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Question
Posted by: Lee | 2012/09/10

Advise please

Hi Dr,

My 32 year old husband was diagnosed with coronary artery disease a few months ago. Doctors said he needed to undergo a triple bypass because he had 3 blocked arteries. He has since underwent 4 angiograms and has had 8 stents inserted. He is diabetic, with a family history of heart disease so from the time he was 28 yrs, he has been on michol, glucophage and treated for high blood pressure as a precautionary measure.

So we were totally flabbergasted when the news of blocked arteries was broken to us.
He is currently on a whole host of medication. From time to time, usually weekly he experiences tightness of the chest, sometimes jaw pain and nausea which eases when he sprays the nitrolingual mixture (TNT) under his tongue.

Why is he still experiencing angina symptoms? Would a bypass not have been a better option?

We are constantly living on edge, not knowing whether he is having a heart attack or not.

Your advise will be highly appreciated.

Thank you.

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Our expert says:
Expert ImageCardiologist

Dear Lee

I am sorry to hear about your husband, who unfortunately has coronary disease at a very young age.

After eight stents your husband should not be having more chest pain. Possible explanations would be either that there was one or more blocked artery, which could not be treated with a stent, or alternatively that one of the treated arteries has blocked up again. His cardiologist should be able to answer this question.

Diabetic patients with coronary disease may do better with bypass surgery than with multiple stents, but I am sure that in your husband’s case the cardiologists were trying to spare him coronary bypass surgery at such a young age. Your husband is unfortunately dealing with a very difficult situation, but should do his best to achieve ideal body weight, reduce his bad cholesterol as much as possible, make sure his blood pressure is well controlled, and exercise regularly. If he has been a smoker he should never smoke again.

If he can do all these things the situation should gradually improve with time. It will be important for him to see his cardiologist on a regular basis, even when he is feeling well.

I hope things go much better for both of you.

Best wishes, JT

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Our users say:
Posted by: Nawaf | 2012/09/22

I am very sorry to hear of your plight, as if you heanvt got enough stress with your medical condition. Its really time the american government started spending peoples'' taxes on its own people not sending it to israel whose people have a much better lifestyle that you not to mentionthe vast amount it spends on war. America is causing havoc around their world in you name, it has got to stop. It it supposed to be your elected government isn''t it? I wish you the best of luck, you poor man

Reply to Nawaf
Posted by: Cardiologist | 2012/09/14

Dear Lee

I am sorry to hear about your husband, who unfortunately has coronary disease at a very young age.

After eight stents your husband should not be having more chest pain. Possible explanations would be either that there was one or more blocked artery, which could not be treated with a stent, or alternatively that one of the treated arteries has blocked up again. His cardiologist should be able to answer this question.

Diabetic patients with coronary disease may do better with bypass surgery than with multiple stents, but I am sure that in your husband’s case the cardiologists were trying to spare him coronary bypass surgery at such a young age. Your husband is unfortunately dealing with a very difficult situation, but should do his best to achieve ideal body weight, reduce his bad cholesterol as much as possible, make sure his blood pressure is well controlled, and exercise regularly. If he has been a smoker he should never smoke again.

If he can do all these things the situation should gradually improve with time. It will be important for him to see his cardiologist on a regular basis, even when he is feeling well.

I hope things go much better for both of you.

Best wishes, JT

Reply to Cardiologist

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