Heart & Cardiology/revascularization

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Question
Hi Dr. Richardson
I am  52- year old mail patient with a pmhs of HTN, dyslipidemia underwent a stress test secondary to dyspnea: ran 10 mins, no c/p, with mild ECG change.
LV Angio : normal size and function with an estimated ejection fraction of 60%
L Main: Angiographically normal
LAD: Proximal LAD bifurcates into 2 LADs: first one has an 80% stenosis and is occluded distally after that with left to left collaterals from its diagonal branch. Other branch gives septal branches and almost reaches APEx
CX and OM: mild mild disease, at the very distal OM2 there is a 90% stenosis with a small distribution distally.
RCA: Co- dominant, mild proximal disease, moderate distal disease, 90% proximal PDA

Please advice me is revascularization is the solution to my problems?

Answer
Hello Mahed,

The indication for revascularization is chest pain you don't want to put up with.  Medical treatment with aspirin, a statin and a beta blocker is as effective in preventing heart attack and cardiac death as is revascularization.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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