Gist for Case explanation / query
I am 45Yrs and 1 1/2 year back (01-07-2015) I had a severe pain in the chest, admitted in the one of renowned hospital and diagnosed as
ATHEROSCLEROTIC HEART DISEASE ICD CODE I 25.1,
ACUTE ANTERIOR WALL MI ICD CODE I 25.2 W/P(1 1/2 HR DURATION) THROMBOLYSED WITH INJ.TENECTEPLASE-40MG,MODERATE LV DISFUNCTION RADIAL CAG:DOUBLE VESSEL DISEASE,
ADVISE: PCI TO LAD (DES),RESCUE PCI TO PROXIMAL LAD,3.0X19mmBIOMIME AURA STENT(DES),R/F:SMOKER ICD CODE J 41.0
After the above procedure with in 15 days I've faced the same previous conditions and breathless ness, giddiness then rushed to hospital and conducted CAG the findings are:
OSTIAL RAMUS 95%STENOSIS AT PRESENT MEDICINES ONLY AND O/o location, CLEAR TO LAD STENT?
Further I went to OTHER HOSPITAL 300 KM AWAY FROM OUR CITY as I felt I was Neither properly diagnosed/Nor properly treated.
There in the new hospital as per the advise of the senior cardiologist we agreed them to proceed for Check Angiogram and diagnosed as
Unstable Angina NSR, MODERATE LV DISFUNCTION. [EF-40%], and with the same complaints on emergency I was admitted in the hospital several times for observation. Finally after a month of time they have conducted
CABG. On 28-09-2015
operation: coronary Artery Bypass grafting surgery (off pump)
1.Left internal mammary artery to left anterior descending artery
2.Saphenous vein graft to Ramus.
3. Saphenous vein graft to Diagonal.
Further, after with post surgical complication in the process that I’m recovering, Again the chest heavy ness! got found a difficulty—
Implanted a Stent on 06-04-2016
and diagnosed as:
#CAD-ANTERIOR WALL MI, S/p TNK
#S/p CAG –TVD
#S/p PTCA with stent to LAD (01-07-2015)
#S/p CAG-Mild ISR of LAD stent
#S/p CABGs 28-09-2015-LIMAto LAD, SVG to RAMUS and D1
#S/p CT CAG 04/04/2016- PATENT GRAFTS, SEVERE DIFFUSE ISR IN LAD
#S/p CAG-DOUBLE VESSEL DISEASE [06/04/2016](OSTEAL LMCA 90% STENOSIS)
ADHOC PTCA+ STENT TO LMCA TO LCX (DES) WITH IABP SUPPORT
Later with some complications and I’ve tried to improve my daily activities like walking twice a day for 1hr wholly. Again and as in different kind now I’ve got a severe neck tightness while I’m in morning walk and rushed to hosp. then admitted and implanted
Two Stents on 19/10/2016 and diagnosed as:
#S/p CAG (19/10/2016)-LMCA+Two Vessel Disease,Patent LIMA to LAD,SVG to Diagonal and RAMUS.
After the procedure conducted to me on the day 19th oct’ 2016 the symptoms are not relieved completely facing the same symptoms even now, after 5 min walk getting neck tightness and slowly palpitations., and can’t even bare a minimal strain like even I can’t perform my daily routine works.
So, Please kindly justify my previous procedures and advise me the right diagnosis/treatment.
In the bottom line:
1(3 vessel) CABG, 1 CT Angiogram,
1(diffused)+1+2 =Total 4 Stents Pre and Post CABG
Medicines using is given under:
4.NICORAN -5 mg-------BD
6.DILZEM SR-90mg-------OD(8 am)
7.MET XL -25 mg-----OD (8 am)
8.Atorvastatin-80mg------OD (9 pm)
9.Restyl -0.25mg-----OD (9 pm)
10.Pantodac-40mg ---OD (6 am)
11.Cremaffin 15ml---OD sos