An acute death of heart muscle resulting from a blood clot in a coronary vessel?
It will be called as acute myocardial infarction, chances of recovery good, but, it can be massive in nature called as acute maasive myocardial infarction, and sudden death ensues. (
+ info)
What is Sinus? Is the coronary sinus differs from a vein or a blood vessel?
A depression or cavity formed by a bending or curving.
Anatomy.
A dilated channel or receptacle containing chiefly venous blood.
Any of various air-filled cavities in the bones of the skull, especially one communicating with the nostrils.
Pathology. A fistula leading from a pus-filled cavity.
Botany. A recess or indentation between lobes of a leaf or corolla.
Any space in an organ, tissue, or bone, but usually referring to the paranasal sinuses of the face. In humans, four such sinuses, lined with ciliated, mucus-producing epithelium, communicate with each nasal passage through small apertures. The ethmoid and sphenoid sinuses are located centrally between and behind the eyes. The frontal sinuses lie above the nasal bridge, and the maxillary sinuses are contained in the upper jaw beneath the orbits. The mastoid portion of the temporal bone contains air cells lined with similar epithelium. (
+ info)
What is the mechanism that allows patents with coronary stents to eventually stop taking Plavix?
While the appropriate duration of anti-platlet or anti-coagulant therepy is currently being investicated (believed to be 6 months, a year or longer), it appears that the general theory is that it can eventually be stopped. Currently, it appears that it can be stopped sooner with bare metal stents than it can with drug eluding stents. What I would like to better understand is, why can it ever be stopped with either stent type. What happens to reduce the chance of clot formation after a year say, that allows Plavix to be discontinued? Is it that tissue grows over the stent? If so, then why go through the trouble of making drug eluding stents, which attempt to fight said tissue growth? Also, if tissue growth is bad, because it causes the vessel to close, then what happens when the drugs on the drug coated stents are used up? Do the drugs just delay the inevitable? If so, how long is the delay?
Thanks for the detailed reply. However, Taxus Express2 DES elude a drug specifically for slowing epitilialization! While I appreciate that there may be a need to minimize this process, so as not to allow too much growth into the vessel, it seems reckless to prevent such growth all together, thereby preventing full bio-compatibility.
If the plaque is soft enough that it can be pressed, like play-doh up against the artery wall, Why can't it simply be scrapped back into the catheter and removed.
----------
-You got it right...let me explain. When the angioplasty is performed - essentially what happens is that a balloon simply crushes the flow limiting lesions (plaques - at least 70% blockage) out of the way. A stent is deployed and "sprung" into place, propping the vessel open. Now after you crush the plaque, this is very thrombogenic as a thrombus is part of the typical healing process (but definitely not too good in the middle of a large artery supplying your heart muscle with blood). The drug eluting stents (DES) are coated with medication that is anti-thrombotic and the Plavix assists the process.
At this point lets compare the bare metal stents - the Plavix of course prevents the thrombus here too. But why do you only need it for three months...because the healing occurs faster (because the healing process was not being inhibited at the site of the stent by the stent) After three months, all healed. The stents have been epithelialized and are now seamlessly part of the artery.
So I hear you asking - why did we ever use the DES in the first place? Because once the angioplasty is performed there is a very high risk period where a thrombus could form shortly after the procedure is performed - thus precipitating an acute event (a heart attack!). The DES have a substantially reduced episodes (roughly 30% for bare metal verses less than 10% for DES). Here's the rub - the DES stents often never epithelialize. That means that there's a rough, mesh, straw-like structure inside the artery forever. Anything that causes swirling or eddies in the blood stream can also be thrombogenic too - hence the recommendation for continued use of Plavix indefinitely in some cases.
We risk stratify based on a few things -
*the length of the stent or stents deployed consecutively
*the location of the stent (high risk verses moderate or low risk)
*the baseline risk for a patient being hypercoagulable in the first place - e.g. smoker, hypertensive, cancer, etc.
*Pateint preference.
Our understanding of this is a best guess at this point. We hope to have some clinical trials to guide us more definitively on all of this some time in the future.
The original flow-limiting lesions are plaques are not the simple intimal lining found in healthy arteries - so having the "skin" that grows over the stents is not at risk for over growth and causing blockage again. The enemy is the plaque.
With our current understanding, these plaques grow through having excess cholesterol and triglycerides in our system. There are some great studies that show with agressive control (always through use of high dose medications, like statins) of cholesterol the plaques can be stablized and in fact reduced. (see the HATS and ARBITOR2 studies)
Not all patients follow our advice, however. They continue to smoke, have poorly controlled hypertension, diabetes, and high cholesterol - which, you guessed it, can result in "in-stent restenosis." This has nothing to do with the thrombogenesis or Plavix we discussed above.
I hope this has answered your questions and helps.
Good luck.
Addendum - I am not sure how you invent a stent that attempts to prevent a biological response entirely - clotting - but then does not affect epithelialization. When first introduced it was thought that once the drug stopped being eluting - about six to nine months, that epithelialization would occur then...and it may in some people. But in others, the show is over and no additional healing occurs...the stent remains pressed in the arterial wall. Really this idea that the intimal lining over-grows and is responsible for stenosis is just not the case.
I understand that there is work being done on a magnesium stent that will actually might dissolve over time - interesting. Also, I am sure, full of potential unforeseen consequences.
The pressures used to clear stenosis is 3 atmospheres; which is significant - it is a misnomer to think of the plaques like Play-dough. It is called angioplasty, afterall - material is moved - 70% or greater blockage (often near totally occluded) to usually to 0%.
"Digging" the material out would in no way change everything we just discussed and we would be back to the days of - no stents - which resulted in frequent thrombosis and restenosis at the same spot. (aka the Halcyon Days for interventionalist cardiologists)
There are "cutting balloons" that are sometimes used to clear severely calcified plaques (have their own risk of embolization - even though a screen is deployed downstream from the procedure).
I hope that answered your questions - and I hope at this point that I have earned my 10 points (uncramping my typing fingers-whew) have a good day, my friend. (
+ info)
Smaller blood vessels and coronary arteries cause you too store more fat and less muscle?
I read that Asians have blood vessels and coronary arteries 70% size of Caucasians. Does this cause us too store more fat when we eat the same amount of food? Should we eat less and try to eat 7-8 small meals a day? How often should we eat these small meals, every hour?
----------
First of all I think 7-8 small meals a day would be crazy. Even people who think they're doing good by eating 6 small meals a day are just wasting their time. Our bodies are made to take about 3-4 meals a day, the reason why people started eating more meals is because of boydbuilders who wanted to make sure they were getting the most out of their supplements (because the body can only absorb so many nutrients in one sitting).
As for the storing more fat due to the arteries being smaller, I don't think thats true, even the arteriest being 70% the size seems a little far fetched. But either way I don't think you should change your daily life from anything typical. (
+ info)
what is the purpose of the coronary blood vessels?why is it so dangerous for them to become blocked?
and what can be done for a person who has blocked coronary blood vessels?
----------
The coronary blood vessels supply blood to and from your heart and are one of the main set of blood vessels in your body. If you aquire a blockage in your coronary arteries it needs to be monitored or fixed depending on the severity. Blocked vessels can lead to a heart attack or many other heart problems including long term heart failure; it isn't something to ignore to say the least.
There are many possible treatment options for blocked coronary vessels including stenting which is a non-invasive procedure that uses a mesh to push the plaque buildup against the walls of your blood vessels and reopen them to restore normal blood flow. Other options include surgical methods such as bypassing the affected vessel to restore blood flow with a healthy one in another part of your body. If a blood clot is blocking flow medications such as warfarin and aspirin(blood thinners) can be used to prevent the formation of dangerous blood clots. There are also medications known as "clot busters" that basically dissolve the clots in your body to restore blood flow. (
+ info)
Does anyone know of any non-invasive, scientifically proven alternative to Coronary Bypass Surgery?
My dad who has been a diabetic for the past 25 or more years and is aged 65 suffered a massive heart attack recently. Angiogram revelaed 100% block in one of the main arteries and also 4 other blocks in other blood vessels ranging from 99-85% blockage. Bypass surgery is recommended. He does not have any other symptoms of breathlessness, pain etc.. Because he is a diabetic I am concerned about his healing process and recovery post surgery.. Any info is appreciated.
----------
It depends on which vessels have the blockages in them. Your father has blockages in multiple vessels, which limits the options. Angioplasty with stent placement is an alternative, but it not as good when there is blockages in multiple vessels. Coronary artery bypass grafting (CABG) was compared to angioplasty with stent placement in patients with multivessel disease and diabetes. Coronary artery bypass surgery was associated with significantly better outcomes in diabetic patients and it is currently recommended over angioplasty in diabetic patients with multivessel disease. In studies, CABG was associated with reduced need for revascularization, which means they required a repeat procedure to fix the blockages. The incidence of heart attack, stroke, and death was also reduced in diabetic patients who had CABG over angioplasty with stent placement.
There are risks and benefits with every procedure. The outcomes after coronary artery bypass grafting are pretty good now. Uncontrolled diabetes does impair wound healing and is associated with worse outcomes with surgery. Therefore it is important to work with his doctor's to make sure his diabetes is well controlled no matter what he decides to do. You should discuss it with the surgeon to review the different options and their risks and benefits. I would recommend that he gets the coronary artery bypass grafting, because the outcomes are better based on studies. (
+ info)
What is coronary artery disease or hypertension?
Why do people get hypertension and what is it.Also what is coronary artery disease ?
----------
Artery is a plaque build-up in the arteries, causing the arteries to be less flexible and smaller inside than they would normally be. The arteries that bring blood back and forth to the heart have smaller openings in them than they normally would. When that happens, there is more pressure from the blood flowing through the arteries, so you can get high blood pressure from this. You can also get high blood pressure if your arteries are constricted from any other reason. Think of how water would flow through a hose. If you had a large hose with a large diameter, the water would flow gradually from the hose. If you put the same amount of water through a hose that is a lot smaller in diameter, the water would be under more pressure (you would see it spurting out faster and harder). Arteries that are larger in diameter make for lower blood pressure than arteries that have a smaller opening. If the doctor says it is O.K. try taking a multi-vitamin with high B vitamins in it, and then also eat lots of fresh fruits and vegetables along with something in your diet that gives you some calcium. Ask your doctor what he thinks about it. (
+ info)
What is the difference between CORONARY and CONGENITAL heart disease?
I'm filling out a family health history form for my doctor and it's asking if anyone in my family has had coronary or congenital heart disease. I know my mom has heart disease but I don't know which kind it is. One of the arteries to her heart was becoming blocked and they had to put a stent in that artery to open it back up - it's called angioplasty. Is that coronary or congenital? Thanks.
----------
Congenital means "from birth." Congenital heart disease is something you are born with, such as a murmur. If her artery is becoming slowly blocked, she does not have congenital disease. Coronary is the build up of plaques inside the artery walls. See attached link :) (
+ info)
What percentage of Coronary artery disease patients are female?
I'm just wondering what the male to female ratio is among patients with Coronary artery disease is. If you could tell me where you got the information from I'd really appreciate it. Thank you.
----------
After attaining the stage of menopause the percentage of CAD cases in males and females is almost equal. Before the menopause the incidence of the coronary artery disease (CAD) in females is very low due to the estrogen and other feminizing hormonal effect. (
+ info)
what r the risks of leaving the right coronary artery block untreated?
Angiogram results: LCA angio shows LMCA is normal.LAD type iii vessel shows 30-40 % stenosis. distal Lad is free of disease.RCA is dominant and has mid long diffused disease followed by total occlusion.good LV function by echo.
----------
Registered Nurse here; Cardiac nurse x 24 years. I hope your cardiologist went over the risk factors of leaving the right coronary artery block untreated. From your report, sounds pretty good, your Left Ventricular is working good. Everyone over the age of 20 begins to have a little bit of steno sis. Overall your report is pretty good, however I would ask the cardiologist the treatments available for Right coronary artery block. If left untreated it will become more blocked, one will have symptoms of shortness of breath, poor endurance, and any amount of exercises will increase the work load upon the heart for the heart will have to work harder to oxygenate the blood cells. The treatments for block artery vary greatly, I would not want to speculate here which is best for you, for it would be totally misguided on my part, knowing nothing of your history. Plus I'm not a cardiologist, just a nurse. Please go back to your cardiologist and ask he or she the very question you have posted here, if still unsure, go ahead and get a second opinion.
I appreciate the opportunity to address such an important question. (
+ info)
We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.