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DrThomasMd
DrThomasMd, Other
Category: Cardiology
Satisfied Customers: 63757
Experience:  Board certified doctor, internal medicine/integrative medicine/advanced training in hormone therapies
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If a 71 year old male, diabetic and hypertensive has 80% blockage

Customer Question

If a 71 year old male, diabetic and hypertensive has 80% blockage in the lower left artery and the other two coronary arteries are fine what is suggested treatment?
Is a stent required ?
If yes, then what is better. A metal one or one which dissolves over time ?
Submitted: 2 years ago.
Category: Cardiology
Expert:  DrThomasMd replied 2 years ago.
Hello
A stent would be the treatment, unless this were the left main artery

is that it?
Customer: replied 2 years ago.
It is the left anterior descending
Expert:  DrThomasMd replied 2 years ago.
OK
This needs a stent in all likelyhood.
They should have told you this on the angiogram or even done it, unless there is some other problem.
As a diabetic, with any symptoms, this should be stented.



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Expert:  Dr. Phil, MD replied 2 years ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Unless this lesion is causing symptoms or caused a heart attack then medical therapy can be initiated

This is aggressive diet and exercise measures plus medication.

This is just as good as a stent outside of active heart attack or angina.

The stent used (if one is used) is drug eluting (not bare metal). Then the patient will need plavix for a year
Customer: replied 2 years ago.
Thank you. What are the risks of having one artery 80% blocked ?

Is it worth taking the risk of not putting a stent in ?
Expert:  Dr. Phil, MD replied 2 years ago.
If this person has had a heart attack or is having chest pain or other symptoms indicating the blockage then it is EXTREMELY high risk

If the lesion seems to be causing symptoms then it is in a very dangerous location.

If that is the case, it absolutely needs a stent.

If that is not the case and it is not causing any symptoms it can be managed medically and with lifestyle changes.
Expert:  DrThomasMd replied 2 years ago.
Hello
I must disagree.
In a diabetic symptoms can be non existent or atypical.

I have dealt with this situation many times over many years.

The lack of symptoms in a diabetic does NOT preclude a stent.

If I were to tell you that I would be wrong.

Sit down with the cardiologist at this point and take this very seriously.

In fact, the location is dangerous in a diabetic, symptoms or not.

I am a double board certified doctor with over 20 years of experience, and I will be glad to help you anytime....any questions.
Find me by request.



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