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An_246564 posted:
10 Months ago I started having angina, not caused by activities. It would wake me in the middle of the night, or any time during the day. The pain would be the same as when I had a MI in 2007.. Arms, upper chest region and into the neck and Jaw region. The pain goes from 0-10 in a matter of minutes. Sometimes it gets so bad I have to take two nitro at a time to get it stopped. My local Cardiac MD took me into the cath lab and found no new blockages. He said it wasn't my heart. Meanwhile the angina is getting worse. By Feb 2012 I was using a bottle of Nitro a week to stop the angina. In March my Cardiac MD took me back in to the cath lab and stented a 95% scar tissue blockage again, bringing my total of 12 stents in the right coronary artery. A few hours after being in the lab, the angina hit again. This time lasted over 2 hours, the nurse put pain meds in my iv and knocked me out for about 4 hours. The next morning the cardiac MD said again, its not your heart go home! The nurse argued with him, but I checked out and left.
My pulmanary MD sent me to a university hospital that is a few hours from here. They diagnosed the problem ordered an EECP. They then decided it was unstable angina, just not in a coronary artery. My microvessels when my scar tissue is from the MI were not getting enough oxygen. They stopped the EECP, and refered me to Mayo in MN for a TMR. Mayo upped my Isosorbide to 120 mg daily and added L-arginine and wants the EECP started again. They said since its on the right side of the heart the TMR will likely not be successful. The PET scan showed the entire lower part of my heart is all scar tissue. I still have angina daily several times a day. I am so weak when they happen, I can hardly move.
Are these repeated angina's in the microvessels causing additional damage? My EF is 50%.
cardiostarusa1 responded:

"Are these repeated anginas in the microvessels causing additional damage?"

As applicable, as reported in various medical literature, the pain of microvascular angina (typically affecting the heart's capillaries) does not mean that the heart muscle (myocardium) is suffering irreversible damage, as episodes of microvascular angina usually does not cause damage to the heart muscle,

"My EF is 50"

Cleveland Clinic

Understanding Your Ejection Fraction

"......bringing my total of 12 stents in the right coronary artery."


One really wants to avoid a "full metal jacket", that is, in which the entire length of a native coronary artery (or bypass graft) is stented.

The bottom line

Coronary stents (bare-metal or drug-eluting) are only a Band-aid or spot-treatment, as it doesn't address the disease process and what drives the progression.

Coronary artery disease (CAD) is a lifelong unpredictable (may/can exhibit periods of stabilization, acceleration and even some regression) condition requiring a continuum of care.

Best of luck down the road of life.

Take care,


WebMD member (since 8/99)



Patient resources

FDA approved non-invasive Enhanced External Counterpulsation (EECP) treatments.

Are You a Candidate for EECP Therapy?

Surgical-based transmyocardial revascularization (TMR, FDA approved)

Patient education site



Living with Heart Disease

Coronary artery disease (CAD)

CAD is a chronic disease with no cure. When you have CAD, it is important to take care of your......

This is especially true if you have had an interventional procedure or....

Recognize the symptoms......

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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 and thirdhand), inactivity, obesity (a global epidemic, "globesity"), high blood pressure (hypertension), Low HDL (now questionable, according to recent studies) high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).



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Saharane responded:
I realize I have a full metal jacket as you say. I know Mayo and the University hospital both were not happy with all the stents in the right coronary. (Mayo) They told me the Pet scan shows there is not enough live tissue to do a by-pass.??
Also according to my Cardiac MD"s I have no plaque in my arteries. My mi was caused by dissection, and five bare metal stents were placed. I have been in the cath lab about 8 times for medicated stents. Once he cut out the scar tissue, each other time i received 2 stents untill Mar 2012 I received One. All because of scar tissue. No plaque.!!
cardiostarusa1 replied to Saharane's response:
"My mi was caused by dissection"

That's unfortunate. As reported, as applicable, spontaneous coronary artery dissection (SCAD, a tear or rip) is an uncommon-to-rare occurrence.

At least, in many cases, drug-eluting stents, though not 100% perfect, have been successful in eliminating restenosis (scar tissue build-up).

I hope that everything works out as well as possible for you.

Take good care,


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