The man went to the eye doctor and was diagnosed with myocardial ischemia due to severe coronary artery stenosis, requiring immediate stent placement to avoid sudden death.
In mid-May, Mr. Vu (73 years old, Lam Dong ) experienced blurred vision. After going to the doctor, he was told that his eyes were cloudy and needed surgery. However, pre-surgery tests showed that the patient had severe myocardial ischemia. Mr. Vu has smoked two packs of cigarettes a day for the past 20 years.
On June 15, Master, Doctor, Specialist I Tran The Vinh, Vascular Intervention Center, Tam Anh General Hospital, Ho Chi Minh City, said that Mr. Vu had myocardial ischemia but did not have typical symptoms such as chest pain or shortness of breath. The patient had moderate heart failure (41%), asymptomatic left ventricular dysfunction. At the same time, coronary angiography detected stenosis in all three main blood vessels that supply the heart. This is the reason why Mr. Vu had silent myocardial ischemia leading to heart failure. If not detected early, the patient is at risk of sudden death.
The image shows two coronary arteries narrowed by up to 90% (image A) and after being re-opened (image B). Photo: Tam Anh Hospital
According to Master, Doctor Vo Anh Minh, Head of the Coronary Intervention Unit - Vascular Intervention Center, Mr. Vu has a history of stage 3 chronic kidney failure. If intervention to reopen all 3 branches of severely narrowed coronary blood vessels in the usual way with a large amount of contrast injected into the body will cause the kidney failure to progress more severely. Therefore, the doctor performed angiography and intervention using the Cardiac Swing technique to minimize the amount of contrast injected into the body.
During the process of angioplasty and stent placement for Mr. Vu, the blood vessels were blocked so the entrance was almost invisible, the doctor had to use a guide wire with a super small diameter of only 0.2 mm (normal guide wire is 0.4 mm). In addition, the narrow blood vessel was also divided in two, making it very difficult to pass the wire through, forcing a small balloon to dilate and "open the way" into the main blood vessel. Thanks to that, the guide wire passed through easily and the stent placement process went smoothly. In particular, the team applied the Kissing Balloon technique to save the main branch, without affecting the side branches.
Dr. Minh emphasized that because the patient was old and weak, the team needed to shorten the procedure time while still ensuring the goal of clearing 3 branches in one intervention. After 2 hours, the doctor successfully placed 3 large diameter stents (4 mm, 4 mm and 4.5 mm) to restore blood flow to the heart. The patient was discharged after 3 days instead of the usual 7-10 days. The condition of myocardial ischemia improved, and heart and lung function were stable.
Doctors perform angioplasty and stent placement to reopen a patient's blocked heart blood vessels. Photo: Tam Anh Hospital
Doctor Vinh informed that silent myocardial ischemia is a serious disease, caused by partial or complete blockage of the coronary arteries. The patient does not have typical symptoms such as chest pain, sweating, shortness of breath, nausea.
To prevent coronary artery stenosis leading to myocardial ischemia, each person needs to adhere to a healthy lifestyle: quit smoking, control and treat diseases that can increase the risk of myocardial ischemia such as diabetes, high blood pressure and high blood cholesterol; have a heart-healthy diet. People with cardiovascular disease or people with risk factors who suddenly feel very tired, have jaw pain or indigestion, have difficulty performing daily tasks... need to go to the hospital for early examination.
Thu Ha
* Patient's name has been changed.
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