my recent myocardial infarction

[jer]

hello, i am an american, working in antwerp belgium and had a small myocardial infarction at a distal coronary artery (age 62).  my angiogram was clean . i have been placed on a beta blocker and an enzyeme inhibitor.  all treatment has been in dutch with some translation into english and i would appreciate an english translation to my questions.
1. under extreme stress, do the cororary arteries constrict?
2. did the fat emboli get loged because of extreme stress?
3. if all my arteries are clean, where did the emboli come from?  
4  what is an enzyeme inhibitor? and in belgium, persons can only be on it for 6 weeks?  the drug is zestril and is it good to be on it longer?
5. what are the pro's and con's of the beta blocker i am on - isoten mitis 5. will i be on this the restof my life?
6. recommendations for return to work and flying back home?

[Gh]

Hi I am 3 years post small mi.
Still on liptor. Suffer from cold hands and feet and sore mussels and joints.

Have lots of exercise and the Cholesteral level is 2.6.
Almost too low.? Went from 92kgs to 64kgs and have kept it of for 3 years.

Am considering going off Liptor although my doc is not too keen.

Any comments please

[CCF-M.D.-CRC]

Dear jer,
1. under extreme stress, do the cororary arteries constrict?
A: Although there may be some slight correlation between stress and heart attacks there is no direct evidence that stress causes coronary artery constriction.

     2. did the fat emboli get loged because of extreme stress?
A: No.

     3. if all my arteries are clean, where did the emboli come from?
A: "Clean" is a relative word.  An angiogram 'sees' only the inner lumen of the coronary artery.  There may be a significant amount of blockage buildup that it cannot see.  The most likely scenerio in your case is that there was a blockage that was cleared by the body before the angiogram was done.


     4 what is an enzyeme inhibitor? and in belgium, persons can only be on it for 6 weeks? the drug is zestril and is it
     good to be on it longer?
A: The is an angiotensin converting enzyme inhibitor also called an ACE inhibitor.  People can and do take this medication long term. It is used in individuals with high blood pressure and in the post-mi setting.

     5. what are the pro's and con's of the beta blocker i am on - isoten mitis 5. will i be on this the restof my life?
A: We highly recommend beta-blockers to our post-mi patients as long as they can tolerate the medication.


     6. recommendations for return to work and flying back home
A: This would be best given by your doctors there.