Hello Sir/Madam, I am (Name Changed) from Rajahmundry. i need a second opinion regarding Cardiac Surgery for my Father-in-law aged about 62 Yrs and he is an Diabetic patient too. About an year ago he has gone through Angiogram Test in (Name Changed),Vijayawada and they suggested an Surgery .Attaching reports please find in the attachments. Now,few days back he went to hospital for general checkup they said again to go for an Surgery as early as possible and they are saying that possibilities of success rate is low i.e less than 40%. so,based on the reports attached can you please suggest me the Best alternative opinion possible..... Thankyou for the services of Desimd... Kasina Bhavani. - Asked by K B on 03-May-2014 22:59:35
Reports / Images Uploaded
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Answered by Dr. Ajay Tripuraneni on 04-May-2014 23:27:27
Dear Ms KB,
Based on the reports uploaded your father in law appears to have blockages in several blood vessels. Heart blocakges can be a reason fo decreased heart function (decreased heart pumping). Per reports your father inlaws heart pumps 40 percent of the blood it gets (normal is 55 percent). Would consider medications such as aspirin, betablockers (metoprolol succinate), lisinopril (angiotension converting enzyme inhibitors - ACE- inhibitors) and or nitrates. These medications needs to monitored and adjusted based on the pulse, blood pressure, and kidney function under a heart doctor supervision. If the heart function is weak from the blockages it is recommended to get them fixed, in this case bypass surgery is strongly considered.
Saying that it also depends on the patient age, activity levels, if he can tolerate the surgery etc. The angiogram pictures are better than the reports for us to evaluate or offer a second opinion through our facilitation services.
This is for information only and not medical advise, please consult your local doctor, or consider speaking with DesiMD doctor who will be available as needed for either information about heart doctors in your area or connect you to a doctor on our panel for second opinion.
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Answered by Dr. AM Mohan Rao on 04-May-2014 15:16:34
Hello Mrs.KB,
Thanks for your note for second opinion. The decision for surgery be best made taking his quality of life into consideration. I assume he is taking medications as prescribed by his doctor. He is also a diabetic and ex-smoker. As such he is at a high risk of CAD. His angiogram showed good Left and Right coronary arteries with some blockage of LAD. He also had an old inferior wall myocardial infarction. He is currently advised CABG based on his shortness of breath and lab analysis. Nothing is known about his weight, diabetic or lipid control, smoking history etc., There are no disabling angina for which he needs to undergo surgery immediately. Taking these into view we can give a limited opinion that he needs to go in for aggressive medical therapy as well as exercise training to cope with stress. But he should do it gradually and carefully within his comfort level and under supervision of his doctor.
AM Mohan Rao