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Question
Posted by: Harriett | 2012-09-27

STENT

In 2003 I had a stent put in the main left artery of my heart after I refused a by-pass, against my cardiologists advice. However I go for annual check ups and he says I am fine although I have a lot of chest pain at times, which he says he can''t explain. Why then did he suggest a by-pass when the stent worked? My second question is my husband went to see the cardiologist (the same one) in March who said he was OK and there were no problems. Three weeks after his exam I returned home from work and found him dead in the chair. He passed away from a massive heart attack. How is it that the cardiologist couldn''t pick up that he would have a heart attack?

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Our expert says:
Expert ImageCardiologist

Dear Harriet

Even today, narrowing of the left main coronary artery is usually treated with coronary bypass surgery. In 2003, before stent technology became as good as it is now, this was even more so. That is why in 2003 your cardiologist suggested a bypass operation, because for people with left main disease surgery is generally regarded as a better and safer option than stenting. As it turned out, the stent worked perfectly well, but your cardiologist could not have known the outcome in advance! His advice at the time was correct and perfectly reasonable.

I am sorry to hear about your husband. Heart attacks by their very nature are unpredictable, and the future is for all of us uncertain. I do not know what symptoms your husband had before his heart attack, if any, or what tests he had, but unfortunately even the best tests are often unreliable. Tests such as exercise testing may fail to detect disease, and even angiograms do not necessarily predict future events. In people at risk, arteries which are only mildly narrowed today, may be blocked tomorrow. That is unfortunately the treacherous nature of coronary heart disease.

Kind regards and best wishes, JT

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