Going in for an angiogram on Monday
Forums:
I've been seriously short of breath with chest pains going back to early April. The workup to date has been very protracted; due to Covid lockdowns early on and a general high demand / short supply for cardiology care on the western slope of Colorado. My workup doesn't immediately point to cardiac issues, but it doesn't rule it out either ... so cardiologist has been hesitant to rush into angiogram, however my symptoms have been getting worse.
Curious if anyone has had this procedure? I've been told I'd be awake with a sedatitve, but not sure what that means exactly? I've had a colonoscopy with sedative and it was as if I was put out vs. being given a xanax for an MRI. Mostly wondering if I waited 6+ hours if I'd be able to drive back home?
- Log in to post comments
Top of Page Bottom of Page PermalinkFull Name: Def. High
Best of luck and good
Best of luck and good outcomes, FOM.
>>>>>wondering if I waited 6+ hours if I'd be able to drive back home?
Ask the doc. But, sounds like a bummer waiting 6 hrs. Get somebody to drive you.
Top of Page Bottom of Page PermalinkFull Name: Keithk1
I've had it done. They went
I've had it done. They went in through my thigh. Gave me a Valium to relax. It's painless. Watched the whole procedure on the monitor. They found a blockage and put in two stints. They plugged up the my thigh and kept me overnight to make sure that healed properly.
The before and after pictures were pretty amazing. You saw where the blockage was and the artery just dead ends. Stint in, artery opens up, blood flow going, felt 100 times better within a couple of weeks. Good luck and don't sweat it. It's a piece of cake.
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
Best of luck and good
Best of luck and good outcomes, FOM.
>>>>>wondering if I waited 6+ hours if I'd be able to drive back home?
Ask the doc. But, sounds like a bummer waiting 6 hrs. Get somebody to drive you<<<
Thank you!
The hospital in Montrose is close to an hour and a half away, but have been close to paranoid about covid with the way I've been feeling ... so hesitant to jump in a car with someone and it's also up in the air if I'd need to stay overnight at the hospital if they do find something and put in a stent. So, would likely stay at hotel overnight otherwise if I couldn't drive.
Top of Page Bottom of Page PermalinkFull Name: New & Improved
Bueno suerte, FOM.
Bueno suerte, FOM.
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
I've had it done. They went
I've had it done. They went in through my thigh. Gave me a Valium to relax. It's painless. Watched the whole procedure on the monitor. They found a blockage and put in two stints. They plugged up the my thigh and kept me overnight to make sure that healed properly.
The before and after pictures were pretty amazing. You saw where the blockage was and the artery just dead ends. Stint in, artery opens up, blood flow going, felt 100 times better within a couple of weeks. Good luck and don't sweat it. It's a piece of cake.<<<
Thanks for the lowdown and good to hear you're doing a lot better!
Actually just spoke to nurse for instructions and she said they're going in through my wrist. She also said they'd keep me overnight at hospital if they do place a stent. Not sure I'll be able to watch on monitor, but we'll see!
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
Bueno suerte, FOM<<< Gracias
Bueno suerte, FOM<<<
Gracias
Top of Page Bottom of Page PermalinkFull Name: long live the dead
I believe it's Pretty common
I believe it's Pretty common stuff
wife did it, spent the night. Way better after
Now takes meds daily
meditate
Go with the flow
be well quick
Top of Page Bottom of Page PermalinkFull Name: Sigmund
Best of luck 19.5
Best of luck 19.5
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
I believe it's Pretty common
I believe it's Pretty common stuff
wife did it, spent the night. Way better after
Now takes meds daily
meditate
Go with the flow
be well quick<<<
Thanks, although going with the flow is a little bit easier said than done watching the covid count rise every day and election craziness ... just hoping to get the procedure at this point.
Hope she's still doing well.
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
Best of luck 19.5<<
Best of luck 19.5<<
Thank you
Top of Page Bottom of Page PermalinkFull Name: Sycamore Slough
FONDESTBESTWISHES !!
FONDEST
BEST
WISHES !!
Top of Page Bottom of Page PermalinkFull Name: Thumbkinetic
Good luck.
Good luck and good health.
Top of Page Bottom of Page PermalinkFull Name: Sycamore Slough
Last M RI was a long process,
Last MRI was a long process, but they did not give me any drugs.
Not too claustrophobic, so it was Fine.
Your idea of nearby hotel room sounds like a Good plan. Then there's no stress about transport and sedation.
Best of Luck !
Top of Page Bottom of Page PermalinkFull Name: treat island
FOM, sent you an email at the
FOM, sent you an email at the request of an angiogram experienced Zoner.
Top of Page Bottom of Page PermalinkFull Name: Philzone Refugee
See what happens when you eat
See what happens when you eat at fast food restaurants and convenience stores?
Best of luck with the procedure. Have faith in your doctors and don't overthink it.
Top of Page Bottom of Page PermalinkFull Name: skyjunk
Best wishes FOM I had it done
Best wishes FOM I had it done thru my wrist. The procedure was a breeze. I was in the hospital for three days thinking I was having a heart attack. Turned out to be a pulled muscle. The procedure though showed that my heart is muy bueno. Lots of morphine drip that weekend
Top of Page Bottom of Page PermalinkFull Name: joy
So the Gitmo in me just
So the Gitmo in me just wanted to make sure you don't need a ride?
Top of Page Bottom of Page PermalinkFull Name: pumpkin lurker
Hi, mostly an occasional
Hi, mostly an occasional lurker here most of the time these days. I have worked in cardiothoracic surgery for 4 years and cardiology for 17 years now as a physician assistant. I order these procedures regularly, and have worked taking care of patients before and after for a long time :)
The anesthesia you had for your colonoscopy will be similar to what you get tomorrow but you will not get propofol. We use Fentanyl and versed (short acting IV benzo), and you can tell your nurse that you want to be asleep or awake. I would not recommend driving the day of your procedure, but the day after is fine. We do about 80% radial access here these days and the remaining 20% through the femoral. That is on par with the national statistics. There are three possibilities from your procedure:
1) you find that your arteries look good and you have to keep looking for what is making you feel unwell. Blockages that are less than 70% are not flow limiting and should not be stented, but rather treated with cholesterol medication and aspirin, along with diet and exercise.
2) you have blockages that can be fixed with stents
3) you have blockages in the wrong place and they suggest CABG (coronary artery bypass graft) surgery. There are some conservative interventional cardiologists that set the bar a lot lower for CABG than others so this should be a discussion. If you do not have Left main blockage and are not diabetic stents are the same as surgery, but you may need to get a second opinion/decline surgery. Most patients don't really understand this and its important to be educated about choice.
In regard to your stay vs leave question, we do outpatient stent procedures occasionally. For the most part we do them as elective overnight stays as there can be occasional complications that can be significant. Diagnostic procedures (ones where no stents are placed) are done as Outpatient procedures and pts leave after several hours. I would look on line and put orbitz on your phone so you can book a room if they are going to let you leave while you are in the recovery area and take cab/uber/hotel shuttle. Hospital security may also be able to give you a ride if those are not available.
In regard to the stents used, most are drug eluting stents (medicated). Some are not, the medicated stents have been around since 2003 and are very good at staying open for a long time. It requires lifetime aspirin therapy and a second medication like clopidogrel (generic plavix) or ticagrelor (brillinta). If they put you on brillinta make sure it is affordable and covered by your insurance as it can be $$$. Generic plavix is equivalent for non-heart attack stents and they should be willing to change you over. The case manager for the cath lab should be able to give you a price quote, or you can call your pharmacy and ask how much it is going to be. A statin for cholesterol is also appropriate if you have blockages. As I mentioned earlier exercise and eating less dairy and animal fat is important as well.
If you have additional questions feel free to email me gregehleatgmaildotcom Happy to chat more if you need. You will do fine!
Top of Page Bottom of Page PermalinkFull Name: jazfish
I am hoping the best outcome
I am hoping the best outcome possible to you, Face.
(((((FACE ON MARS))))
Top of Page Bottom of Page PermalinkFull Name: Highnote
Good luck. I hope you feel
Good luck. I hope you feel better soon.
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
Thank you for your detailed
Thank you for your detailed response phishie, it is most appreciated. Likewise to others who've offered advice or well wishes!
Top of Page Bottom of Page PermalinkFull Name: pumpkin lurker
No Prob, good luck today!!
No Prob, good luck today!!
Top of Page Bottom of Page PermalinkFull Name: nebulous nelly
Good luck, Face.
Good luck, Face.
Top of Page Bottom of Page PermalinkFull Name: Strangha
Sure is cool when someone can
Sure is cool when someone can help like phishie did. Good luck today, FOM.
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
1) you find that your
1) you find that your arteries look good and you have to keep looking for what is making you feel unwell. Blockages that are less than 70% are not flow limiting and should not be stented, but rather treated with cholesterol medication and aspirin, along with diet and exercise.
2) you have blockages that can be fixed with stents
3) you have blockages in the wrong place and they suggest CABG (coronary artery bypass graft) surgery. There are some conservative interventional cardiologists that set the bar a lot lower for CABG than others so this should be a discussion. If you do not have Left main blockage and are not diabetic stents are the same as surgery, but you may need to get a second opinion/decline surgery. Most patients don't really understand this and its important to be educated about choice<<<<
So, it turned out it's #1 and "#4". My arteries look good in terms of no blockages from plaque buildup, but there is some form of a systemic bio-mechanical impediment to my heart's arteries / vasculature functioning properly. Unfortunately, I didn't write down the diagnosis, but will hopefully see the report soon. My cardiologist at first recommended increasing my dosage of isosorbide that I was already on, but after mentioning that it felt like I took a couple steps backwards (in terms of a not being to exert myself as much) after starting the regimen three months ago, he instructed me to stop taking it altogether for a couple of weeks to see how I feel and proceed from there. Hoping this can at least be managed with drugs. Likewise, living at 9,600' elevation might be a contributing factor that may exacerbate this condition I have (or it might be unrelated) .... so will likely see how I do living at lower altitudes.
He's not sure if this diagnosis (whatever it's called) is responsible for all of my symptoms, but it's good news to at least rule out a plaque blockage.
Top of Page Bottom of Page PermalinkFull Name: Sun so hot, clouds so low
Sounds like good news?
Sounds like good news?
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
Sounds like good news?<<<
Sounds like good news?<<<
I'm really not sure about where this is headed, but definitely good news not to have cholesterol-related blockage.
Going back for a follow-up in about 3 weeks, so hope to learn more.
Top of Page Bottom of Page PermalinkFull Name: fishcane
Phishie, great post ...where
Phishie, great post ...where are you at?
I’m a CRNA and my wife is a cardiac surgery pa/ team manager here in cny
Top of Page Bottom of Page PermalinkFull Name: pumpkin lurker
Burlington, VT. I also worked
Burlington, VT. I also worked in New Haven, CT for 4 years in cardiothoracic surgery after graduating from PA school there. It was a great time to live in the tri-state area for sure (97 to 2003)!
FOM, I would agree that it is good news. What you describe has several names, vasospasm, microvascular disease, syndrome x (which is an old name). It can represent slow flow caused by blood vessels not relaxing appropriately to allow for good blood flow. Drugs like calcium channel blockers and long acting nitrates can help with this significantly. Be in touch if you have additional questions!
Top of Page Bottom of Page PermalinkFull Name: 19.5 Degrees
Thanks again and for
Thanks again and for confirming it's good news phishie, much appreciated!
The report was just uploaded. The cardiologist didn't actually use a diagnostic name, but described it as such:
Left anterior descending artery: The left anterior descending artery is a large-caliber vessel that courses to and wraps around the cardiac apex giving rise to a moderate to large sized first diagonal branch, a moderate-sized second diagonal branch, a small to moderate-sized third diagonal branch, and several septal perforating branches. The left anterior descending artery has branches have mild irregularities. There is mildly reduced antegrade flow in the left anterior descending artery which improved after the administration of intracoronary nitroglycerin
He did find it odd that the 30 mg Isosorbal seemed to adversely affect my ability to exercise. Not sure if there are other drugs in the same class that for whatever reason might be more effective for some people? I'm assuming him taking me off this for two weeks to see how I feel part of a diagnostic approach.
Top of Page Bottom of Page PermalinkFull Name: Alan R
Finally some good news this
Finally some "good" news this morning. Glad you didn't wake up full of spare parts.
Come back down to sea level and mellow out. You're probably too old to ski and shovel snow anyway.
Top of Page Bottom of Page PermalinkFull Name: Sycamore Slough
Nice keeping us all informed.
Nice keeping us all informed.
Good that you don't have to do any surgeries.
Also sounds good that your Doc is removing drugs from your diet rather than prescribing a bunch more.
Feel better !!