Can medicines reduce heart block?

Question

Hi doctor,

My father had a major heart attack 15 days ago. The angiography report showed LAD or Diagonal - type III LAD. Mid has 90 % stenosis. LCX/OM non-dominant. Early OM1 has 90 % stenosis. OM2 has 80 % stenosis. PTCA with DES to LAD has been performed. Now, what should we do with OM1 and OM2? Please guide.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Any blockage of more than 70 %, if possible, should be stented. In your father's case, the heart attack was due to a mid-LAD block (left anterior descending coronary artery), which has been treated. OM (obtuse marginal) branches supply papillary muscles and the posterolateral wall of the left ventricle; these are also significantly blocked, but the area they supply may have collaterals that we cannot say as collaterals are very tiny vessels. But, as he is on antiplatelet medicine now, he will mostly not get sudden blocks of OMs. You can wait and see how he is feeling on walking and exertion. If there is no pain, then ask your consultant for TMT (Treadmill test) and then decide on a plasty.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Papillary muscles are muscles that hold and maintain the closing of valves between the atrium (upper) and ventricle (lower chamber). If the supply to them is stopped, some parts of them will be dead, and then the valve will leak blood back to the upper chamber. Collaterals are tiny blood vessels from a big vessel. In this case, collaterals can come from LAD (which is stented now) to papillary muscles, which are mainly supplied by OM. So, these muscles have blood supply from two places. No, blocks cannot be reduced by medicine. Medicines can prevent heart attacks because a heart attack comes when a blood clot comes in a blocked vessel, and that will not occur when you are on Ecosprin and Clopidogrel.

I hope this helps.

Please revert so I can assist you further.

Thank you.