Heart question for MGB (or anyone else)

My 80 year old mother-in-law just had a slightly abnormal stress test (the chemical kind).

The cardiologist wants her to have a heart catherization test because the is the "possibility" she "may" have a blockage. She has no symptoms of heart problems.

I just know that years ago a friend of my parents died from the catherization test. I don't know if they still do it the same way or not. They plan on threading it through the groin. Is this test still as dangerous as it was in the past?

She is diabetic and takes daily insulin shots. Other than that she is a very active, lively woman. She has never smoked and seldom drinks. She was adorable last night doing jello shots with me because she wanted to taste them. At her 80th birthday party she was the one out on the dance floor shimming to "Wipe Out".

Ultimately it is her decision as to whether to have the test or not. We just want her to be as informed as possible.

Thank you,

Charlotte

I have no answers to your questions, Charlotte. I just wanted to comment on how much fun your m-i-l sounds! Marc is the right person to ask. He's a font of information.

Wishing your mother-in-law many happy dancing years!
£eslie

Hi Charlotte (thanks Les )

Heart caths do have risk to them. They do involve threading a sheath into the femoral artery (some other arteries can be selected, but the femorals in the groin seem to offer docs the best access). After the sheath is in, catheters are threaded up into the heart to inject contrast dye. Cine x rays are taken with and without contrast to visualize the vessels to check for openings and blockages.

There are risks...the cardiologist should explain them. I have had a total of 10 femoral artery catheterizations. 9 to the heart, one to the brain. The brain angiogram has the highest risk.

Given the risk vs. reward, I would go for the cath--in fact I most likely will be ending up in the cath lab again sooner than later.

For me, the risk is exponentially getting higher--each time you have a procedure, you chances of risk increase. Not to mention radiation exposure.

If it was me, I'd check up on the doc and the hospital doing the work. I've had excellent caths done at hospitals, and the worst cath in terms of pain and procedure at one the highest ranking cardiac centers here.

If she's 80, and this is her first one, then I think she'll be fine. She just has to follow the rules. Cardios are used to dealing with older patients (having a young guy come in throws them the real monkey wrenches).

You can die from just about anything, so I wouldn't let an old negative outcome from a test, from someone else, make my decisions for me--no way.

My mother almost died twice on cath lab tables (one foot on the banana peel, one of the grave), but survived. If I let that bother me, I'd be dead by now--I'm not kidding. Caths for me are necessary to really establish what's going on with my arteries.

Fire away with any questions...


mgb

Thanks MGB,

I think that was the type of reassurance I needed to hear. Thank you for lessening my fears.

My MIL and I have not always seen eye-to-eye, but in the last ten years we're come to accept and appreciate each others differences. I have deep affection for her and only want what's best for her.

Thanks again, Charlotte

I have a question.

What is the difference between Angioplasty and Heart Catheterization?

Cindy

cindy,

catheterization is a term for when the docs enter a vessel with the aim of examining an the vessels in the body....it can be done on just about everything including arms, feet, legs, heart, brain.

a heart catheterization is a procedure where the heart and it's large vessels are viewed using contrast dye ane cine xray.

angioplasty as well can be done to vessels that have a build up of plaque. the doc, using a catheter as a delivery device to the artery that he wants to fix and inflates a tiny baloon to compress a plaque that has built up in the artery.

cardiac angioplasty is not used as often due to it's higher rate of failure. The plaque can return to its original size quickly. Mostly stents are used...a metal wire "tube" that is inflated against the vessel wall to compress the plaque and keep the vessel open.

hope that answers your question.

Do they have to do these procedures from the groin arteries because that is the best place for them to access them? What I am getting at is why start so far away from the heart to begin with? I am supposing there is no easy access to the correct artery from the abdomen, chest, or neck, correct?

easier acces, and it depends what and where they want to go. it's more of a direct pass to the heart through the femoral. but they can go through other great vessels.

you are correct. abdomen access is not done. some of the larger branches off the aorta can be tapped but its all need and access dependant.

Charlotte,

I have a dear friend that works in the Cardiac department doing Angioplasty in Kansas City.

He helped me out alot when my husband had his A-fib problems and partly because of what he told us, we got a second opinion and hubby did not have to have the surgery that the first surgeon told him he needed.

He is very passionate about Cardiac issues and knows so much about it.

I would be happy to put you two together if you would like to ask him some questions.

He sees this stuff everyday so I just thought it might be helpful.

Cindy

MGB,

I am allergic to contrast dye for MRI's. Is this the same contrast they use for the catheterization? I am asking because I am having a bubble study soon to find out if I have a PFO which may relate to TIA symptoms as well as chronic frequent migraines.

The surgery to close the PFO involves a catheterization or full-on surgery (in some cases). If I would have to go through the contrast situation after the first allergic reaction it would be an automatic no-go for that procedure for me, regardless of stroke risk. I'd rather take the daily medication.

I wouldn't even concider full-on surgery at this point in my life, I'm a scaredy cat.

Any thoughts on this would be appreciated.

Cindy,

Sorry I didn't read your post. I think my SIL & MIL have already made the decision, though I don't know what it is. They are not always good about keeping me in the loop, or it could also be that they told Hubby and he forgot to tell to me. Generally I find out about family get togethers the day before the event and have to scramble to the grocery store to get something to bring.

Then hubby will sheepishly say "sorry, I forgot to tell you". A couple of my nieces have gotten to just texting me and by-passing hubby altogether and that works out best.

Charlotte

LG,

Complex question. There are a few types of contrast agents used in CT and MRI scans--gadolinium is often used. Cardiac caths are different.

However, both can cause reactions. You'll need to talk with your docs about this.

Something that I'm scratching my head--who has planted it in your brain that you have a PFO? Neurologists often will bring this up, but most people don't have it. I'm a little concerned that you are getting ahead of yourself.

The bubble study is nothing to worry about. There are many other things in life to stress you out, and believe me, a bubble study is a piece of cake.

Contrast dye, surely can be rough on the body. My last dose for a brain angiogram really nailed my kidneys. I've had a lot of dye over the years, a lot of radiation from tests, and it's not pleasant.

A PFO could exist, but don't get to fired up about this IMO. I saw a neuro today that asked me about this, and I've been checked--it's on everyone's radar screens but rarely causes a blip.

Don't get too concerned about a cath.

Take care,
mgb

Thanks mgb,

My specialist is very hard to book and I do have the bubble study coming up shortly, then in a few weeks after I will see him for the results. He is very "active"! He likes to find things and fix them which is good and bad. Since he is so busy and very on-the-ball I want all the information I can have for my appointment with him so I don't waist his time or mine...or a copayment. These darn copayments are putting me in a hole!

He gives me so much time to talk to him during an appointment and I want to pack everything in one. I know I am getting ahead of myself but I want to gather research up so I can discuss all of it with him in an organized fashion. He put a bit of pressure on me during my last appointment and I was standing there with a blank look on my face, little droplets of drool coming out of my mouth LOL.

I am still keeping an open mind in all of this, I may or may not have the PFO...there's a 50% chance since I am a migraine w/ aura patient. There's an even slimmer chance that the PFO is causing TIA's but still..information is great to have even if you don't have the condition. My brain keeps getting bigger and bigger! Besides if he discusses the procedure with me if I come back positive for PFO I don't want to be the idiot drooling all over myself when he goes into technical talk again. hehe.

I don't want to be pushed into a procedure that is not necessary, which from what I gather..it isn't unless the PFO is causing TIA or strokes.

Thanks for the knowledge of contrast dye. I had never known there are different types, I guess I should go back to the hospital that had originally given me my MRI and find out which dye I am allergic to for my medical files. It would probably be good information to know! I avoid that stuff like the plague. After my very scary reaction the last thing I want is someone injecting me with contrast of any type...besides, it made me feel like I was wetting my pants. They said that was normal...well it didn't feel normal!

It's great to have you around mgb, really appreciate it.
LG