64 Slice Coronary Ct Scan

This is the most wonderful technology :) 6 months ago I had my first. It was 100% correct as to the size and location of my blockages. A few days later I had a cath and 2 stents. I think they are closing off, due to increasing BP and chest pain. I saw my doc Monday. He is a joke. He said I needed another cath or angiogram. I asked about another ct scan. He said he didn't think they could see through the stents. I said well, can't they see the goes intos and goes out ofs (bloodflow)? He said maybe so, we'll try another one. The receptionist said she would call with the appointment time.

I went home and started to worry about whether I would be spinning my wheels by having this test. I started searching the net for info as to whether the scan could see through, or determine if blood flow through the stents was sufficient. I couldn't find a thing I guess because of the "newness" of this technology.

Yesterday the receptionist called me and said the scan was scheduled for next Tuesday. I told her that I wasn't really sure that I wanted the test, due to the lack of knowledge by the doc and myself, and that I was going to make some calls about the capabilities of the test. She explained that she could have the best tech at the clinic to call me and see if she could help. 10 minutes later this wonderful lady called and said no problem whatsoever. The scan can see through the stent. I told her that someone should tell Dr. Nobrainer and she said yes, Dr. X will call him and explain.

Dr. NB is about ready to retire and all he does is rest {float} on his laurels. He would have had me have another cardiac catheterization vs this test.....Could be a life or death matter, i.e. cath vs scan..... There are risk involved here.

I guess that most of the polymer, that contains the paclataxal inside of the stent has gone. I don't know and didn't ask. I was too glad to hear her confidence in the scan and the fact that Dr. X would call Dr. Happygolucky.

Doctors should have to take constant requalification exams, like those that generate electricity using nuclear power do. There would probably be a 60% decline in death rates around the world.

RJ

Thanks Elisha :)

Congrats on your mod squad job....You seem to be a very sweet and thoughtful lady. (kissing up already here, he he he)

RJ

Dgirl

Yes I have the Taxus Express Two drug eluding stents. The restenosis rate is better that the older non-medicated stents, but still the restenosis rate is ~ 15-20% I think.

It may be tough for you to find the "64 slice" scan. The equipment is very new and expensive, but will soon be in most good hospitals. The older 16 slice scans will not do what these latest machines can do. The latest MRI technology, which competes with computed tomography (CT) technology, is probably even better at imaging coronary artery blockages (maybe?).

I have not heard anyone who has had stents, mention the fact that during insertion, and inflation of the balloon within the stent, blood flow through the artery was stopped and resulted in severe angina. My 2 was inserted into the largest portions of my only 2 good coronary arteries. Maybe this is why? The doctor warned me well ahead of time. To me, angina feels like a dull, but powerful ache that burns. It radiates from the heart. There are varying degress of angina though. This was extreme angina that occured during the stent deal, because all of the blood flow was stopped 2 times, and the balloon had to remain pressurized for some time (6 or 8 seconds I think...it was recorded in my records), to press the stent into the artery wall. The balloon is pressurized to around 240 psig. This varies I guess, amongst people and blockages, as far as the pressure and time the balloon remains inflated.

They checked my blood for heart muscle enzymes afterwards, to see if any damage was done to my heart during the procedure (due to lack of coronary artery blood flow).

How high is your cholesterol and triglycerides? Don't get all stressed out, ok? Keep cool, calm and ever so collective :)

Hopes ya feel better soon,

RJ

See there....I told ya :) Ha ha ha

You are most welcome. Now I must travel many miles, dragging all my tools with me to replace my daughter's hot water heater :(

RJ

P.S. Y'all be good now!

Aldo,

yes, the new 64-slice scanners are wonderful -- HOWEVER, the one thing they do not tell you is the radiation exposure, as well as the dye load. The new 64 slice scanner has a radiation exposure of about 15.2 to 21.4 mSv (typical chest xray is about 0.02 - 0.05 mSv) That is the radiation equivalent of 500 to 1000 chest xrays. So 6 months ago, you had that number of Chest Xrays. Then you had a coronary angiogram with another set of radiation load (a diagnostic coronary angiogram is about 3mSv, which does not include radiation needed for the intervention part). Now you are having another coronary CTA.

In addition, the restenosis rates for TAXUS stents depends on the location and size of the TAXUS stents--good data can be found here. http://www.medscape.com/viewarticle/501427 

Data on Xray exposure of 64 slice CTA here: http://circ.ahajournals.org/cgi/content/full/112/15/2318

 

hi aldo, wow this is a lot of info to assimilate, i went to the stent site and it was a little hard to understand the graphs, but looks like the stents we have are better. you asked about my cholesteral and tryglicerides. my total cholesteral is 320 my trys are 189. my good ,or hdl levels run around 55. got any scoop on that info?

Aldo, 2.75 stent is one of those border zones. Again, I am not taking care of you, so your physician is who I would defer to in regards to this, but if your chest pain has become significant enough again, perhaps another look with a coronary angiogram is warranted. Your doctor may wish to do a stress test instead; however, as that has fairly good predictive value, especially for anterior wall defects.

You are most welcome Dgirl :)

You know that you need to lower your LDL. Your HDL is close to normal range. Do a search on"lowering LDL" and you will have some herbal alternatives to read about. I am STILL going to make my little list, but I haven't had time. I have taken polisconol (sp), but not in high doses, only as part of a blend of lipid lowering supplements, or herbs. I take 5000 mg/day of fish oil. That may be too much? Don't want to cause harm to a member. It is supposed to have good anti-inflammatory affects, as well as the oh so good omega 3 fatty acids. Do you eat oatmeal, raw almonds and walnuts (unsalted, of course)?. Do you exercise?

Dgirl

You're most welcome for the conversation. We have a very worthy subject, I think. I promised to try to gather some info on supplements that lower cholesterol. Here is a site with an exotic list of chemical concoctions said to do the trick. Many of these I have taken in a blend. Some I have taken in fairly high doses, but since I got the stents, I have cut back. I didn't want to put anything exotic into my bloodstream, lol.

Remember this site sells the products, but they do give helpful information about natural cholesterol lowering preparations, not regulated by the FDA. Here is an example of some info and a link :

"Guggul Benefits

High cholesterol: Studies show that a 14-27% of LDL cholesterol and 22-30% of triglycerides levels were reduced when guggul was given to men and women with high cholesterol for 12 weeks with no change in diet or exercise. Several clinical studies were published in the Indian Journal of Medicine (volume 84) in 1986, Indian Pharmacoepia and in the Journal of the Association of Physicians in India (vol. 34 & 37) all stating the efficacy of guggul in lowering LDL cholesterol and triglycerides. Dr. David Moore and his team at the Baylor College of Medicine in Houston found that the guggulsterone, the active ingredient in the Guggul extract, blocks the activity of a receptor in the liver's cells called Farnesoid X Receptor (FXR). Later, Dr. David Mangelsdorf at University of Texas Southwestern Medical Center in Dallas confirmed that the guggul blocked the receptor and affected how cholesterol is metabolized.

Atherosclerosis: Two compounds, Z-guggulsterone and E-guggulsterone, appear to be responsible for guggul lipid's cholesterol-lowering effects. Guggul also appears to boost levels of "good" cholesterol although the exact mechanism is unknown. Both of these actions help prevent Atherosclerosis. Guggul is also an antioxidant, which helps stop the oxidization of cholesterol and the subsequent hardening of the arteries.

Dreamgirl,

Fish oils are wonderful. However, make sure you are buying a reputable brand and not some generic fish oil -- the way they extract the oil can concentrate any mercury/PCB's that is in the fish, so make sure you are using a company that advertises toxin-free and mercury free -- which most good companies will advertise. If you have a question, call that company and ask.

I do not mean to rain on your hopeful parade on the fatal event, but all it takes is one blockage to have a fatal event--proximal LAD and left main are usually the most common, but other arteries can cause it as well. However, usually those "fatal events" are due to a sudden change in blood flow--due to a artery being 40-60% blocked and then becoming completely blocked due to a thrombus, and fatal events are not usually due to the gradual closing of an artery, which usually is what causes symptoms. The concept of vulnerable plaque is a big topic in cardiology currently.

Dreamgirl,

Not sure what mt lad is. Is that mid lad? Again, after stenting usually patients are fairly safe from sudden death from acute heart attack (as long as they continue their aspirin and/or plavix). Restenosis usually causes pain but not acute sudden death.

Article on vulnerable plaque: http://www.tmc.edu/thi/vulplaq.html

In regards to salmon oil, again generics are worse than upper brand name oils -- and any fish oil is fine whether it be fish oil or salmon oil. I personally use Cardiotabs, but that is my preference, and there are others as well, including 1 you can get by prescription. ( Omacor ) http://www.solvay-omacor.com/

Hope this helps.

I had bypass surgery done 14 months ago. Had a stress test done last week and on friday the cardiologist called and said " I wish I had good news for you, but the tests show abnormal blood flow to the same area that the bypass was done in and we need to go in and do a heart cath asap to see if we can "hopefully fix it".

Soooooo, I called a CT Scan place here in Ft Myers and spoke to them. They told me that without having the report from the stress test as well as the post op report from the bypass surgery then the results from a CT Scan will most likely NOT be accurate.

Just reporting what I was told 15 minutes ago.

Grrrrr

Thank you Els,

funny how these things go huh? When I had the first cath 15 months ago I was panicked from just getting the cath. Now when it came to do the open heart surgery, THAT was terror.

To do another cath isn't scary now. What might happen next though

Rgrds