Deciding to refuse cardiac catheterization.

Posted , 9 users are following.

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.

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  • Posted

    Ask for a non invasive CT coronary angiogram.
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    • Posted

      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. 

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    • Posted

      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. 
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    • Posted

      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.

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    • Posted

      I dunno, the Interventional Cardiology route is a bigger earner so,, um, I suspect far less often cheesygrin 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 rolleyes lol redface So yes the Cardiac Catheterization risks are true neutral
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    • Posted

      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.

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    • Posted

      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 smile
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    • Posted

      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.

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    • Posted

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

      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?

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    • Posted

      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.

       

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    • Posted

      to be honest, after having two angio grams it sounds familiar

      ​i heard that a few times my self oh sorry we do not have one a stent like the one the cardiologist asked for, so im confuswd with this procedure too

      ​did not think it happened

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    • Posted

      Friend just had angiograpy PCI.  Needed permanent pacemaker.  Fortunately for her, she was attended by a thoracic surgeon.  Not all cath labs are created equal.
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