Is bariatric surgery advisable for a coronary artery disease patient?

Q. If I have coronary artery disease, is bariatric surgery contraindicated?

Answered by
Dr. Prashant Valecha
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Mar 10, 2022 and last reviewed on: Jul 20, 2023

Hi doctor,

I planned to go in for bariatric surgery and was instructed to take some pre-op tests for medical clearance. It included lab work, chest X-rays, and cardiology. So, today I received my EKG test results back. What does this mean? I immediately sent an email to my doctor, but he is yet to reply. I am terrified. Diagnosis lines: Normal sinus rhythm, T wave abnormality, consider inferior ischemia. Abnormal ECG, Non-specific T wave, abnormality now evident in lateral leads. Ventricular rate - 100, BPM atrial rate - 100 BPM, PR interval - 168 ms, QRS interval - 84 ms, QT interval - 330 ms, QT corrected - 425 ms, frontal axis - 50 degrees, right axis - 41 degrees, frontal axis - 26 degrees. Please help.

#

Hi,

Welcome to icliniq.com.

I understand your concern. It is not a very serious matter but suggests that there can be ischemia that is decreased blood supply in one region. It can also be a normal variant in inferior leads and females. To confirm and rule out any coronary artery disease, you need to do TMT (treadmill test). I hope this helps.

Hi doctor,

Thanks for your reply. If they determine artery disease, will they have to do a heart catheter? I was reading up on that. Also, if artery disease is detected, how is it treated? Do you think this will rule me out for bariatric surgery? Please help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern. For surgery, cardiac fitness is needed. It can be assessed by effort tolerance of patient like how long one can walk or jog without chest pain or breathing difficulty or by doing TMT test. If it suggests disease in coronaries, they will ask you to get the cardiac problem treated first. For CAD (coronary artery disease), if TMT is positive, then the cardiologist will first do a coronary angiogram (CAG). Then if it is significant, they may advise PTCA (percutaneous transluminal coronary angioplasty). CABG (coronary artery bypass graft) is done if the disease is present in multiple vessels. I hope this helps.


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