64 Slice Coronary Ct Scan

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Aldo
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Date Joined Jan 2006
Total Posts : 289
   Posted 2/15/2006 10:21 AM (GMT -7)   
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

els
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Date Joined Oct 2005
Total Posts : 4031
   Posted 2/15/2006 10:35 AM (GMT -7)   
Hi Aldo,  I agree with you on that physicians should be required to have the some sort of requalification.  Just like when people go to get their CPR certification, you know it and pass it but you still have to recert every year or you lose your license.  I have been lucky that I don't have a physician like this that is currently treating me.  It is good that you are outspoken and do your research.  Good luck on your test......

~elisha
 


Aldo
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Date Joined Jan 2006
Total Posts : 289
   Posted 2/15/2006 12:28 PM (GMT -7)   
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

DREAMGIRL
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Date Joined Jan 2006
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   Posted 2/15/2006 5:47 PM (GMT -7)   
RJ, DID YOU HAVE THE NEW COATED STENTS, I THOUGHT THEY WERE NOT SUPPOSE TO RECLOSE AS EASILY AS THE NON COATED. GLAD TO HEAR about THE CT SCAN, I WILL WRITE THAT DOWN BECAUSE MY DOC SAID THE SAME THING IF I EVER NEEDED TO FIND OUT about MY ARTERIES, ANOTHER ANGIOGRAM. PLEASE HOW SCARY IS THAT. AND I WANTED TO TELL YOU THAT NO I DID NOT HAVE ANGINA INDUCED WHEN I GOT MY STENTS, SO CAN YOU DESCRIBE AT ALL HOW IT FEELS. I HAD A SIGNIFICANT ANXIETY ATTACK LAST NIGHT, HAVING TO STOP THE STATINS , IT WAS LIKE A SECURITY BLANKET THAT I HAVE LOST. THANKS I THINK THERE IS A BIG DIFFERENCE IN HOW MEN AND WOMEN TOLERATE THOSE STATINS WE DISCUSSED AND ALL THE HEART RELATED ISSUES. THANKS

Aldo
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Date Joined Jan 2006
Total Posts : 289
   Posted 2/15/2006 8:01 PM (GMT -7)   
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

els
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Date Joined Oct 2005
Total Posts : 4031
   Posted 2/16/2006 6:20 AM (GMT -7)   
Why thank you RJ!~  tongue
~elisha
 


Aldo
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Date Joined Jan 2006
Total Posts : 289
   Posted 2/16/2006 7:08 AM (GMT -7)   
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!

dave z
Regular Member


Date Joined Dec 2004
Total Posts : 164
   Posted 2/16/2006 9:21 AM (GMT -7)   
Hi Dave Z here.  My daughter is a 64 CT scanner technician at a major university hospital.  Originally the 64 CT scanner was introduced to do virtual colonoscopies.  The theory being that they would be able to perform many more virtual colonoscopies than the more invasive colonoscopy.  They also began to use the 64 CT scanner on heart patients.  The cardiologists are very excited with the information they can see from this scanner as they can now see the heart functioning in REAL TIME.  It also allows the cardiologist to see much smaller blood vessels in the heart than they can from a catheterization.  It is truely a major break through in CT capabilites, with more major advances to come.  You can go to http://www.64slice.com/patients/cardiac.php    where there are some fascinating images from this scanner.  However the 64 CT scanner is not necessairly replacing real colonoscopies or heart catheterizations, but is to be used at times in conjuction with those tests.   I just found this article on my email from webmd, which is a discussion about the 64 ct vs catheterization.  http://www.webmd.com/content/chat-transcripts/2/110388  then go to live event transcripts then cardiac imaging coronary cta

Post Edited (dave z) : 2/16/2006 10:22:52 AM (GMT-7)


erskinej
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Date Joined Jan 2006
Total Posts : 32
   Posted 2/16/2006 9:52 AM (GMT -7)   
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
 
 
 
 

Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 2/16/2006 10:23 PM (GMT -7)   
Thanks Dave for all the info. You must be proud of your daughter :)

Erskine..... wow that is scary. I worked in the nuke power industry for >20 years. 1 millisievert is = 100 millirem.....so.....that tells me that a ct scan like I had, gave me a dose of 1.52 to 2.14 REMS! The Nuclear Regulatory Commission (NRC) limits nuke workers to 3.0 Rems/year. This is most unhealthy for younger people. Since I am 53, I have to weigh the risk of a cath....to the risk of cancer. I don't think I will make it long enough to develop cancer from the scan, but I don't know. I have a left dominant heart or artery arrangement. My Rca is worthless, and closed around 60%. My Lad has a 2.75 diameter stent. My obtuse marginal is a tad smaller. The doc said my coronary arteries are small. I have diffuse disease (blockages at ~30%) the entire length of my Lad. My Rca is "congenitally small and insignificant", per the cath report. It is too small to be stented. The doc told me Monday that I could have an infarct in my right ventricle.

What do you think?

Thanks to both of you for your replys,

RJ

DREAMGIRL
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Date Joined Jan 2006
Total Posts : 600
   Posted 2/17/2006 11:18 AM (GMT -7)   
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
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 2/17/2006 7:17 PM (GMT -7)   
Well yes..... :

Total Cholesterol= HDL + LDL + (triglycerides/5)

LDL Calculation: LDL = TC – (TG/5 + HDL)

Your LDL = TC {320} - (TG/5 {37.8}) + HDL {55})

Your LDL = 227.2

Your TC/HDL ratio is 5.82. It should be < 5.0 with the optimal amount being 3.5....
.
Your LDL/HDL ratio is 4.13. This ratio should be below 3.5.......

****If TG > 400, calculation is not accurate

I am trying to put a list of all the food and supplements that are recommended, and that I have tried in the past and currently am using, to increase my HDL and lower my triglycerides and LDL.

I have become discouraged and almost bankrupt, lol, from using/buying these supplements.

I religiously take loads of fish oil. Can you tolerate niacin?

P.S. Check my math....I have holes in my white matter :)

erskinej
Regular Member


Date Joined Jan 2006
Total Posts : 32
   Posted 2/19/2006 9:24 PM (GMT -7)   
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.

DREAMGIRL
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Date Joined Jan 2006
Total Posts : 600
   Posted 2/20/2006 10:08 AM (GMT -7)   
hi aldo,thanks for all the numbers you workded on. i have been taking different natural rememdies also and just have other side effects, mostly with my intestinal tract, so finding a solution is truly difficult. i started taking fish oil about a month and a half ago, three capsules daily,have tried red yeast rice and could not tolerate that, that is a natural statin. i wish i could remember where i saw that list of foods i was telling you about where the man said his bp was now 90/60, how much fish oil do you take? i have tried niaspan and i was aokay until i raised it to 1000mg, i will see my cardiologist in a bit and will see if it is okay to add this to my regimen. i am also considering policosona, have you tried that?

Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 2/20/2006 1:58 PM (GMT -7)   
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?

DREAMGIRL
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Date Joined Jan 2006
Total Posts : 600
   Posted 2/20/2006 7:39 PM (GMT -7)   
yeah  yep, i do all the right things aldo, pretty much always have, since i have such problems lowering my ldl i thought if i could get my hdl up that woul make the ratio less dangerous. i am going to increase my fish oil to 4000 daily and later this week or maybe next go for a blood draw, if my numbers are still bad i am going to add nicin and after that i just do not know. i have the name of a chinese pharmcay that offers natural rememdies, i may see if they have anything new.  aldo, thank you so much for all the conversation, it means a lot to me.

Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 2/20/2006 9:25 PM (GMT -7)   
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
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Date Joined Jan 2006
Total Posts : 600
   Posted 2/21/2006 10:19 AM (GMT -7)   
tongue  hi to you again aldo. thanks for the info again, i will wait to add anything else. do you take co q 10 enzymes?  aldo, i was reading your conversation with erskine, sounds like you are having continued problems, soryy for the angina, seems like the use of the fish oil has not really helped the restonosis problem. i am a christian too and will keep you in my prayers, just remembering each other at times of prayer is nice. be cool and don't be too anxious, i would think we would have to have 2or 3 major artery blockages to have a fatal event. does that make sense to you?

erskinej
Regular Member


Date Joined Jan 2006
Total Posts : 32
   Posted 2/21/2006 11:28 AM (GMT -7)   
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
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Date Joined Jan 2006
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   Posted 2/21/2006 5:45 PM (GMT -7)   
:-)  hi erskine, we are using aldo as a conduit right now but i don't know what vulnerable plaque is. yep you rained on my parade alright, i was trying to appease myself as well as also,  ha ha.i buy my fish oil at costc, someone told me to buy salmon oil instead, do you concur with that opinion... i know   iknow, just your opinion. i have a 2.5X12 stent in mt lad and one in my d1 whatever that is, are those the arteries you were discussing.  i will not be afraid of the answer, i finally realize what will be will be thanks,   hi aldo.

erskinej
Regular Member


Date Joined Jan 2006
Total Posts : 32
   Posted 2/22/2006 8:33 AM (GMT -7)   
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.

DREAMGIRL
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Date Joined Jan 2006
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   Posted 2/22/2006 9:38 AM (GMT -7)   
tongue  erskine, actually that was a typo, i was trying to say my LAD. i really must pay closer attention to my writing. nice to have you on this forum. bye for now.

MrTudo
Regular Member


Date Joined Jul 2006
Total Posts : 31
   Posted 7/3/2006 8:37 AM (GMT -7)   
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

els
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Date Joined Oct 2005
Total Posts : 4031
   Posted 7/3/2006 9:49 AM (GMT -7)   
Hi MrTudo,  Welcome to Healing Well forum, we are happy to have you.  I am sure that is frustrating and scary what you are going through.  Please keep us posted on how your doing.  I went through a cath in March and it wasnt so bad but they didnt do any repairs other than fixing my pacemaker lead.  There are many members here that are more knowledgeable on this than I so I am sure they will post soon.  take care, my thoughts and prayers are with you


 


MrTudo
Regular Member


Date Joined Jul 2006
Total Posts : 31
   Posted 7/3/2006 9:54 AM (GMT -7)   
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 nono
 
Rgrds
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