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Is it possible to treat ANGINA without surgery. ANGIOGRAM.

Resolved Question:

I am a 73 year old male and had a heart attack 6 months ago. Angiogram showed 3 blockages 85-90%. Taking lipitor, beta blocker, calcium channel blocker, ace inhibitor and ismo but still suffer from angina after toilet and eating.

Is it possible to rid myself of angina episodes without surgical procedures?


Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
I also apologise for the delay in reply.
Before I can give my opinion, I need to see your recent ECG, your BP and cholesterol levels. Angina is contributed by the lack of blood supply, however a high BP, and higher cholesterol levels also contribute to the incresed episodes of angina. So it is extremely important to know these values first.
Typically the anginal episodes are relieved by GTN/ or Isosorbide Mononitrate and does not last more than a minute or two after taking the drug.
Can you tell me how many anginal episodes you're getting on an average?
Is it everytime you go to toilet? And how long do the episodes last?
Feel free to discuss further,
Regards.


Patient replied :

My blood pressure with medication is generally 120/59. I have included angiogram from when I had a heart attack last June along with my latest blood test and list of medications that I take.
With all the medications that I take and the vegan reversal diet that I follow, I still have episodes of anina at various time. Many of the incidents are after using toilet and eating.
Is there anything else that I can do in order to get beyond the angina?
Also, What is your prognosis insofar as longevity in cases such as mine.
Would EECP be recommended.
Thank you for your response.
Carl Bethell


Expert:  Dr. Vivek Mahajan replied 3 Days.

Hello

Your angiography suggests significant double vessel disease. Bypass surgery or cabg is advisable for your condition. You get angina inspite of medications. That's a good enough indication. Eecp is not a recommended therapy by American college of cardiology and other scientific body guidelines. If you have angina on walking even a few metres woth maximum medications then you have approximately 5 percent to 10 percent risk of cardiac event in the next year.

You prefer a non surgical therapy. Alternatively you could undergo an angioplasty to the lad and manage the 100 percent occluded rca with medicines. That would give you significant relief. medicines like ranolazine trimetazidine nikorandil nitrates can be added to your medical therapy to reduce the angina. But the best therapy remains bypass surgery or alternatively angioplasty to lad
Regards
Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

Hello

Your angiography suggests significant double vessel disease. Bypass surgery or cabg is advisable for your condition. You get angina inspite of medications. That's a good enough indication. Eecp is not a recommended therapy by American college of cardiology and other scientific body guidelines. If you have angina on walking even a few metres woth maximum medications then you have approximately 5 percent to 10 percent risk of cardiac event in the next year.

You prefer a non surgical therapy. Alternatively you could undergo an angioplasty to the lad and manage the 100 percent occluded rca with medicines. That would give you significant relief. medicines like ranolazine trimetazidine nikorandil nitrates can be added to your medical therapy to reduce the angina. But the best therapy remains bypass surgery or alternatively angioplasty to lad

Regards
Dr Vivek Mahajan
DM Cardiology



Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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