Blurred vision, a medical examination revealed a blockage or narrowing of the heart's blood vessels.

A man who went for an eye exam was diagnosed with myocardial ischemia due to severe coronary artery stenosis and needed immediate stent placement to prevent sudden death.

In mid-May, Mr. Vu (73 years old, from Lam Dong province ) noticed his vision was blurry. A doctor diagnosed him with cataracts and said surgery was necessary. However, pre-operative tests revealed severe myocardial ischemia. Mr. Vu had been smoking two packs of cigarettes a day for the past 20 years.

On June 15th, Dr. Tran The Vinh, a specialist in Cardiac Intervention at Tam Anh General Hospital in Ho Chi Minh City, stated that Mr. Vu suffered from myocardial ischemia but did not exhibit typical symptoms such as angina or shortness of breath. The patient had moderate heart failure (41%) and asymptomatic left ventricular dysfunction. Furthermore, coronary angiography revealed stenosis in all three main blood vessels supplying the heart. This was the cause of Mr. Vu's silent myocardial ischemia leading to heart failure. Without early detection, the patient was at risk of sudden death.

The images show two coronary artery branches narrowed by up to 90% (Figure A) and after recanalization (Figure B). Photo: Tam Anh Hospital .

According to MSc. Dr. Vo Anh Minh, Head of the Coronary Intervention Unit - Center for Vascular Intervention, Mr. Vu has a history of stage 3 chronic kidney disease. If revascularization of all three severely narrowed coronary arteries were performed in the conventional way with a large amount of contrast agent injected into the body, it would worsen the kidney disease. Therefore, the doctors performed angiography and intervention using the Cardiac Swing technique to minimize the amount of contrast agent injected into the body.

During the angioplasty and stent placement procedure for Mr. Vu, the blocked blood vessel branches made access almost impossible, requiring the doctors to use a guidewire with an ultra-fine diameter of only 0.2 mm (normal guidewires are 0.4 mm). Furthermore, the narrowed blood vessel was split in two, making it very difficult to maneuver the guidewire through. A small balloon had to be used to create a "pathway" into the main blood vessel. This allowed the guidewire to pass through easily, and the stent placement process was smooth. Importantly, the team applied the Kissing Balloon technique, saving the main branch without affecting the side branches.

Dr. Minh emphasized that because the patient was elderly and frail, the team needed to shorten the procedure time while still ensuring the goal of opening all three branches in a single intervention. After two hours, the doctors successfully placed three large-diameter stents (4 mm, 4 mm, and 4.5 mm), restoring blood flow to the heart. The patient was discharged after three days instead of the usual seven to ten days. Myocardial ischemia improved, and heart and lung function stabilized.

Doctors perform angioplasty and stent placement to restore blood flow to blocked coronary arteries in patients. Photo: Tam Anh Hospital.

Dr. Vinh explained that silent myocardial ischemia is a serious condition caused by partial or complete blockage of the coronary arteries. Patients do not experience typical symptoms such as angina, sweating, shortness of breath, or nausea.

To prevent coronary artery stenosis leading to myocardial ischemia, everyone needs to adhere to a healthy lifestyle: quitting smoking, controlling and treating conditions that may increase the risk of ischemic heart disease such as diabetes, hypertension, and high blood cholesterol; and having a heart-healthy diet. People with cardiovascular disease or risk factors who suddenly experience excessive fatigue, jaw stiffness, indigestion, or difficulty performing daily tasks should seek medical attention promptly.

Thu Ha

The patient's name has been changed.

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