Deciding to refuse cardiac catheterization.

Heart health and blood vessels
1

After doing the best I can to ferret out the risks vs benefits of cardiac catheterization.  92% of my brain says, "No."  That niggling 8% is a real pain.

I am female.  I am over 60.  I have not had a myocardial infarction, (that they're telling me about anyway).  I have some stress wall hypertrophy, but that's pretty much it.  If I could get the physicians/cardiologists, to give me better evidence of need for such an invasive procedure, I might consider it...however...

I know me.  Just having the procedure would be psychologically, and, therefore, physically, ruinous.  I think I understand - but who can understand this really - that choosing not to have the catheterization, and whatever may happen as a result, means I might sign out quite unexpected.  But is this a better way to live?  I think so.

I have not felt "well" for at 7 years.  (I'll spare you the ailments).  However, I don't get colds, flu (no vaccinations)...I don't have hypertension.  I'm told I have angina, but I am convinced that the post-meal sensations I get are due to gastric/diaphragm...more on that order of things.  I don't have frank chest "pain."

I'm figuring that it will be a complete craps shoot to refuse the catheterization, but I am 100% certain, that there is a better chance of me surviving an invasive procedure if I don't die before I have it, then lending myself to what looks like a never-ending routine of invasive procedures.

What I'm currently hoping for, but have been unable to get, is a cardiologist who will agree to fully monitor me; one who truly understands the various medications available and who would find one that is best suited for this particular body, and who considers cardiac catheterization, et al, a last resort, rather than a first.  (Nice fantasy).

So far, I've had the general practitioner I see, attempt to scare the hell out of me without telling me on what evidence he was doing so.  (I would change to another GP if there was another one around).  That kind of tactic is not only useless, but demoralizing.  When it comes to "heart," demoralization can, without a doubt, lead to "heart trouble."

It's all a quandry.

2

Ask for a non invasive CT coronary angiogram.

3

Yeah a CT Coronary Angiogram would cover most of the bases  

4

How often are they done in comparison to the standard procedure?

I complained about my last angiogram that took 50 minutes. He kept on asking for other sizes of catheters and at one point asked the nurse if she would try to get it round an awkward corner. No way! she said. At that point he gave up saying the rest was all right so that probably is.

After I complained to the head of cardiology he said it was part of X's learning curve. 

5

Thanks.  I need to see if CT- angiograms illustrate microvascular blockages; weigh the radiation exposure; and what degree of blockage seen on CT is considered valid for invasive follow-up. 

6

I was actually told that a powerfull MRI Scanner can checl for blockages, and I actually read online that a new study proved it to be more effective than CT scan. Maybe something to look into, but it needs to be a powerfull MRI scanner.

7

Your possible heart condition will be much more dangerous than the radiation exposure you get during an angiogram or a CT scan.  

I must have had over 400 X-Rays in my lifetime and at 80 do not yet glow in the dark.

8

I dunno, the Interventional Cardiology route is a bigger earner so,, um, I suspect far less often  I was last in the Cath Lab in March,, I ended up with an Aortic Dissection - now cured - and had to stay in for days    So yes the Cardiac Catheterization risks are true 

9

Wow! that was very unfortunate. How do they repair it ?

I don't expect that having signed the consent form that you got any compensation.

10

So sorry.

11

Thank you. 

12

Apparently because it was a "... 5cm present. IVS to LAD non flow limiting lesion." it / they just heal themselves, it was gone 5 days later 

13

It's OK, I feel good  Good luck with yours 

14

Are you liable to need another procedure?

With my first one I did not even realise that he had actually started. I felt the pushing at my groin then he turned away fiddling with his monitor that was turned away from me. After a minute or so I inquired when he was going to start.

Start? he said, I'm watching the action replay now and turned the monitor towards me.

15

Yeah it's inevitable that I'll need it again, to be honest my experiences haven't put me off  The vast majority of people have no problems at all and I haven't had a bad time every time at least 

16

Hi, I so know where youre coming from. I think sometimes orthodox practitioners feel it their duty to scare the pants from you instead of allowing you to make your own decisions and work with you. There is an old book written by Dr Dean Ormish called reversing heart disease. He was able to trial some patients supporting them with diet exercise and counselling (to release any stress) and some medication without any surgical intervention. This proved a very successful trial. My advice to you would be not to stress over your decision (which wouldnt be good for you) but to keep positive, deal with any past upsets (I find by realising that you always learn something from any bad experiences) and most of all be happy. You say you have pain after eating. See how and what you are eating. If you gulp your food or eat when stressed this could give you pain.

For some people following the orthodox route is right but for the odd few that are worried about that route, we follow our instinct. I would like to stress, these are only my points of view, I am not advocating any particulsr route for you to follow. I wish you a long and happy life.

17

They heal themselves.  Interesting. 

18

Thank you.

19

I'm not going to have it done.  The interventionalist stated that having the catheterization, possible angioplasty/stenting, will not decrease the chances of having a heart attack.  Other than doing what I can to keep my body as healthy as possible, medication seems an unavoidable component, and yet I do not have a cardiologist involved with my care who seems to have an iota of knowledge about these types of pharmaceuticals. 

I keep being told that one type is as good as another.  So much for the tomes of published studies on beta blockers, calcium channel blockers, angiotensins, etc., etc., etc.  It's as if those studies, which clearly have indications that should prompt prescribing one type over another, and even within the various subgroups, were someone's fantastic invention.

It doesn't look promising that I'll get the right pharmaceutical regimen.  Why aren't there pharmacologic cardiologists anyway?

20

What is an interventionalist  and how was your angina diagnosed?

I was told that I had angina in 2003 after having cardiac like chest pains and being monitored in hospital for four days that did not show anything but a stress ECG showed that my heart was not getting enough oxygen so they said angina. I did not agree nor did my then GP.

Seven years later I had your post meal chest pains and when my BP was checked it was 210/110, I had an ECG and echocardiogram and later when my BP had dropped with medication I was again told that I had angina after a stress ECG, My then GP and I both thought otherwise.

After another failed stress ECG the next year I had an angiogram that showed my arteries to be clear, Failed stress ECG's? false positives they said.

In 2011 I was diagnosed with aortic stenosis and had another angiogram after a stress echocardiogram indicated two narrowed arteries. Again the arteries were found to be clear but I think it was worthwhile having them done.