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What's next?
robjben posted:
5 years ago I sufferd a major heart attack in which my left main was 100% blocked and 2 other areas were 60%. I got a sent in the left main, but the damage was done. A year after that my cardiologist suggested that I get a ICD implanted, which I did. Since then I have had to retire at age 49 ( I am 54 now) becuse of the stress and condition of my heart and go on SSDI. Well this past week I had another incident in which my right main was 100% blocked. I got 2 stents now in that one. So what's next? Is this pretty much the end? Every little twitch my body does cocerns me now, I am having a real hard time sleeping (I may be sleeping but I am not resting) and now the depression has started.
billh99 responded:
There are a number of things that might help.

Often meds can help slow or stop the progression.

As can healthy lifestyle changes, diet and exercise.

And have you been through cardiac rehab? Even if you have been in the past you probably need to go again after this last event.

That can help somewhat with the stress. But you might also need to see a councilor.

And see if there is a cardiac support group in your area.

And you need to ask your doctor about this. Get specific answers on what measurements are and how they have changed.
James Beckerman, MD, FACC responded:
You might consider talking to your doctor about cardiac rehabilitation - studies show that it not only helps people live longer with heart disease, but improves quality of life. There are even thoughts that it can help with depression, which is unfortunately all too common in association with heart disease.
cardiostarusa1 responded:

..."and now the depression has started."

Depression (which may/can also be a side effect from drugs) is common, happens in many individuals with cardiac-related conditons, and depression often can be effectively treated and defeated (sometimes with the help of professional counseling).

Cleveland Clinic

Depression & Heart Disease

..."in which my left main was 100% blocked..."

That's an absolute worst case scenario, as an actual (true) total (100%) occlusion in the left main (LM) coronary artery (feeds massive left ventricular area), is extremely rare and almost always invariably fatal.

The LM arises from the aorta (the largest artery in the human body), typically 1 to 25 mm in length, with the diameter of a straw, and then splits (bifurcates) into the left anterior descending (LAD) and the left circumflex (LCX).

"So what's next? Is this pretty much the end?"

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, as well as good doctor-patient/patient-doctor communication and understanding at ALL times.

Best of luck down the road of life.

Take care,


WebMD member (since 8/99)



Be-well informed


Living with Heart Disease

Coronary Artery Disease (CAD)

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

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

Recognize the symptoms......

Reduce your risk factors......

Take your medications.....

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

Coronary artery anatomy

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


Heart-Healthy Foods

Avoid foods high in saturated fat and cholesterol. Choose skim or low-fat milk, low-fat yogurt and reduced-fat cheeses. Eat more fish and poultry. Limit servings to five to seven ounces a day. Trim visible fat. Limit egg yolks. Substitute two egg whites for one whole egg or use an egg-substitute. Eat more fruits and vegetables, whole grains, breads and cereals. Use less salt and fat. Season with herbs and spices rather than with sauces, gravies and butter.

- -

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).


As applicable to the patient

Cardiac Rehab




"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


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robjben replied to cardiostarusa1's response:
Accordign to the paperwork and all I have, my first heart attack, my LAD was 100% blocked. In this event, my RAD was 100% blocked.
I start Phase II rehab next week after my follow-up with my cardiologist..
robjben replied to robjben's response:
sorry RCA.
cardiostarusa1 replied to robjben's response:
..."my first heart attack, my LAD was 100% blocked."

Thanks for the clarification.

That could have been just as bad though as a total left main blockage. As applicable to the patient, and as indicated by X-ray angiography, a 100% blockage of the proximal (closest to the point of origin) portion of the left anterior descending (LAD) coronary artery is known as or nicknamed the "Widowmaker" due to its prognostic implications (it is often lethal)..

More about the LAD

The LAD runs on the front of the heart in a groove that demarcates the left and right ventricles (lower pumping chambers) and provides blood supply, oxygen and nutrients to a large part of the interventricular septum, and the front wall (anterior) of the left ventricle.

Obstruction of this artery causes damage to a large area of heart muscle (myocardium) in the left ventricle, and can also lead to acute/sudden heart failure (dramatically reduced left ventricular ejection fraction, LVEF) or shortly afterwards.

"I start Phase II rehab next week"


Take good care,


robjben replied to cardiostarusa1's response:
oh and I forgot to tell you that my ejection fraction was about 20% before this last event.
cardiostarusa1 replied to robjben's response:
An LVEF of about 20% is considered as severe heart failure.

Some individuals who have a low (moderate) or a really low (severe) LVEF feel fine and function well, while others do not.

As applicable, in some cases, along with a doctor recommended/authorized exercise regimen (unless contraindicated), LVEF can be increased, sometimes substantially, by customizing/tweaking prescription drug-therapy (such as, Coreg, which showed, back in its clinical trial days, that it could boost LVEF in some individuals) and supplemental (complimentary or integrative medicine) therapy, as deemed applicable.

Just one example of complimentary medicine is the use of the supplement Coenzyme Q10 (CoQ10 or ubiquinone, a vitamin-like substance) for heart failure (though currently not scientifically proven, some doctors may advise the patient to give it a try) which may/can (i.e., along with doctor directed prescription drug-therapy, and with the doctor knowing about any supplements being taken) help to improve LVEF in some, with other supplements sometimes added to the mix as well.

Cleveland Clinic

Understanding Your Ejection Fraction
......"my cardiologist suggested that I get a ICD implanted, which I did."

It is often said that an implantable cardiodefibrillator (ICD) is like having a rescue squad inside your chest.

As demonstrated in clinical studies, and as deemed applicable (meets the current criteria/guidelines) to the patient, in some cases, especially in those with a low (moderate) or very low (severe) LVEF, an ICD can improve the outcome (especially if/when the heart's electrical system goes haywire).




Be well-informed

WebMD/Cleveland Clinic

Living with Heart Failure

American Heart Association - Live and Learn

Forum: Heart Failure

Heart Failure Society of America (HFSA)

Heart Failure Stages

(Class I-IV)

Heart Failure Center

Stages of Heart Failure

Classifications of Heart Failure

Patient resources

Implantable com

Website provides a focus for information related to the field of implantable pacing and defibrillation.

Pacemaker Club

Our purpose is to help cardiac pacemaker and implantable cardioverter defibrillator (ICD) recipients meet, share information and support each other.

LifeBeat Online

An e-newsletter created to help people with cardiac devices and heart or blood vessel conditions live full, active lives.
LLDAILEY responded:
dear rob i had a quadruple bypass on march2012 , thought all was well in july had a heart attack got 3 stents still not well at all back to doctor 4 more stents with each doctor saying dont worry this will be you last we promise before i had the bypass i was sleepy alot but chest pains were not bad. and i could walk a good mile or two. now i cant lay on my right side because of dizziness, i cant walk the lenght of my house, taking nitro almost dailey if im active at feeling at all in either breast, cant stay awake longer than three or four hours at a time. and like you every little twinge scares the hell out of me. but i will pray for you as thats about all ican do these days, live on day at a time, thats all you can do .
An_247575 replied to billh99's response:
For those who have had a heart attack and survived, you must know what to do after heart attack, in order to get in shape, get healthy, and get your life back to normal. Of course you have to make lifestyle changes from your diet, to the amount you exercise, but you also have to make a mental change. You must be willing to get past it, learn what has to be done to recover, and learn the best way to cope with getting your life back in order After heart Attack.
How soon you can return to regular activities

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