Cardiovascular Issues: A Patient's Journey Through Diagnosis and Treatment

Cardiovascular disease

Dear Dr.
He,
I apologize for my unclear writing, which may have caused some confusion.
I have some questions that I feel uncomfortable asking my doctors, even though I know it's my right as a patient.
At the age of 29, I first visited a cardiologist, who discovered that I had no pulse in my left arm.
As a result, I underwent a cardiac catheterization, during which the doctor informed me that there was a blockage in the left main coronary artery with a density of 95% (as thin as a hair), and that it could not be treated with stents or balloons.
The surgeon found a blood vessel connecting from my neck to my brain at the site of the blockage, which formed a T-shape.
The doctor mentioned that attempting to clear the blockage could potentially lead to a stroke, as it was uncertain which brain vessel might be affected.
Therefore, he decided that I needed to undergo a bypass surgery.
During the winter, my left hand felt as cold as an ice pop and was numb.
In September of the previous year, I was scheduled for surgery.
However, before the operation, the surgeon reviewed my cardiac catheterization data and noticed something unusual, leading to an arrangement for a CT scan.
The results revealed that I had vascular inflammation (autoimmune antibodies causing vasculitis), which meant that surgery could not proceed.
This concern arose after I experienced left-sided numbness and loss of balance, which lasted about five minutes.
I would like to ask you the following questions:
1.
I have been taking anticoagulants, but I am no longer on them as my rheumatologist has discontinued them (I felt too shy to ask).
2.
Does the presence of certain autoimmune antibodies mean that I cannot undergo surgery?
3.
Is it possible to draw blood or administer injections in both arms? I feel embarrassed to tell the nurses that I have no pulse in my left arm.
I apologize for troubling you again, and I wish you all the best.
Sincerely,
Doctor Q&A Teams

Dan, 30~39 year old female. Ask Date: 2008/04/15

Dr. He Dongjin reply Cardiology

Dear Dan,
I am not sure which hospital you visited before.
Have you been to National Taiwan University Hospital? With antibodies and vasculitis, it is likely that you are concerned about the inflammation of blood vessels, which can make them more fragile and difficult to heal after surgery, potentially leading to rupture.
The blood draw is from a vein and is unrelated to arterial stenosis issues.

At that time, which specialty physician prescribed you the anticoagulants? If it is due to vasculitis, the decision can be made by an immunologist.
If it is related to cardiac arrhythmia, then you should discuss it with a cardiologist.
Thank you for your message.

Reply Date: 2008/04/15

More Info

Understanding cardiovascular issues can be a complex journey, especially for patients who have experienced significant health challenges like you have. Your case illustrates the multifaceted nature of cardiovascular disease, including the interplay between structural heart issues, vascular health, and autoimmune conditions.
1. Anticoagulation Therapy: You mentioned that you were previously on anticoagulants but are no longer taking them due to your rheumatologist's recommendation. Anticoagulants are typically prescribed to prevent blood clots, especially in patients with a history of vascular blockages or those at risk for stroke. If your rheumatologist has deemed it safe to discontinue these medications, it may be due to a reassessment of your risk factors or the underlying condition that necessitated their use. However, it is crucial to have a thorough discussion with your healthcare provider about the implications of stopping anticoagulants, especially considering your history of vascular issues.

2. Autoimmune Conditions and Surgery: You raised an important question about the relationship between autoimmune conditions and surgical interventions. Indeed, if you have an autoimmune condition that causes vascular inflammation, it can complicate surgical decisions. Surgeons often assess the risk of surgery based on the patient's overall health, the stability of their autoimmune condition, and the potential for complications such as increased bleeding or infection. If your blood vessels are inflamed, performing surgery could pose significant risks, including the possibility of exacerbating the inflammation or causing further vascular damage. It is essential to have a multidisciplinary approach involving your cardiologist, rheumatologist, and surgeon to determine the best course of action tailored to your specific health needs.

3. Blood Draws and IV Access: Regarding your concern about blood draws and intravenous (IV) access, it is understandable to feel apprehensive about discussing your left arm's lack of pulse. It is important to communicate this to your healthcare team. Nurses and phlebotomists are trained to find alternative sites for blood draws or IV access, especially if one arm is not viable. They can often use the veins in your right arm or even consider using veins in your feet or ankles if necessary. Do not hesitate to inform them about your situation; they are there to help you and ensure that you receive the best care possible.

In summary, your journey through diagnosis and treatment has highlighted several critical aspects of cardiovascular health, including the importance of managing anticoagulation therapy, understanding the implications of autoimmune conditions on surgical options, and effectively communicating your needs to healthcare providers. It is vital to maintain open lines of communication with your medical team, as they can provide the necessary support and adjustments to your treatment plan based on your evolving health status.
As you navigate these challenges, remember that you have the right to ask questions and seek clarity about your treatment options. Your health is paramount, and being proactive in your care can lead to better outcomes.

Similar Q&A

Seeking Guidance on Persistent Cardiovascular Symptoms: A Patient's Journey

Dear Dr. He, Good day. I have been experiencing a health issue since the end of May this year, which has persisted for over two months now. I have consulted several doctors from different hospitals and specialties, but I have not found a solution. I would like to seek your advic...

Dr. He Dongjin reply Cardiology
Hello, the symptoms you described sound like a case of autonomic nervous system dysregulation syndrome combined with some neuromuscular symptoms. You have undergone multiple cardiac evaluations, and since your blood pressure, heart rate, and oxygen levels are all normal, there sh...

Understanding Post-Stent Care: Addressing Patient Concerns and Communication

The system seems to be malfunctioning. My email is correct, yet I am not receiving replies and cannot select satisfaction ratings. Regarding the previous question: 1. Currently, my physician, although not the original attending doctor, possesses expertise, and I have always belie...

Dr. Li Han reply Cardiology
Hello Mr. Lee, I have not received a response to your previous inquiry, which I find puzzling. However, I will reflect this matter from the hospital's side regarding the persistent chest pain and elevated blood pressure that have been troubling you. I can imagine your anxiet...

Understanding Cardiovascular Issues and Improving Blood Flow Health

Hello Dr. Lin, I was diagnosed with hypertension about 5 to 6 years ago. Over the years, I have been inconsistently taking medication. My blood pressure mostly ranges between 130 and 140 mmHg (systolic), while my diastolic pressure varies from 62 to 100 mmHg, with most readings ...

Dr. Lin Jixiong reply Cardiology
Hello: The fields of cardiology and cardiovascular medicine are essentially the same, with only slight differences in terminology. As for the mentioned erectile issues, it is advisable to seek assistance from a urologist as soon as possible to address the related concerns. Sincer...

Understanding Heart Health: Insights on Doppler Ultrasound and Holter Monitoring

Hello, Director. I am 60 years old, with a cholesterol level of 235 and a glycated hemoglobin (HbA1c) of 6.4. I am currently taking medication to lower my cholesterol and blood sugar. Recently, for the past 3-4 days, I have been experiencing palpitations and an irregular heartbea...

Dr. He Dongjin reply Cardiology
Hello, there are moderate to frequent atrial premature contractions (total 299) and occasional ventricular premature contractions (total 216) with multiform, bigeminy, trigeminy, and quadrigeminy patterns. Some arrhythmias have been associated with palpitations and irregular hear...