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Cancer Treatment Induced Heart Disease

Cancer: Managing Symptoms | Last Active: Sep 1, 2022 | Replies (54)

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@inali

Hi Marti,
I'm happy to answer your questions:

1. Stents were inserted April 2017. I was still in the process of seeking a diagnosis for my shortness of breath. All pulmonary and cardio tests found nothing. I went to a new cardiologist two hours drive from my home. This is the highest rated hospital in the state. She suggested another stress test. I said 'and what if that shows nothing of significance?' - which had been the case with previous tests - she said, then we'd do a cardiac cath next. I said then let's just do the cath. During that procedure, blockages of the RCA were found, and stents inserted. Problem solved -- or so I thought...

2. No pain.

3. No heart attack (so far - knock on wood!)

4. Due to my experience, and what I now know, I would advise a candid conversation with doc/surgeon regarding the much higher likelihood of restenosis after stenting in those with RIHD. Considerations include the potential effectiveness of medication treatments, vs the risk to heart of a 100% occluded artery. Apparently, much depends on which artery is blocked. Also good to discuss any future surgical interventions that may be necessary, including CABG, and to what extent the stenting might further complicate those. My artery was apparently a challenge in that the blockage was at a 'hockey stick' point, or practically 90 degree turn, making stenting difficult. I was not as aware as I should have been that the cath was more than just a diagnostic tool; I should have realized more acutely that profound and unchangeable actions could be taken while I was having the procedure done. It is fortunate that you ARE aware and are asking all the right questions so that you can be well informed and manage your expectations accordingly.

5. There certainly ARE medications designed to fight the build-up of plaque (statins) and prevention of clots (blood thinners). Prior to my cath, I was taking no medication of any kind. Following what was learned about my condition during the cath, my cardiologist prescribed five: clopidogrel, atorvastatin, metoprolol, furosemide, and potassium. This procedure and an echo also revealed the valve issues and I received - for the first time - a diagnosis of congestive heart failure. Just a little icing on the cake of the CAD. If you and your doc agree, I suppose you could try the meds for a time and see if the progression of your condition slows or halts as a result of that and major lifestyle adjustments. Wouldn't that be wonderful? If you are having no symptoms at this time, your doc might consider that option reasonable. As we saw in the Widowmaker, stenting is pretty commonplace now, but it is not a magic bullet for everyone.

Let me know what you decide. These are not easy decisions. It is hard to predict outcomes for RIHD patients when each of our situations is so very unique. One awesome thing you have going for you is the fairly early discovery that you have it so that you have time to make adjustments in those areas of your life over which you have control - including having those candid discussions with your health care providers.

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Replies to "Hi Marti, I'm happy to answer your questions: 1. Stents were inserted April 2017. I was..."

Thank you so very much, Inali, for answering my questions so clearly. I am still learning and was feeling overwhelmed the past couple of days. I didn't even know that "bypass" and CABG (graft) were about the same thing. I am so so sad to hear of the diagnosis of congestive heart failure. I now understand even more why you feel exactly as you do.

I am on atorvastatin (Lipitor) now as well as vitamin K2 and CoQ10. Supposedly, K2 helps the body process calcium so that it goes more into the teeth and bones instead of kidney stones (which I had) and calcium in coronary arteries--as found in the CCS test. Many people are deficient in K2 and I think I am too.

I do know that my downing of the calcium units my Dr. prescribed for my osteopenia was a bad thing also. Articles came out a little after my kidney stone problems began in 2012 that stated that many menopausal women are now getting kidney stones most likely from the calcium carbonate pills they're taking. I take algae calcium now 1-2 times a week only and try to get the rest of calcium from spinach and organic milk along w/ vitamin D3 and magnesium pills on occasion.

I've felt a heaviness in my heart area off and on for a year. Had some shortness of breath 3 years ago but that went away with more regular exercise and some weight loss. Have minor chest ache when turning a certain way suddenly, like to grab something on my left off an end table, for example.

Will just keep monitoring how I'm doing on these pills I'm taking for now until seeing regular Dr. in May.

Your information and suggestions are invaluable to me and I again am so sad about the resistance to recognizing RIHD by so many in the medical field until just very recently. i will be extremely reluctant to get the stents, even the newer medication-laced ones. It sounds like some hospitals might do CABG for those of us with RIHD now when our arteries are very clogged and heart attack seems very likely.
That seems the best route to me at this time after all you wrote.

I would probably choose going to Mayo, like you. I read the articles from the Cleveland Clinic, as you know. But, know, as you said that one of the Drs. resistant to CCS is still on staff there as you said AND it's a long way from our house. We do live about 100 miles from Mayo and it seems like they are fully "on board" w/ CCS, RIHD, and the most up to date procedures, if any, that can help us.

Again, thank you so much for your wisdom and willingness to share it. Please keep in touch and let me know how you are doing. I admire your strength and honesty. Marti