Thanks for the information ❤️

@DoctorBoladCardiology

Жыл бұрын

You are welcome

Thank you. Very informative. Especially choices for the patient.

@DoctorBoladCardiology

8 ай бұрын

Happy to help.

I had bypass more than 10 years ago

Thank you so for the information Dr Bolad, I smoke, some things in the morning I don't feel better, when sleeping at night , I sleep very well but once I wake up I don't feel good and I don't know if its ulcer or heart disease that am having, pls help me out. Each time I feel as if my blood pressure is high when I woke up in the morning. Thank sir and God bless

@DoctorBoladCardiology

Жыл бұрын

It can be difficult to differentiate between a stomach ulcer and coronary heart disease. I suggest that you check with your doctor to examine and evaluate you. For more information, you can review my video about this issue kzread.info/dash/bejne/h6Bh0bdpZLfgpKw.html

Doctor thank you for your very informative video . I have got three blocked arteries ranging 50. 70 and 90 percent blocked. However I'm asymptomic . I run mist days ten Kms , am not overweight , gave up smoking 10 years ago and follow a diet . I have absolutely no symptoms currently and for last several years on medication . I am a border line diabetic and take matamorfim but sugar under control for last few years . I have been reccomneded a bypass but am not sure or comfortable due to my asymptomic nature and no pain or angina . Medication seems to be working . I'm 59 years , 173 cm and 70 kgs and generally follow a sugar free diet and minimis meat consumption. Appreciate your advice on whether the bypass will add value currently or I could continue on medication and lifestyle .regards jhon

@DoctorBoladCardiology

6 ай бұрын

I suggest that you discuss with your doctor whether you would benefit from ischemia evaluation by performing perfusion stress testing. If there is ischemia, meaning reduced blood flow to the muscle of the heart, and depending on its extent, then a decision can be made. Also discuss with your doctor whether you would benefit from a echocardiogram to assess the heart function.

I'm 71years old, my Aorta valve is to narrow and next month I'll be taking to cardiac surgery. I prefer open heart surgery but i have had mitral valve surgery 2× already, so I know what to expect. I live alone and no one can help me once home. I'm also diabetic on metformin. The doctor will be checking if I have and blocked arteries before my surgery.

@DoctorBoladCardiology

Жыл бұрын

I hope everything goes well.

Do you have a section of minimally invasive coronary bypass surgery? I think that would be a good option for those who may have blood clotting and bleeding issues. Thanks.

@DoctorBoladCardiology

Жыл бұрын

Good point. Thanks.

Doctor Please read the below and give me advise please

Hello doctor, thank you very much for the great work you are doing, My doubt is, If we are having good 2d echo and ECG then can we be sure that our Heart health is good ? Because I would like to do these for my parents 1/2 times in a year to have a check on Heart health. If there are any other tests which we can do once in 6 months to check our heart health then please let us know Thank you

@DoctorBoladCardiology

Жыл бұрын

An echo and the ECG can be done as baseline tests. If they are normal, then there is no need to repeat every year. If there is an abnormality, and depending on it, then yes then might need to be repeated. If there is suspicion of coronary disease, then a stress test might be helpful. Your doctor who have seen and examined your parents, will be able to evaluate them and decide about this, based on the clinical situation.

@gowthamreddy4871

Жыл бұрын

@@DoctorBoladCardiology thank you very much for the info Doctor :)

@DoctorBoladCardiology

Жыл бұрын

Happy to help

I have 70-90% blockage in LAD, I’m diabetic hypertension mild overweight with symptoms of shortness of breath low energy. The cardio CAT test yesterday and the contrast made sick, vomiting in the CAT machine. They are scheduling a cardiac cath but have told me nothing but get to ER if I have chest pains. 67 years old w/family history of heart problems. Would I try to get the bypass to maybe get 15-20 more years or a stent that may fail in less time?

@DoctorBoladCardiology

2 ай бұрын

This depends on the location of the blockage in the LAD, and any other blockages in the coronary arteries.

Hello Doctor, My mother aged 66 had a chest pain last week and the doctors did Angiogram. She told the pain was not that much intense and it was more like a burning sensation and gastric trouble.The doctors said there are 3 blocks,discharged after 4 days and asked to come back for CABG. Now she is using the prescribed medicines and is stable now. Please share your opinion. How to share the reports to you? Thanks

@DoctorBoladCardiology

10 ай бұрын

I am glad your mother is doing well. I provide information to help you understand the heart disease issues, but as I am not your mothers doctor, I unfortunately can not provide medical advise. You can write a summary of the report here on this forum and I will provide information as needed.

Can stenting be used in patients with TVD and DM?

@DoctorBoladCardiology

Жыл бұрын

If the patient does not want to pursue bypass surgery, then depending on the blockages size and locations, then yes stents can be considered.

What is the role of collaterals if pt doesn't want to go for either of procedures otherwise asymptomatic

@DoctorBoladCardiology

Жыл бұрын

Generally collateral circulation if present help, but they can only provide up to 40% of the normal flow provided by the main artery.

@ravindraverma534

Жыл бұрын

@@DoctorBoladCardiology thanks for your input🙏

I am 74 years old, has ckd 3, diabetes type2, AIC 5.8. Can’t take aspirin as it irritates stomach. Has frequent chest pressure feelings, chemical stress test showed ischemia of R heart. Cardiologist said that this ischemia doesn’t affect heart function. Anglo of last year showed 70% narrowing of mid LAD. Dr is saying I am not a candidate for steering because I can’t take aspirin. I have pacemaker, on Eloquis. Does post CABG also require aspirin? What’s the next step for me?

@DoctorBoladCardiology

Ай бұрын

There are different options for people in your situation. However you doctor who knows your medical condition well is the best person to advise you.

Dear Dr. Bolad - I have 3-vessel coronary disease and a recent stress exercise echocardiogram shows I have left ventricular dysfunction. I will get an angiogram soon. Will the interventional cardiologist make a decision on his own during the procedure whether to use stents, or is he expected to consult with my cardiologist before doing so? Will the interventionalist tell me his findings while he is performing the angiogram? If he wants to use stents will I be asked to give my consent, even though I will be sedated during thr procedure? Thank you.

@DoctorBoladCardiology

7 ай бұрын

Before the procedure you can discuss with your interventional cardiologist how you wish to proceed depending on the blockages. The Interventional cardiologist can make the decision about which option is best for you, but you can always have your input.

@michaelwilliams4677

7 ай бұрын

@DoctorBoladCardiology Thank you, Dr. Bolad. I also have an aortic root aneurysm that isn't large enough to warrant surgery yet, and may never be. My cardiologist says if I need CABG the surgeon would fix the aneurysm at the same time. Since the aneurysm may never get to 5.5 cm, I would prefer to have CABG with robotic surgery to avoid a sternotomy. I read how robotic CABG surgery has lower risk of stroke.

@DoctorBoladCardiology

7 ай бұрын

Sounds reasonable. After the angiogram, your doctors will ne able to advise you about the options.

@michaelwilliams4677

7 ай бұрын

@DoctorBoladCardiology Thanks again.

Hello Dr, 13 years ago my father had done a CABG procedure. Since then he is been going through gastrointestinal problems such as indigestion, constipation and many times he needs to take a medications to eject the waste. Would it be a side effect of any blood thinner tablets that was taken during these years? We were advised to see gastroenterologist at many occasions but it doesn't help much. Is it normal to be like that?

@DoctorBoladCardiology

Жыл бұрын

This is unusual to occur and continue for so many years after coronary bypass surgery. I agree with your doctors recommendation to see a gastroenterologist to look into all the medications and possible other causes that might be causing this.

@barakathcs

Жыл бұрын

@@DoctorBoladCardiology Well thanks for your kind reply Dr. We did contact gastroenterologist many times they don't have any solid answers. It's become a habit of taking Cremalax 10mg daily to make the system work. Would you suggest any other solution? His regular optimal medications are Nikoran OD 10, Cardivas CR 10, Aquazide 25, Conchol-C 10, Ivabratco 5.

@DoctorBoladCardiology

Жыл бұрын

These medications are generally well tolerated. One suggestion would be to check with a clinical pharmacist to review any interactions between them, or any other medications that your father might be taking.

@barakathcs

Жыл бұрын

@@DoctorBoladCardiology Thanks Dr for your kind reply

@Gourvisharma602

Жыл бұрын

Hey.. Which byapss surgery did he went through From legs veins??

Hi doctor. My dad just have open heart surgery 4 months.. He’s still suffered from blockage and doctor advice stent for next step.. Does it sound right please? Thank you!

@DoctorBoladCardiology

4 ай бұрын

Yes this is possible.

Sir my mid lad 99 and RI is 99 what should i do .And i am dibetic

@DoctorBoladCardiology

12 күн бұрын

This depends on different factors as described in my video.

The doctor tried doin pci but he couldn’t reach to my arthritis because of the location not sure why but I have 3 of them blocked 100% .. when I asked about doin bypass he told me my arteries are too small can you tell me what to do because I have angina and it’s hard to live like that

@DoctorBoladCardiology

Жыл бұрын

This depends on the size of the arteries that are blocked. One suggestion is to get an opinion from a large heart center where you are located for their input.

@naser0725

Жыл бұрын

@@DoctorBoladCardiology I am in Charlotte nc thank you

For the bypass surgery of my wife, internal mammery vein was used about 6 months ago. But till today there is no sensation on her left breast. Will it come to normalcy? please advice. Thanks.

@DoctorBoladCardiology

Жыл бұрын

Generally there is significant improvement by 4 to 6 months, although some take longer. I recommend that you discus this with the surgeon who performed her surgery.

Sir my mother is 65yrs old, have rheumatoid arthritis. Now having chest pain sometimes. Doctor said she have blockage in coronary artery. Which will be good for her stent or bypass?

@DoctorBoladCardiology

11 ай бұрын

This depends on the site and extent of the blockage, in addition to other risk factors. Has she been investigated by cardiac catherization to evaluate the blockage?

Sir, my father is 61yrs old, diabetic, suffering from CAD with 80% blockage in LAD and 25% in RCA. Which will be better stenting or MICS bypass?

@DoctorBoladCardiology

11 ай бұрын

This really depends on multiple factors as stated in the video. Generally, diabetics benefit more from bypass surgery.

Sir i have 90% blockages in my mid and distal segments of my rca artery. Is one stent in mid segment enough?, As per my doctor's advice?

@DoctorBoladCardiology

3 ай бұрын

This is possible as one stent can cover both blockages. I recommend that you ask you doctor to explain more to you about this.

@jyotisirkiclass8347

3 ай бұрын

He says to me that your distal RCA area is already well filled with collateral flow from left so there is no any need of stenting .🙏

@DoctorBoladCardiology

3 ай бұрын

I suspect that fixing the second blockage might be challenging. The fact that there are collaterals is reassuring.

My father is 75 and needed by pass but refused and he has diabetes so he had 4 stents put in what is life expectancy compared to bypass?

@DoctorBoladCardiology

7 ай бұрын

This depends on the site, severity and stent of the disease/blockages.

Hello Doctor , i m 34 year old , my angioplasty done 7 month before, my angiogram Lmca normal,Lcx Normal, rca normal, Lad ostial 100% thrombotic occlusion , D1 60-70% blockage. My Lvef 60%, grade 1LVDD , my stent is Drug eluting stent , no diabetes, no hypertension, i m doing regular exercise, take ragular medicines. My question- is stent Life long? Can i live my full life after the angioplasty procedure?❤

@DoctorBoladCardiology

3 ай бұрын

Glad you are doing well. Yes you can.

My mother put two stent in her heart. Chest pain for several days now.A another block comes where the doctor is thinking ..By pass surgery is good for her now?? Or again put another stent in her heart..need your suggestion please..

@DoctorBoladCardiology

Жыл бұрын

This depends on the the location of the blockage, severity and whether or not it involves multiple arteries and whether there are other conditions such as diabetes.

@allblacks4729

Жыл бұрын

@@DoctorBoladCardiology good day sir, i have a question, can you not go for a CT scan to check for blockages, but go straight to PCI? if so, how does the patient knows the % of his blockages? he may not even know how serious or harmless his heart problem is...am i right? thanks in advance

@DoctorBoladCardiology

Жыл бұрын

Generally we screen patients by stress tests before proceeding with cardiac catheterization or CT coronary angiogram to evaluate the coronary arteries. We do not go straight to cardiac catheterization or PCI without having some evidence of the status of the coronary arteries.

A question please doctor answer to me. My husband has been found with a 50% blockage of a stent that was fitted in the left artery. They are suggesting a bypass but we find thisnoperation very invasive. Allmother arteries are fine, the muscle in the heart fine, evrrything else fine. Just this 50% blockage of the stent. They are not recommending stenting again. Why not? Please advice. Bless you.

@DoctorBoladCardiology

12 күн бұрын

Coronary arteries are generally not treated until the blockage is about 70%. I suggest that you ask your doctor as to why he/she would like to treat a 50% blocked artery.

@mariadeneuve6772

11 күн бұрын

@@DoctorBoladCardiology first of all thank you so much for replying and taking your time, it speaks volume about you. They are saying that because is on the main stem left artery is high risk. I saw the angiogram and it did look like more than 50%. Another cardiologist, with whom I had an informal conversation and saw the report, told me that he agreed with the bypass procedure and that my husband with his condition would have otherwise a great chance of dying within a year.

@DoctorBoladCardiology

5 күн бұрын

Generally yes, Left main blockage more than 50% is best treated by bypass surgery rather than stent, unless there is a contraindication or high risk from open heart surgery

My name is Israful Alam , My age is 42 year, My CAG report Date 11/09/2023 National Heart Foundation and Research Institute, Bangladesh, capital city in Dhaka. My CAG report , LMCA: Free of disease , LAD: type Iv vessel and 80-85% stenosis in its proximal segment followed by 99% stenosis in its mid segment and 40-45% stenosis in its distal segment. LCX free of disease. OM has got 80-85% stenosis in its proximal segment . RCA: Dominant vessel and 80-85% stenosis in its proximal segment followed by 99% stenosis in its mid segment and 50-60% stenosis in its distal segment. LIMA Free of disease . Now I need Stent or Bypass Surgery.

@DoctorBoladCardiology

8 ай бұрын

What you are describing is what we call 3 vessel disease, and generally the first option is bypass surgery. It also depends on other underlying medical conditions like diabetes. However, the patient's age is young, and bypass surgery should be reserved for later years, and stents considered at this age, if possible. Your doctor who performed the procedure and who knows your medical history well, would be the best person to advise you about whether bypass surgery or stents is the best option for you.

@israfulalamrinkusir7782

8 ай бұрын

Thanks a lot, good decision. I have no diabetes. I need how many stents for me. I went to stents your hospital. how to contact you. sent your hospital location. md israful alam from Bangladesh

My fiance is 75 years old and his Dr at the veteran hospital suggest he have bypass surgery he already have 3 stents along with prostate cancer once someone has developed heart failure will they always have this condition?

@DoctorBoladCardiology

2 ай бұрын

If the heart failure is secondary to reduced blood flow to the muscle of the heart, and if the muscle is viable, then restoring blood flow either by stenting or bypass will help improve the heart function.

Hello Doctor My father is 71-72 years old. He just had palipitations at night for few years when we got his tests done his Lvef was reduced to 45-50 percent. After angiography the doctors found out RCA is blocked 90 perecnt with a lot of collaterals already present and LAD blocked 75 percent . The doctors went for stenting since my father was old and had diabetes too. The doctors couldn open RCA with stent because the block was too hard and LAD was stented successfully. The doctor told us he is fine now as the RCA has blood supply of collaterals and the rest 2 arteries are open.After the angioplasty he was sick for 7 days as his started having hypotension and then also got infection in the hospital. After 7 days he got completely fine and was discharged. He is on medications now. Can you tell us that what should be our future steps and what do you think of his treatment. what all tests are recommended for follow ups? medicines you would want to recommend?

@DoctorBoladCardiology

4 ай бұрын

Generally, if the artery narrowing cannot be treated, and the patient does not have symptoms, then medications would be a reasonable option. The doctors who have seen and examined your father would be the ones who would give your father the best advise.

Thanks a lot, good decision. I have no diabetes. I need how many stents for me. I went to stents your hospital. how to contact you. sent your hospital location. md israful alam from Bangladesh.

@DoctorBoladCardiology

8 ай бұрын

The number of stents depend on the lesions. You are best served by a local doctor nearby where you reside.

Hello Sir My father 45 years old went to bypass surgery 2 years ago Procedure was leg veins was used Is this procedure is good? Please help me sir! Is veins procedure from legs is long lasting

@DoctorBoladCardiology

Жыл бұрын

It is common to use leg veins for bypass, and they last for a years.

@Gourvisharma602

Жыл бұрын

@@DoctorBoladCardiology Like for most probably for how many years? Is there is any difference with between in life expectancy of leg veins and chest artery??

@DoctorBoladCardiology

Жыл бұрын

Arterial grafts like for example the internal mammary artery, are less prone to failure than venous grafts. Your doctor who performed the procedure should be able to help you answer the questions specific to your father.

@Gourvisharma602

Жыл бұрын

@@DoctorBoladCardiology For how many years leg veins work

@DoctorBoladCardiology

Жыл бұрын

There is no specific number of years for individual vein grafts. For detailed information, I suggest that you review the following article about this issue, at the following link www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.052163

Why is diabetes such a big factor? Is age ever taken into consideration?

@DoctorBoladCardiology

11 ай бұрын

Uncontrolled diabetes can cause acceleration of coronary disease. Yes age is taken into consideration.

LM: NORMAL LAD, PROXIMAL 80% STENOSIS, FOLLOWED BY MIDSEGMENT CRITICAL SUBTOAL OCCLUSION WITH GOOD DISTAL FLOW LCX: MIDSEGMENT 80% BIFURACTION LESION (1:1:0) MEDINA WITH GOOD DISTAL FLOW RCA: MIDSEGMENT TIGHT LESION WITH GOOD DISTAL FLOW

@DoctorBoladCardiology

Ай бұрын

This is what we call three vessel disease, meaning there are blockages in the three main arteries of the heart.

@naveedhussain4000

Ай бұрын

What's your advice in this scenario?

@naveedhussain4000

Ай бұрын

Stent or CABG

@DoctorBoladCardiology

Ай бұрын

Generally, three vessel disease is managed by bypass surgery as I mentioned in the video. However, this depends on different factors nd sometimes stents are used. Your doctor will be the best person to advise you.

@DoctorBoladCardiology

Ай бұрын

Please see my comments above.

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