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Atherosclerosis+COPD=death sentence?
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An_193023 posted:
Hi all,
My brother is 62 years old and had triple bypass surgery 4 years ago. Up until that point, he was relatively healthy and active. One year ago he was diagnosed with COPD (had smoked for 30+ years before the bypass surgery.) He was recently diagnosed with atherosclerosis of his heart and has been having a lot of trouble with his heart being able to pump his blood. His doctor put him on medication to keep his blood pressure down since his heart couldn't keep up in it's weakened state. Now he has been having mild pains and fainting spells. After another visit and numerous tests, his doctor basically sent him home with the diagnosis that there's nothing else that can be done. With all the technology and advances in medicine, I was dumbfounded to hear the doctor's prognonis (basically, "go sit at home until you die".) I want him to go see another doctor, but without having any insurance, this is financially impossible.

Would it be worth it to find another doctor and is having atherosclerosis and COPD really just a death sentence?
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CardiostarUSA1 responded:
Hi:

"Would it be worth it to find another doctor"

Definitely!

"Is having atherosclerosis and COPD really just a death sentence?"

Not necessarily, though this can not be properly addressed via the Internet, as everyone is unique, with each and every health/medical case/situation being different.

In general only here, coronary artery bypass graft (CABG) surgery is just a clever way of temporarily circumventing the problem (atherosclerosis), as this does not address the underlying disease process and what drives the progression.

Most important, coronary artery disease (CAD) is a life-long unpredictable (which can exhibit periods of stabilization, acceleration and even some regression) condition, requiring a continuum of care.

The very best of luck to your brother down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)



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Be well-informed

WebMD

Living with Coronary Artery Disease (CAD)

A chronic disease with no cure. When you have coronary artery disease, it is important to take....

This is especially true if you have had an interventional procedure or surgery to improve blood flow to the heart....../It is up to you to take steps......

Recognize the symptoms......

Reduce your risk factors......

Take your medications......

See your doctor for regular check-ups......

http://www.webmd.com/heart-disease/guide/living-with-heart-disease


Coronary artery anatomy


Starting with left anterior descending (LAD), the most critical, next to the ultra-critical left main (LM)

http://www.heartsite.com/html/lad.html

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Good to know, for the primary and secondary prevention of heart attack and brain attack/stroke


Epidemiologic studies (EDS) have revealed risk factors (encompasses some new, novel, or emerging) for atherosclerosis (typically affecting the carotid, coronary, and peripheral arteries), which includes age, gender, genetics (gene deletion, malfunction, or mutation, diabetes (considered as being the highest risk factor), smoking (includes second hand), inactivity, obesity (a global epidemic "globesity") high blood pressure (hypertension), high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, LOW HDL (less than 40 mg/dL, an HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease), high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).

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Cleveland Clinic

Understanding Your Ejection Fraction

http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx

American Heart Association - Learn and Live

Forum: Heart Failure

http://myportal.americanheart.org/jiveforum/forum.jspa?forumID=16

Heart failure, congestive heart failure patients info

http://www.chfpatients.com

Heart Failure Society of America

Heart Failure Stages (Class I-IV)

http://www.abouthf.org/questions_stages.htm

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Pulmonology Channel

COPD

http://www.pulmonologychannel.com/copd/index.shtml


How to Prevent a COPD Flareup


http://www.ehow.com/how_5624281_prevent-copd-flareup.html

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Quote!

"Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

- Charles Inlander, People's Medical Society

.


WebMD/WebMD Health Exchanges does not provide medical advice, diagnosis, or treatment.


WebMD does not endorse any specific product, service, or treatment.
 
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DeadManWalking57 responded:
Does he eat a lot of fruit and vegetables, have a high anti-oxidant (HAO) diet ? An HAO diet is extremely cardio protective.

Does he drink green tea, eat pistachios, berries, blueberries, pomegranates, plums, prunes, cook or eat herbs and spices regularly ? If not, he needs to.

I had emergency CABG 5 years ago, and the same prognosis AFTERWARDS of not much I could do, without COPD. Predicted heart failure.

There are a lot of lifestyle choices heart patients can do, and he may not have made them all yet. Most patients refuse to make them all, and it shows in diminished quality of life.

CABG should have improved his situation, not worsen it. Many people think the exercise requirement is too difficult, and choose to do nothing, and thereby let their heart grow weak. And they go downhill faster.

I was a former athlete, very competitive, and refused to just wait to die with my prognosis. I did my own rehab, and rehab is something a CABG patient can not ever abandon. I can not do everything I want, but I am pretty happy anyway. Four years after surgery, I was playing basketball, and not with a bunch of old men. Teens at the park, full and half court.

You brother needs to start exerciise with what he can do. even if that is just walking. If he's bedridden, then he's in a really bad way. If not, he starts with what he can do now. He also needs to commit to learning every possible lifestyle change there is for atherosclerosis patients, and to committing to adopting them as soon as possible. He should search for diet and exercise tips and resources for heart disease and cardiac rehabilitation authored by me here on WebMD, under either DeadManWalking56 or DeadManWalking57.

My disease is/was extreme. Your brother may be able to overcome his prognosis, but only if he tries. I have insurance, but I have not used it for my research, or my exercise, or my diet changes. I went extreme, and did research and found information avialable but not published in mainstream media.

The only nuts I can eat are pistachios. All other nuts bring on chest discomfort if I eat them regularly.

I can provide lots of other exercise suggestions and ideas appropriate to pretty much any conditioning level. If he can move, and wants to, then we can hope to get him doing more little by little. But the desire has to come from him. After CABG, my ejection fraction was 43. The doctor thought it would drop further. I took it up to 63 instead.

DMW
 
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DeadManWalking57 responded:
Life is a death sentence.

We can shorten it or extend it, enjoy it more, or not.

Its all in the desire and the choices we make everyday.
 
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DeadManWalking57 responded:
http://www.ncbi.nlm.nih.gov/pubmed/20236716 High-dose rosuvastatin in chronic heart failure promotes vasculogenesis, corrects endothelial function, and improves cardiac remodeling - Results from a randomized, double-blind, and placebo-controlled study. BACKGROUND: The full impact of statins on patients with chronic heart failure (CHF) is unknown. Therefore, we aimed to evaluate the pleiotropic effects of rosuvastatin on vascular and tissue regeneration, its impact on endothelial function and hemodynamics in CHF.
METHODS: Forty-two patients with CHF (LVEF 30 /-1%) were randomized to 12weeks of oral rosuvastatin (40mg/d) or placebo. At baseline and at 12weeks, VEGF and oxidized LDL (oxLDL) were assessed by ELISA. Circulating endothelial progenitor cells (CPCs) were quantified using FACS. CPC function was determined by matrigel assay. Number of CD34( ) stem cells and capillary density were measured in skeletal muscle (SM). Flow-mediated dilatation (FMD) and left ventricular (LV) function were determined by ultrasound.
RESULTS: Rosuvastatin increased VEGF by 43% (p=0.004 vs. placebo) and decreased oxLDL by -27% (p=0.04 vs. placebo). This was associated with an elevation in CPC count by 224% (p=0.04 vs. placebo) and an augmentation of CPC integrative capacity by 91% (p=0.03 vs. placebo). Capillary density increased by 14% (p<0.001 vs. placebo), which was associated with an enhanced homing of CD34( ) stem cells. Rosuvastatin improved FMD by 163% (p<0.001 vs. placebo) and enhanced ejection fraction by 27% (p<0.001 vs. placebo).
CONCLUSION: In CHF, rosuvastatin activates CPCs that contribute to neovascularisation and to the enhancement of endothelial function. Correction of vascular abnormalities leads in part to an increase in LV function. Therefore, rosuvastatin's non-lipid effects may have the potential to promote endogenous tissue regeneration and improve LV performance in CHF.


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