Q. Can medicines reduce heart block?
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 to do with OM1 and OM2? Please guide.
Hi,
Welcome to icliniq.com.
Any blockage of more than 70% if possible should be stented. In your father's case heart attack was due to mid LAD block (left anterior descending coronary artery) which has been treated. OM (obtuse marginal) branches supply papillary muscles and posterolateral wall of left ventricle, these are also significantly blocked but area supplied by them may have collaterals that we cannot say as collaterals are very tiny vessels. But, as he is on antiplatelet medicine now mostly he will not get sudden block of OMs. You can wait and see how he is feeling on walking and exertion. If no pain then ask your consultant for TMT (Treadmill test) and then decide for plasty. For further information consult a cardiologist online.
Hi doctor,
Thank you for your immediate reply. May I know, what are papillary muscles? What is posterolateral wall and collaterals? How much is the danger now? Can the blockage get reduced to some extent by continuing the mentioned medicine? Can heart attack be expected due to OM branch block?
Hi,
Welcome back to icliniq.com.
Papillary muscles are muscles that hold and maintain closing of valves between atrium (upper) and ventricle (lower chamber). If supply to them stopped, some part of them will be dead then valve will leak blood back to 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 attack because heart attack comes when a blood clot comes in a blocked vessel and that will not occur when you are on Aspirin (Ecosprin) and Deplatt (Clopidogrel). For further information consult a cardiologist online.
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