Just to add. I think if your arteries were able to provide good collaterals, they would have done so during your attack, preventing muscle damage.
The confusion is that the first ecg shows mild diastole problems, while the second one does show a slight increase in the problem. This can only be due two things really. First you have had another attack, second you have severe worsening ischemia.
My opinion on the collateral formation is all of those things you ask. You see, for collaterals to open, there must be a good blood flow from somewhere, and you seem to be lacking this in all three main vessels. If someone has a blocked LAD then you often see a feed open from the LCX or RCA (depending on their map type) to feed into the LAD and help out. If all three vessels are severealy blocked, above 70%, then these collaterals wont have the pressure to be opened up. My Left circumflex feeds my LAD and if this vessel gets a blockage of 90%, then the pain is incredible because the collaterals start to shut down.
Why do you feel no problems with three major blockages? Well, that's an answer which is being searched for constantly. There are some people who feel absolutely nothing when they have a heart attack. They are shocked to learn they've had one when they have an ECG during a medical for example. Before my first attack, I was working in construction, and doing very labour intensive tasks. My LAD was being fed by numerous collaterals from the LCX which developed a clot. After stenting, they saw how badly my LAD was and it had obviously been that way for many years. We all assumed that with the LCX stented, then I should be back the way I was before the attack. This didn't happen and nobody can explain why.
I have totally changed my views on Herbal medicine after hearing something shocking. A friend of mine in the states is on her last year of pharmacy, and she told me about a herbal remedy for cancer that was being given to patients who were seen as terminal by hospitals. This herbal remedy was curing many hundreds of patients, of different cancer types and very quickly. The FDA suddenly appeared at the premises and confiscated the paperwork, and insisted they stop all treatments or they would be locked up. Now, why would natural herb in the form of tea be a legal issue? Obviously the reason this was stopped is that the herbs cannot produce profit because you can grow them at home. When you hear such things, then investigate it to find it is true, it can seriously damage your trust. I know that meds do help in some way, I learned that the hard way, but I can't help but wonder if the meds we have are the BEST that can be given or simply the quickest way to make huge profits. Can we really say that drug manufactures are thinking of mankind rather than money, when they stop 100% cancer cures from reaching the public.
Also forgot to mention, that I am taking herbal meds from a doc (now for two mo.s), who has cured people in my situ with herbs and he assured me that, I can be cured with his meds. Only problem is, I am not doing the regimen 100% due to 1. complicated preparations, 2. Horrible taste, 3. pacification on my part after little relief etc. Will try to do my best though.
Hello Ed, Thanx for your time again. Seen your diag. also. We need you here Ed, so hang in there. If I may ask, (this information quite old now and how your arteries look now would be totally guess work) yes, 11 mo.s, however, I am unable to get a new diagnose from the Docs, as they are adamant in doing the bypass. They will make 40-50gs doing it, but, I am not willing to be the guinea pig, so readily. (((You have some damaged heart muscle which will cause delay in the diastole phase (t-wave). This makes it quite confusing to me, in that the two ECGs are not THAT much different.))) What is the confusion??? (((The problem is that you don't have any clear vessels to act as a good source to develop collateral feeds, all three have major blockages. )))) Is this opinion/judgement/conclusion derived from the angiogram OR from the Doctors' sketch ??? since, I do not want to believe the docs totally due to their one track minded approach. ((((Perhaps you could ask if they will stent the circumflex and see if you then develop collaterals into the left and right sides.))))) These guys are set on doing a bypass and consider no other option/s. You are lucky to have some decent help in your case. I am stuck with a useless lot here. Ed, most surprising to me is that just few days prior to my attack, I was having a lot of energy and doing things fully normal. How can somebody with 95, 90% blockage in every artery possibly be that way??Your comments will be much appreciated again and again.
Looked at your images, but isn't this information quite old now and how your arteries look now would be totally guess work. Something has come to light looking at those images and would explain the T-wave issue. You have some damaged heart muscle which will cause delay in the diastole phase (t-wave). This makes it quite confusing to me, in that the two ECGs are not THAT much different. After having 10 stents (5 which have closed up) and a triple bypass (which lasted just 3 months), I take a different look on surgery now. Can you imagine how upsetting it is that a triple bypass fails before you even recover from the surgery itself. I have put a home made diagram of my current situation on the net, here https://dl.dropboxusercontent.com/u/89809360/my%20arteries.jpg and you can take a peek. The black dots show long 100% blockages, and the green show collateral vessels that have opened up. My collaterals do not show on an angiogram because they are small in diameter, but numerous. I am lucky in that I have a co-dominant mapping of the arteries, and so my circumflex could come to the rescue. By the look of your angiogram it appears you could also be co-dominant, but it's hard to tell. The problem is that you don't have any clear vessels to act as a good source to develop collateral feeds, all three have major blockages. If you are dead against open heart surgery, then perhaps you could discuss a different approach with your cardiologist. Perhaps you could ask if they will stent the circumflex and see if you then develop collaterals into the left and right sides. This would require a nuclear scan about a month after stenting, to test for the oxygen levels in the muscle because an angiogram wouldn't see the results. My circumflex has 5 stents in total and none have re-blocked because my cardiologist uses a slightly different technique. Most procedures use a given pressure to deploy the stent for a substantial amount of time. My Cardiologist uses higher pressure, but less time and has found much better long term results. Of course I am not saying not to have open heart surgery, I am saying that I understand your concerns and simply offering an alternative. I had another heart attack just over a week ago, and again, my left circumflex kicked into action within 20 mins, giving more collaterals. This vessel is my lifeline and has been 3 times now which is why they always ensure it stays fully open.
Hi erijon, During the last few months, I have read extensively to find out more facts abt CAD etc,,,There are many schools of thought, like <<>>> Studies show that atherosclerotic plaque can be reversed, and cholesterol lowered without drugs or surgery. Making significant dietary and lifestyle changes allow many people who suffer with coronary heart disease, high cholesterol, obesity and/or high blood pressure to reduce or even eliminate their dependence on medications and avoid invasive surgical procedures.....CAD can be reversed from 90% to 80% to 70% downward. I personally had spoken to people who did this without the help of any FDA approved medicine or procedures. Living in the US, one can get oblivious to the world outside, as I did for over 15 years.
All said and done, I appreciate your time in responding with your perceived opinion, which is not a medical advice as you had written yourself.
EKG will show any changes, however when you have 90% blockages the next change may be when you move to 100% as you don't have much artery left. Also, I don't know of any treatment that will cause your blockages to improve by much if any. Once the plaque is there it can not be removed. The thing you need to be very aware of is the risk of putting it off on the hope that they will improve.
Hi erijoin, Thanx for taking your time to post your comment. I am under no illusions to take any forum posts as qualified medical advise but personal opinions of some knowledgeable individuals. As, I am coming from another part of the world, unlike most forum members are, my perceptions ,experience and convictions also differ. Having said that, I believe your suggestion is in good faith, to the best of your knowledge and am very thankful as well. I hate to cut up my sternum and try to avoid that situ as long as, I possibly can. Also I am taking some time proven herbal medications now over 2 mo.s and feeling /moving physically much better than before. I was hoping for some comments on the ECGs thankfully.
Keep in mind, we're not doctors here so please don't take anything we post as medical advice, especially in your case, we are not qualified to suggest other options to the ones your doctor has given.
Having said that, Ed is correct. Also, based on your link, you have 90% blockages in both branches of the LAD. If it were me, I would be scheduling surgery as these can close up very quickly and are more vulnerable to clots or plaques that break loose elsewhere.
How to attach,,,,could not do it.
Hence pls. see in http://www.shopcarpro.com/aaaa/Blockages.jpg
Hello ed34, Thanx sooooooo very much for your time. Frames of my Angiogram are as seen here - http://www.youtube.com/watch?v=qfC7GXJwjug
This was done at the time I initially went to the ICU, 10mos. ago. Attached is the diag. the physician drew initially, demonstrating the restricted arteries.
Hope the above info. suffice. Pls. give your opinion here.
Do you know where the Ischemia is, which vessels? I'm assuming you have had an Angiogram for them to suggest bypass over stenting?
From your first ECG the most evident problem to me is the T-Wave. This is the bump after the very tall one. The very tall one is your ventricles contracting, while the next bump is them relaxing again. The T-wave should start with a gentle curve, bend at the top, then descend at a sharper angle than it inclined Yours in the first ECG doesn't appear too bad but shows obvious sign of ischemia. The second ECG is definitely worse.