Patient's Query
Hello doctor,
I am a 42-year-old male. My half-brother had a heart attack at 21 and passed away. Because of this, I paid for an angiogram and exercise stress test. The stress test showed a good result, but the angiogram revealed triple-vessel heart disease. The cardiologist stated that it was very mild and likely caused by smoking. My cholesterol levels were in the normal range. I was prescribed statins and a low-dose Aspirin and was discharged. The doctor reassured me that I should not worry, as many people my age have mild atheroma.
However, I am concerned because triple-vessel disease sounds serious. I also have a printout of the angiogram, which I do not fully understand. I need a second opinion. I am feeling very anxious about it every day and am worried.
Hello,
Welcome to icliniq.com.
Thank you for providing the detailed note (attachment removed to protect patient identity). I understand your concerns, but there is no need to worry—you will be fine. The study shows only minimal evidence of coronary heart disease, which is currently reversible. In cases like this, I usually advise my patients to modify their lifestyle. Engage in regular exercise for at least 30 minutes, three times a week, quit smoking, and adopt healthy eating habits. Continue the medications as prescribed, and hopefully, you will be fine.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
Is the second diagram a picture of my arteries, with the edges showing very mild stenosis? I could not understand the two diagrams. What are they supposed to show?
Hello,
Welcome back to icliniq.com.
Yes, exactly. The second diagram depicts your heart and its vessels. It is meant to show areas where blockages may be present. It is just a schematic representation of your heart's vessels. When was the last time you underwent any cardiovascular tests? Do you currently have any symptoms?
Patient's Query
Hello doctor,
Thank you for the reply.
The angiogram was taken when I was 40, and I am now 47. I have no symptoms at all. I quit smoking seven years ago and exercise regularly. From my understanding, the main arteries seem to have only very slight CAD, with no significant narrowing and a fairly uniform appearance. Does this look unremarkable to you?
I have already made the necessary lifestyle changes, but I read somewhere that mild CAD can be dangerous, as small plaques might break off and cause a heart attack. What level of stenosis does this appear to show? I have been worrying about this daily for years.
I spoke to a cardiologist during a follow-up appointment, but he seemed a bit annoyed. He described the findings as incidental and reassured me that there was no need to worry. However, my brother had 100 percent blockages at 21 and passed away. The doctor said he likely inherited this from his father, who is not related to me.
I think what worries me most is that the angiogram noted triple-vessel involvement. Do you think I still have a chance at a reasonable lifespan? Would you agree that my stress test results looked good?
Hello,
Welcome back to icliniq.com.
I understand your concerns, and it is completely normal to feel this way. Please feel free to ask any questions you have. In the diagram, there are no significant signs of blockage because the narrowing is very minimal. Mild CAD can become dangerous if medications are not taken as prescribed or lifestyle changes are not maintained.
Your stress test results are reassuring, and I believe you have a very good chance of enjoying a normal lifespan. As for your brother’s passing, it is understandable to be worried, but his condition was likely influenced by genetic factors from his father, whom you do not share.
Regards.
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Answered byDr. Isaac Gana
Medically reviewed byDr. Nithila. A
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