# Partly blocked arteries.



## gavroche (17 Dec 2021)

Two of my brothers have had stems fitted because of partly blocked arteries. One was 73% blocked and the other 90%. We have genetic cholesterol problems in our family and I have been on statins for a good 20 years now but how do I know my arteries are clear? 
I have 6 monthly blood tests and every time my doctors says I am within the limit.
So my question is: can I ask my doctor for a proper test to check my arteries and what does it involve?


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## oldwheels (17 Dec 2021)

Cannot comment on arteries in general but my heart valves are ( tho’ covid has interrupted that) checked by ultrasound. I have also had a suspect narrowing in my neck checked again by ultrasound. The neck was given the all clear but my heart is supposed to be checked annually. The latest covid variant has meant the one due now has been postponed. Arterial stenosis is the problem which could mean a new valve needed if I live long enough.


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## slowmotion (17 Dec 2021)

An angiogram will show how clogged your coronary arteries are. The doctors feed a thin tube into a fairly major blood vessel in your upper thigh and thread it up through your vascular system to your heart. Don't worry, you don't feel a thing but it can be a bit uncomfortable while they make the initial incision. Then they inject a dye into your heart that shows up on X rays. From that, they can see how open or clogged your arteries are. I've had a couple of them and they don't take very long, about twenty minutes. You don't need any anaesthetics and it can be done as an outpatient.


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## Cycleops (17 Dec 2021)

I think @Fab Foodie has had stents fitted, perhaps he can give you some more information.


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## DRM (17 Dec 2021)

slowmotion said:


> An angiogram will show how clogged your coronary arteries are. The doctors feed a thin tube into a fairly major blood vessel in your upper thigh and thread it up through your vascular system to your heart. Don't worry, you don't feel a thing but it can be a bit uncomfortable while they make the initial incision. Then they inject a dye into your heart that shows up on X rays. From that, they can see how open or clogged your arteries are. I've had a couple of them and they don't take very long, about twenty minutes. You don't need any anaesthetics and it can be done as an outpatient.


I had the same, but they went in through my wrist, it’s most peculiar looking at your arteries on a huge tv screen


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## slowmotion (17 Dec 2021)

DRM said:


> I had the same, but they went in through my wrist, it’s most peculiar looking at your arteries on a huge tv screen


I would have much preferred the wrist, not least because of the embarrassment of having a stranger fiddling about in your groin.


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## DRM (17 Dec 2021)

slowmotion said:


> I would have much preferred the wrist, not least because of the embarrassment of having a stranger fiddling about in your groin.


When they finished they fitted a bracelet thing that screwed down tight on the incision iirc it had to stay on 20 minutes, possibly longer, to give it a chance to clot, I can’t imagine what is used in the groin area


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## slowmotion (17 Dec 2021)

DRM said:


> When they finished they fitted a bracelet thing that screwed down tight on the incision iirc it had to stay on 20 minutes, possibly longer, to give it a chance to clot, I can’t imagine what is used in the groin area


When they open up the blood vessel to get the catheter in, there's a fair bit of blood leakage which ended up on the green rubber sheet I was lying on. It looked quite alarming but I didn't see it until the end of the procedure. In order to stem the leak, they use a collagen plug as a sealant and that stays on your thigh for a few days. Fortunately I'm not particular squeamish because I used to watch my veterinary surgeon father operating on animals from early childhood. I think that they do offer patients some sedatives if they ask for them.


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## DaveReading (17 Dec 2021)

DRM said:


> When they finished they fitted a bracelet thing that screwed down tight on the incision iirc it had to stay on 20 minutes, possibly longer, to give it a chance to clot, I can’t imagine what is used in the groin area



I had a DSA (cerebral angiogram) a couple of years ago, with the probe going in through my groin. In my case, it involved 20 minute sustained pressure on the incision by a junior doctor once the probe was pulled out.


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## vickster (17 Dec 2021)

Wouldn’t you have symptoms potentially, like angina?
https://www.nhs.uk/conditions/angina/

blocked arteries, aka atherosclerosis
https://www.nhs.uk/conditions/atherosclerosis/


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## slowmotion (17 Dec 2021)

vickster said:


> Wouldn’t you have symptoms potentially, like angina?
> https://www.nhs.uk/conditions/angina/
> 
> blocked arteries, aka atherosclerosis
> https://www.nhs.uk/conditions/atherosclerosis/


It's quite possible to be symptom-free if you are otherwise pretty fit and taking regular exercise


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## numbnuts (18 Dec 2021)

I have a blocked blood vessel and they can't put a stent in, but it only supplys 2% of blood to that area so they are not too worrried, I was at first, but so far so good


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## Arrowfoot (18 Dec 2021)

Mate of mine lost his wife to cancer when the only son was still in primary school. He started to fret about a heartache although he was fit looking. The fear was leaving his son an orphan. He went to the GP a few times and we thought it was psychological as he himself did not have any symptoms. Finally GP caved in and sent him for angiogram and he had blockages in 3 places and ended up with 3 stents. 

With OP's family history and with stents an all, I would persuade the GP for an angiogram.


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## pawl (18 Dec 2021)

I was sent for an Angiogram some years ago as I passed out when my heart rate went above 100 BPM.
As others have said it is a fairly simple procedure 
The diagnosis showed one of the flaps in the Aortic valve was not fully opening restricting blood flow 
The only problem I had following that procedure was wanting to pee .I had to have a short period laying down to recover Despite only being a couple of steps from the toilet the nurse wouldn’t let me get up and gave me the dreaded urine bottle This is where it got embarrassing I couldn’t stop and filled the bottle to overflowing The nurse did have a bit of a laugh .Must have brightened her day


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## DRM (18 Dec 2021)

DaveReading said:


> I had a DSA (cerebral angiogram) a couple of years ago, with the probe going in through my groin. In my case, it involved 20 minute sustained pressure on the incision by a junior doctor once the probe was pulled out.


That’s what I suspected would happen, by going in via the wrist I suppose it’s a junior doctor that’s available to do something else, the bracelet used on me did look like something from the Spanish Inquisition!


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## Bonefish Blues (18 Dec 2021)

DRM said:


> I had the same, but they went in through my wrist, it’s most peculiar looking at your arteries on a huge tv screen


...and seeing the Doc feeding it in just like our chimney sweep does our flue.


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## DRM (18 Dec 2021)

slowmotion said:


> When they open up the blood vessel to get the catheter in, there's a fair bit of blood leakage which ended up on the green rubber sheet I was lying on. It looked quite alarming but I didn't see it until the end of the procedure. In order to stem the leak, they use a collagen plug as a sealant and that stays on your thigh for a few days. Fortunately I'm not particular squeamish because I used to watch my veterinary surgeon father operating on animals from early childhood. I think that they do offer patients some sedatives if they ask for them.


I think they thought of that as they went in on my right wrist and said look at the big screen on the left, it was bizarre seeing the arteries showing up after a squirt of dye, then they injected something to get your heart rate up, whilst laid there doing nothing, a very strange sensation


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## Bonefish Blues (18 Dec 2021)

DRM said:


> I think they thought of that as they went in on my right wrist and said look at the big screen on the left, it was bizarre seeing the arteries showing up after a squirt of dye, then they injected something to get your heart rate up, whilst laid there doing nothing, a very strange sensation


Yes, it's an out-of-body moment, for sure  

They told me, after testing, that whilst there was a narrowing - which I could see - the flow wasn't obstructed, so nothing to do, but then the Registrar confidently stated that he would see me again in the future, which I though distinctly unhelpful in the circumstances.


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## PaulSB (18 Dec 2021)

I've had a stent fitted with insertion through the right wrist following a heart attack. In this procedure the "wire," for want of a word, is pushed up to the heart to clear the blockage and insert the stent. It's quite an amazing sight to suddenly see blood flood into an artery and veins which were not visible a few moments before.

I don't know how far the "wire" is inserted for an investigative angiogram as being discussed but after a heart attack this operation is initially an investigation.

In my experience it's not something to worry about but is far from pain free. I was able to feel the pressure of the wire being pushed up my arm and more so as it crossed my chest.

There was one point when I felt very real pain which was obviously noticeable to the surgeon. He commented "that's what you would have felt with a severe heart attack."

It's better than the alternative!


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## oldwheels (18 Dec 2021)

I got dye and a tube put up from my groin to check my kidneys which would be similar to the heart procedure. We were given to understand that a sedative would be given beforehand but this was not forthcoming. I mentioned this to a nurse and she said they only did that if you tried to jump off the table.
After the procedure I was given a pad to keep pressure on the insertion point and taken back to the ward where I was told if it started bleeding to shout loudly for help immediately.
This was in 1981 so things may have changed by now.


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## Ming the Merciless (18 Dec 2021)

vickster said:


> Wouldn’t you have symptoms potentially, like angina?
> https://www.nhs.uk/conditions/angina/
> 
> blocked arteries, aka atherosclerosis
> https://www.nhs.uk/conditions/atherosclerosis/



Invited for a health check every 5 years. Ha ha ha ha ha. Even in pre pandemic times that didn’t happen.


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## DaveReading (18 Dec 2021)

DRM said:


> That’s what I suspected would happen, by going in via the wrist I suppose it’s a junior doctor that’s available to do something else, the bracelet used on me did look like something from the Spanish Inquisition!



Coincidentally, during the same spell in hospital at one point they had me wired up to a real-time BP monitor for 24 hours. 

A junior doctor inserted it in my wrist, taking 20 extremely painful minutes to get it in, to the barely suppressed amusement of the nursing staff.


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## dave r (18 Dec 2021)

slowmotion said:


> An angiogram will show how clogged your coronary arteries are. The doctors feed a thin tube into a fairly major blood vessel in your upper thigh and thread it up through your vascular system to your heart. Don't worry, you don't feel a thing but it can be a bit uncomfortable while they make the initial incision. Then they inject a dye into your heart that shows up on X rays. From that, they can see how open or clogged your arteries are. I've had a couple of them and they don't take very long, about twenty minutes. You don't need any anaesthetics and it can be done as an outpatient.



When I had my last stent fitted they went in through the wrist, with the first 4 they went in through the thigh.


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## DRM (18 Dec 2021)

Mine was blocked at a 3 way branch, one of the three being blocked, the surgeon did say that because of where it was it couldn’t have a stent, also it stated on my record that the heart attack occurred whilst on a long bike ride, and the surgeon was asking what bikes do you have and was saying his new titanium bike was being returned for a 3rd time due to a cracked frame again, it helped take my mind off things at least


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## DRM (18 Dec 2021)

DaveReading said:


> Coincidentally, during the same spell in hospital at one point they had me wired up to a real-time BP monitor for 24 hours.
> 
> A junior doctor inserted it in my wrist, taking 20 extremely painful minutes to get it in, to the barely suppressed amusement of the nursing staff.


Ouch, I suppose they have to learn, but blimey surely someone should have stopped him


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## DaveReading (18 Dec 2021)

Or, in this case, her.


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## presta (18 Dec 2021)

slowmotion said:


> An angiogram will show how clogged your coronary arteries are. The doctors feed a thin tube into a fairly major blood vessel in your upper thigh and thread it up through your vascular system to your heart.





slowmotion said:


> I would have much preferred the wrist, not least because of the embarrassment of having a stranger fiddling about in your groin.


I've not had an angiogram, but they put a catheter up the vein in my groin when I had an ablation. That involves burning the inside of you heart with a radio frequency probe, so it was done under sedation. The last thing I recall was the nurse tearing the paper underpants off.


DRM said:


> When they finished they fitted a bracelet thing that screwed down tight on the incision iirc it had to stay on 20 minutes, possibly longer, to give it a chance to clot, I can’t imagine what is used in the groin area





DaveReading said:


> I had a DSA (cerebral angiogram) a couple of years ago, with the probe going in through my groin. In my case, it involved 20 minute sustained pressure on the incision by a junior doctor once the probe was pulled out.


The first thing I recall when I was half conscious coming round from the sedative is the nurse taking my right hand and pressing it onto the dressing on my groin wound, and by the time I went home a few hours later there was no dressing on my groin at all. Some patients describe waking up in the middle of the night at home, and finding a pool of blood in the bed....


pawl said:


> The only problem I had following that procedure was wanting to pee .I had to have a short period laying down to recover Despite only being a couple of steps from the toilet the nurse wouldn’t let me get up and gave me the dreaded urine bottle This is where it got embarrassing I couldn’t stop and filled the bottle to overflowing The nurse did have a bit of a laugh .Must have brightened her day


I needed a pee in A&E after I pranged the car. I needed three hands, one to hold the bottle, one to hold my tackle, and another to hold the dressing on my nose. The nurse chose to hold the dressing. 


DRM said:


> then they injected something to get your heart rate up, whilst laid there doing nothing, a very strange sensation


A high heart rate goes with the territory when you have atrial fibrillation. I've sat in the armchair chatting to paramedics with a HR as high as 260, but there are doctors who won't believe that's possible, and insist I'd have been unconscious if my HR was as high as 200.
You know when the computer crashes, and you switch it off and back on again? They do that to your heart when you have an arrhythmia, a shot of adenosine to stop your heart altogether for several seconds.


DaveReading said:


> A junior doctor inserted it in my wrist, taking 20 extremely painful minutes to get it in, to the barely suppressed amusement of the nursing staff.


I get that every time they put a cannula in, gouging at one vein after another trying to ge it in. They see my bulging blue veins and think it's going to be easy, but it isn't.
"Aah, nice easy veins!"
"That's what they all say"
"Nonsense, they're no problem"
Then after another gouging session: "Ooh, you're not wrong, are you" 

A paramedic once saw my whole forearm black and blue:
"What's all this!?"
"Oh that's where they were putting a cannula in"
"Who did it, Stevie Wonder?"

I'm told it's the valves in the veins that obstruct the cannula.


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## Fab Foodie (19 Dec 2021)

Cycleops said:


> I think @Fab Foodie has had stents fitted, perhaps he can give you some more information.


I think @slowmotion has answered perfectly. If you suspect you have heart-related issues then an Angiogram is the only way AFAIK.


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## Fab Foodie (19 Dec 2021)

slowmotion said:


> It's quite possible to be symptom-free if you are otherwise pretty fit and taking regular exercise


Agreed - my 'symptoms were atypical until I had a massive Angina attack...only then I figured what those strange sensations in my back were.


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## Fab Foodie (19 Dec 2021)

Bonefish Blues said:


> ...and seeing the Doc feeding it in just like our chimney sweep does our flue.


It's exactly like that!!


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