer 64 slice CT scanners: http://www.medicinenet.com/ct_coronary_angiogram/article.htm However, this may not be a good idea for your mother-in-law because of the arrhythmia. > I've had enough angiograms to know that if an artery is blocked you won't see > it. We would either see a "stump" or "feel" the catheter "engage." > So how can they determine if the lack of proper contrast dye is > due to an antomical malformation, or a 100% blocked artery. Largely by experience. > The info I get is that EKG apparently is fine (how can it be fine with > an arrythmia?), as well as other blood and functional workup Perhaps, the arrhythmia was transient. If so, then a CT coronary angiogram would now be possible. > I'm hoping I can get on a 3-way call with my sister-in-law and her > mom's cardiologist so I can get some unfiltered answers. I want to > know if the apparent anatomical malformation is the cause of the > arrythmia. It would not be else she would have had the arrhythmia for as long as she has had the congenitally anomalous coronary arteries, which would be for 85 years since birth. > And what tests/procedures are really necessary. Being that your mother-in-law is 85 years old so that she has done well without such tests/procedures for 85 years to check for something she would have had for 85 years, your concerns about medical necessity are justified. Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow Dr Chung I have the angio diagram. She is missing what the Dr has identified as the LQ, but it looks like there is no CX to me. I presume typically the CX branches off the same stem from which the LAD arises? Thats what the drawing shows. He also said the RCA has produced lots of collaterals. I'm at work, but my wife is at hoem and she'll be chatting with the cardiiologist very soon. He said if we don't have surgery, its suicide. Whihc, unless she is having symptoms, I think is a very bad thing to say to try to force her to have surgery. Jerry On May 2, 9:14 am, jerry.ra...@pioneer.com wrote: > Dr Chung > I have the angio diagram. She is missing what the Dr has identified as [quoted text clipped - 8 lines] > > Jerry Jerry, Chung is a mentally ill, religious whadadoo, quack who has not practiced medicine since being thrown out of his first post-fellowhip job in Florida in 2001. Read several of his posts and you'll get the idea. Additionally, he will call me Satan for having pointed this out to you. Is that how a real cardiologist would respond? Get a second opinion from a real, practicing, competent cardiologist that your mother sees face-to-face. Nothing that Chung says about any subject is useful or reliable. Don't let your mother's care be compromised. > Dr Chung > I have the angio diagram. She is missing what the Dr has identified as [quoted text clipped - 8 lines] > > Jerry Since you are still requesting Chung's advice, then you must be a sockpuppet of Chung or an idiot, and if that is not the case, then get yourself to Cnung's office in Mableton Geargia so he can personally see her and evaluate all your studies and if you need surgery, and it is not amenable to his 2PD Blah Blah, then he can refer her to one of the surgeons he personally know. So if you want to put your wife's life in Chung's hands, then do it completely. actually I read the handwriting wrong, it is labeled as LCX, not LQ >I have the angio diagram. She is missing what the Dr has identified as >the LQ, but it looks like there is no CX to me. I presume typically [quoted text clipped - 5 lines] >suicide. Whihc, unless she is having symptoms, I think is a very bad >thing to say to try to force her to have surgery. Read some of Chung's other posts, even if only in the last 24 hours, before you take anything serious from him. Beware!!! http://HeartMDPhD.com/ARF <>< http://HeartMDPhD.com/ChristianBrethren >http://HeartMDPhD.com/ARF > ><>< > >http://HeartMDPhD.com/ChristianBrethren Wow, yet another satanic morph of this user name to killfile! Zob http://HeartMDPhD.com/Convicts/PrayForZob <>< http://HeartMDPhD.com/HolySpirit/Love shes marginally diabetic too, managed by diet alone > shes marginally diabetic too, managed by diet alone This keeps getting better and better. ain't it the truth ! but to her credit, she didn't want to take injections, so she dramatically changed her diet, lost weight, is very active, and she looks great....sometimes we need our lives shaken up before we make/take the appropriate life-style changes that are most beneficial to a healthy existence >> shes marginally diabetic too, managed by diet alone > >This keeps getting better and better. On May 2, 12:47 pm, jerry.ra...@pioneer.com wrote: > ain't it the truth ! > but to her credit, she didn't want to take injections, so she [quoted text clipped - 8 lines] > > - Show quoted text - >This keeps getting better and better. > ain't it the truth ! Whooosh...Right over his head. > so she > dramatically changed her diet How did shge do that? Don't know exactly because we live in Iowa and she in Chicago, so I don't see her much. But she stayed away from candy, processed flour goods, limited her caloric intake, has litter "junk" food, lots of veggies, lean meat (mostly chicken), complex carbs (I think she limited her potatoes and rice) walks a LOT I think she'd say staying away from the baked goods and staying fit Jerry >How did shge do that? Got further data here is a usual heart www.jerrysbigworld.com/usual.jpg this is hers www.jerrysbigworld.com/MIL.JPG she is missing the LCX. My wife spoke with her mom'scardiologist today - he seems very competent.I think the mixed messages we were getting was from the mis-interpreation of the ditzy daughter who lives near her in Chicago. She tends to exaggerate everything. The Dr said he's been practicing for 30 years, and he's seen congential malformations of the coronary arteries, but that this particular one was quite rare (maybe they'll get a publication out of it ??), so the dauughter interprets this as the Dr has never seen anything like this and doesn't know what to do. On the contrary, the Dr is very cautious because the MIL has done well for 87 years with this defect, and she is symptomless. He is concerned that intervention is a greater risk than doing nothing. Anyway, they will do a CT angiogram tomorrow (Sat) gather more information, and hopefuly set the path of treatment more definitively. He does not yet know if they need to do a bypass, or use stents. Jerry > Got further data > [quoted text clipped - 17 lines] > for 87 years with this defect, and she is symptomless. He is > concerned that intervention is a greater risk than doing nothing. Without symptoms, the risks of intervening may indeed be greater than benefit. > Anyway, they will do a CT angiogram tomorrow (Sat) gather more > information, and hopefuly set the path of treatment more definitively. The utility of the CT angiogram would be primarily to double-check that indeed there is no LCx and will not really "set the path of treatment more definitively." > He does not yet know if they need to do a bypass, or use stents. It would still be wise for your MIL to seek a cure for her diabetes regardless of whether or not she gets a coronary intervention by eating less, down to the optimal amount: http://HeartMDPhD.com/BeHealthy It is likely that her original problem with feeling funny is due more to her diabetes than her occlusive coronary disease. May GOD bless you and yours in HIS mighty way making you healthier (hungrier) than ever, in Jesus' awesome name. Amen. Be hungry... be healthy... be hungrier... be healthier: http://TheWellnessFoundation.com/BeHealthier Prayerfully in the infinite power and might of the Holy Spirit, Andrew <>< -- Andrew B. Chung, MD/PhD Lawful steward of http://EmoryCardiology.com A latter-day disciple of the KING of kings and LORD of lords. http://HeartMDPhD.com/HolySpirit/DiscipleNow |
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