Dr. Isaac Gana
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 42-year-old male. Because my half brother had a heart attack at 21 and died. I paid for an angiogram and exercise stress test. I had a good exercise outcome, but the angiogram showed triple vessel heart disease. The cardiologist said it was very mild and probably due to smoking. Cholesterols were in the normal range. I was placed on Statins and low dose Aspirin and discharged. The doctor told me that I need not worry and many people would have mild atheroma at my age. My concern is triple vessel sounds very serious and also I have a print out from the angiogram that I cannot understand. I need a second opinion. I am so anxious about it every day, and I am worried.
Hello,
Welcome to icliniq.com.
Thanks for providing a detail note (attachment removed to protect patient identity). I understand your concerns, but no need to be worried you will be fine. The study only shows minimal evidence of coronary heart disease, which is reversible as of this moment. In cases like this, I usually advise my patients to modify their lifestyle. Do the regular exercise of at least 30 minutes three times a week, stop smoking and adopt a healthy eating habit. Continue the medications as prescribed and hopefully you will be fine.
Patient's Query
Thank you doctor,
Is the second diagram a picture of my arteries with the edges showing very mild stenosis? I Could not understand the two diagrams and what are they supposed to be showing?
Hello,
Welcome back to icliniq.com.
Yes, exactly the second diagram depicts your heart and the vessels. The picture is supposed to show areas where there is a blockage. It is just a schematic representation of your heart vessels. When was the last time you went to any cardiovascular test? Do you have any symptoms as of this moment?
Patient's Query
Thank you doctor,
It was taken when I was 40. I am 47 now. No symptoms at all. Stopped smoking seven years ago and exercise a lot. It looks to me like the main arteries only have very slight CAD with no particular narrowing anywhere. Looks quite uniform. Is this quite unremarkable? I have made the necessary lifestyle adjustments. I just read somewhere that mild CAD can be more dangerous with bits breaking off and causing a heart attack. What sort of level of stenosis does that look like to you? I have been worrying daily for years now. I spoke to the cardiologist for a follow-up, and he seemed a bit annoyed. He said it was an incidental finding and I do not need to worry. My brother had 100 % blockages at 21 and died. The doctor said he probably inherited it from his dad who is not the same as mine. I suppose I’m worried mostly because he said it was a triple vessel. Do you think I still have a chance at a reasonable lifespan? Do you concur that my stress test looked good?
Hello,
Welcome back to icliniq.com.
I understand your concerns. You have every reason to be worried and feel free to ask any question you want. On the diagram, there is no sign of blockage because it is very minimal. Mild can be dangerous in cases where you are not taking medication as prescribed. Your stress test result is fine. I am sure you have a very good chance of a normal lifespan. You need to be worried about the death of your brother. He probably got it based on the fact that you do not share the same father.
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Cardiology
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