Surviving heart attacks: The Magic of Cardiac Collateralization
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- čas přidán 27. 07. 2024
- It is logical to say that the single most important factor in terms of prognosis from a heart attack is the size of the affected territory. The larger the territory that dies, the weaker the heart gets. The consequences of death of a large territory include death as a consequence of the heart attack or If the patient is lucky enough to survive the heart attack, a severely weakened heart and a lugubrious overall prognosis.
If areas within the heart were to receive blood from multiple arteries and therefore not dependant on a single blood artery then even if one vessel blocked off, the amount of damage would be minimised because cells within that territory would continue to receive blood from the other artery. Reassuringly, we now know that the coronary arteries are not isolated end vessels. They give off multiple smaller branches which in turn give off very tiny branches which connect to very tiny branches of the other coronary arteries so it is possible for the blood to get to areas of the heart supplied by an occluded vessel through the branches of another non occluded vessel. This is known as the coronary collateral circulation.
The same situation happened with me. I had a 100% blocked LAD. And it was found by accident. I went to my doctor to get medicine for my allergies and he did an EKG because I had not had one in a long time. My EKG was abnormal. He was concerned so sent me to a cardiologist. The cardiologist put me through a battery of different exams and tests to include a cardiac Cath and a stress test. That’s when they found the blockage, but because my body created collateral arteries around the blockage to feed the area of the heart that needed it I had no symptoms, and no damage to my heart muscle. I definitely got lucky. I’m now on the proper medication, controlling my cholesterol I had a stent placed two years later my cholesterol is looking great and I am healthy. My doctor told me one of the things that saved my life was my level of fitness, I run 4 to 5 days a week and I work out with weights five days a week he said my body created a need for more blood flow to my heart and a creative these other accessory arteries
How old are you..and how long have you been exercising.
any guess on the cause of your blockage?
Hi I am Dr Sudhakar
If your LAD was blocked 100% & had no symptoms why & when stent was put?
Stent put before or after diagnosing LAD block?
Is there any position to increase my heart rate while sleeping 🙏🏻🙏🏻🙏🏻34 ppm
I had 100% blockage of LAD as well. After a hard workout I started getting a burning in my chest anytime I would walk on treadmill or climb stairs etc. Stress test and CT scan found blockage. Couldn't stent it was too blocked apparently tried twice. Had single bypass 11 years ago at age 34. Doc said no heart attack due to collaterization. Never knew the name of it until about two weeks ago. Saved my life though.
You end the video with a thank you to us all ! It’s actually us who must thank you for your selfless giving in this way which helps and blesses everyone🙏🥰
Genius how you explain the complexity of the Heart in ways we can relate with an analogy. Gives understanding. And allays Fears. Thank you 😊 for your humble kindness.
If only all cardiologists took the time to explain to patients what is happening it would not only educate patients but also relieve stress and provide HOPE
Understood better/more than my college 3hr lecture! You are an excellent teacher Dr Gupta, thank you for your service🙏🏻
And second! Man, I was on time. I love this channel.
Similar to others' stories, I began hiking on a regular basis 10 years ago and have never had any angina. In 2020 I had an ultrasound which showed an aortic aneurysm so I was referred for a catscan, which showed that I have 3-vessel coronary artery disease with an Agatston.score of 352 in the proximal LAD alone and an overall calcium score of 754. Given my ability to pass a stress echo test and go on difficult hikes with no chest pain or shortness of breath, my cardiologist and two interventional cardiologists agreed that I didn't need CABG or PCI and didn't even need an angiogram. Keep moving!
Wow that’s amazing!
Thanks, Chanel V. If my aortic root aneurysm keeps growing I will need open heart surgery someday; if so, I will have to get a pre-operative angiogram and the surgeon might perform "prophylactic revadcularization" of the coronary arteries to reduce the risk of a stroke or heart attack during the aneurysm repair. I understand that the best chance to avoid aneurysm repair is to keep your blood pressure in a healthy range - another reason to keep exercising.
Thank you, Dr. Gupta, for 'drawing us a picture'! It helps me to understand so much more easily when I can picture it in my mind.
You are my favourite UK Doc and and helped me understand my sister low pulse ✌️
Amazing presentation!
We are the ones who are immensely grateful and beyond blessed to have you.
Thank you!!!
Thank you for all of your great work!
This was my situation, went in with a STEMI in the LAD but they also found a CTO in the Lcx that was mitigated by collateral vessels. Very informative channel, thanks for doing it and all your other good work.
Yes, me too. Has CTO of the RCA and ended up that was more like 99% blocked and I had some collateral help too.
Thank you for the hopeful message.
Explained so wonderfully. Thank you!
I appreciate your kind, human demeanour and outlook on life, as well as the amazing video content, thank you !
Your sir an awful lot to reassure anxious cardiophobia patients like me.
Thank You for this great VIDIO!
Thank you Dr Gupta amazing video. You are truly looking out for us.
Dear Doc your post are very informative and I am thankful to you from the core of my heart. You are doing a great service to the humanity 🙏
You say so much in such a small space; Much Appreciated
Really appreciate your clear, concise explanations.
Very informative, many thanks.
This is a really important video, pure genius.
Thank you for this great message. I had a heart attack two years ago when I was 69. My LAD was completely blocked. I was lucky to be flown in a helicopter to the nearest hospital. Three stents were introduced. After three days in hospital my LV election fraction was 45%. I started a heart rehabilitation program, educating me to do the appropriate exercise. I do now 50 minutes of cardio training every day (HR at 110-115). After a year my LV ejection fraction was back up to 55-60.
I know that I’ve been extremely lucky. It was mysterious how I could have so little damage to my heart after such a significant blockage. I understand now that I had perhaps some secondary circulation in place, and it was further developed by the regular exercise I’ve been doing since the heart attack.
Your explanations are always the best I find on CZcams.
Hi buddy ..I'm very new to the heart problems we all suffer...recently had my ef 35 and had a Sicd and pacemaker fitted incase needed..I am intrested in what cardio you do as I want a better EF aswell..male 49 years old..kind regards nel
@@nelm8257 sorry to read your problem. I followed precisely the recommendation of the cardio rehabilitation program I followed after my heart attack. I started this rehab program three weeks after the attack, for a six weeks program. They gave me precise guidelines which I followed rigorously. I do now almost every day 50 minutes on my home bike, of which the first ten are for warming up. After these ten minutes à keep my heart rate at approximately 110-115 bpm, with occasional spikes to 130. These parameters were calculated on the basis of my age and resting heart rate. However I was lucky that miraculously the damage to my heart was limited. Every case is different and you should do your training program according to your cardiologist recommendation. I wish you courage in your recovery. It is well worth it.
@@albertlevert2988 hi buddy very very greatfull for your reply in depth and I understand you....well as I said I have had a SICD FITTED AND PACEMAKER incase later needed..I will contact my cardiologist regards can I train a little to try improve my ef...after my sca..4 shocks later my ef 35 with serious scarring and mis shaped....put on meds for 3 months then a follow up echo gram and no change ef 35 the same as was...but if I can try improve my heart ef now I will be happy to try...no rehab as yet hope to start next month ...I'm in UK....and hope I can improve my ef...are you in the US.?..as I wish I could start rehab sooner the better ....male 49 years out of hospital cardiac arrest survivor....forever greatfull.....love to all fellow patients..
@@nelm8257 I am in Switzerland, not in the US. We have great medical care here. Sorry to read that you suffered so much at such a young age. Be patient and consistent in all dimensions (rest, exercise, food, stress management, and it will help a lot).
@@nelm8257 Apart from exercise I would suggest carnivore way of eating. Kerry at CZcams channel “HomesteadHow” had a poor EF and arrhythmia since birth and he healed since birth his heart as well as other illnesses.
Thank you, very well explained. Greetings fromMelbourne❤
As always great information from a wonderful Dr.
I really appreciate this information. Thank you, Doctor.
Thank you again for reminding me that exercise is so very important! Thanks again.
Thank you for such a clear explanation🙏
Thank you. Very, very interesting.
You are AMAZING! Thank you so much for your extension knowledge & care ❤
Got an appointment with you next month can’t wait to get some Answers thank you for the free information you provide in these videos dr a true one of a kind 👍
Thanks, for the info Doc!
Oh the Cat arrived!! And it’s Gorgeous! 👍🏽😻😻😻
Good morning Dr. Gupta! How are you today? This information is so great! I may be seeing a cardiologist in the future. Appreciate you and what a pleasant an kind face to see first thing in the morning ! Have a wonderful day!
Thank you for this valuable information.
Excellent presentation! So much potential for patient education and primary and secondary prevention and tertiary prevention treatment rehabilitation post stent or CABG! 👍
Very kind of you dear dr .
Dear Dr Gupta, I would love for you to do a podcast with Dr Aseem Malhotra, or at the very least make a video addressing your opinons on his concerns and statements. I am living in constant fear of having a heart attack after having a medical procedure a couple of years ago that was previously not being used. I don't know if im imagining this but it seems to be more common place that were seeing more SADs than in previous years. What is the best test to check there are no blockages and that the heart is in good health. Many thanks
You have a way of teaching that is informative and your gentle kindness is always present too. Thank you Dr. Gupta.
Love listening to you Doc 🤗 when I can 💜
You are one of the best Dr
Yet again many thanks for another great video Im rather hoping that my Collateralization is helping me 10yrs on from stenting !!!Also the video on K2 we have located some live Kimchi and embarking on a de calcification program Many thanks for you work
You are a genius, your explanation of heart is excellent. Thanks a lot for your advice on exercise as a potential solution in increasing the blood flow and recovery process.
I stopped smoking after 35 years immediately after a stemi heart attack ,thank you doctor for all your very valuable information
Great information
Thankyou Dr Gupta for your knowledge.
Excellent knowledge
Oh! Love your sweatshirt!
Thank you
Canadian here: Your hoodie is a hoot !!!!!!!!!!!!! I am sure smiling and laughter is very good for the heart.... lol
Doctor you are the best CZcamsr 😊
Could you please do a video of a leaking heart valve ? I lost a friend a few years ago completely misdiagnosed ! Symptoms persistent dry cough ! I have a constant dry cough not breathless on exercise but fatigue for sure recently ! Many thanks 💗💗
Thank you for going into detail with this. I have a loved one that had 70 to 90% blockages in his right coronary artery and his left was occluded. He was diagnosed after shortness of breath. He didn’t have a heart attack thanks to a well developed collateralization. He had CABG times 2 and a new aortic valve and has been wonderful in the years since. Thank you for deepening my knowledge of this.
My dear friend also went through the same with a CABG and aortic valve replacement. He’s doing well now and still coaching HS football.
This indeed appears to be the explanation why in spite of 80-90% blockage in LAD proximal segment my heart functioned normally and there was no myocardium infarction!!! As explained here my exercise regimen was fairly steady for nearly 7 years and I was often pushing my bpm to nearly 130 bpm without causing stress or distress!! And my age is 82 now!! Thank you doctor for this revelatory explanation.
This is very reassuring and proof of God’s wondrous design of the human body. May God bless & keep you Dr. Gupta 🙏🏻
I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. ~ Psalm 139:14
Lets focus on science ,not magic.
@@genasgenas lol who do you think gave mankind “science”??! that you believe God, creator of all things including your rebellious in denial & ignorant ass proves he did indeed give men free will lol. Free will to be stupid enough to believe something can come from nothing. You are proof that something (wisdom) cannot come from nothing (idiots) 😂😂😂 I forgive you but I’m not the one you need to worry about gaining forgiveness from 🙏🏻
I grew up with that scripture but don't believe it any more. Personally I reckon there is so much that can go wrong that I no longer believe in something a man wrote thousands of years ago about a body he had no clue about before the days of medicine.
@@riteasrain then you don’t understand what sin brought into the world which is decay and disease thus explains why your body breaks down. That does not negate that God instructed and divinely inspired select men to pen his word. That you don’t believe the Bible is Gods word proves your heart is darkened and you are blinded by the ruler of this world - Satan. Prayers for you.
Allah is great
Thanks ❤
Dear Dr Sanjay .. ur right on point in explaining the arterial collaterals which my body had developed around the 100% blockage in LAD . As i was previously diagnosed with CAD 3 years ago in ER and i refuse to get any stent or by-pass back then i was 168 lbs . Since that time i had lifestyle change ( plant base 70% of my food intake , low salt, minimal to low or no sugar , olive or avocado oil only ) , regular weight training and cardio exercise , medication management ( aspirin 325 mg for 6 months and statins 10-20 mg for 6 months then i wean down to 81-100 mg Aspirin + pantoprazole and 5-10 mg statin ) and taking amlodipine then switched to diovan angiotensin ) plus other naturopathic ( niacin, omega 3, berberine , vit k2 + vit D3 , turmeric, magnesium , iv therapy ( glutathione, vit c , b12 ) daily juicing ( celery , cucumber, flaxseed, mix vege, avocado, banana n other fruits etc ) plus Intermittent fasting
Thank you! I’ve also been following Dr. Esselstyn’s studies and book on reversing heart disease. He is almost 90, a Yale graduate and spent decades with studies on the network you speak of. The assiduous dietary change in diet to a no oil, no sugar, not added salt Whole Foods plant based diet over time has reversed many cases. Thanks again.
The pioneering researcher is Dr Dean Ornish whose books are encyclopedic on reversing heart disease.
Exercise makes a huge difference! I just went through a CABG triple bipass. My surgeon said I had very well developed side arteries which prevented me from having a major heart attack. I was jump roping daily and doing 50 meter sprints 3 sets 3 times a week before my chest tightness caused me to look into the problem. I hope to get back to challenging cardio once I'm healed from the surgery. I will always wonder what if I never elected to have the surgery. I made the best choice with the information I had and I hope it pays off.
That was the best video on heart disease I've found. How long does it take collaterals to form if we are doing 1 hr of aerobics most days? Your kindness and gentleness knocked me out!!And I find it very healing besides!!!
You are amazing and pure heart im also going throw etopic heart beat when im worried i just see your video abt etopic heartbeat then i relaxed
Dr Gupta, I would appreciate your explanation of the Third Brain.
I think this applies to me I’m on drugs to slow the heart down reduce blood pressure and exercise daily. Thank you Dr Gupta for this explanatory video.
RCA CTO (40mm) here. Coronary collaterals saved me. My only symptom was chest pressure that only occurred four or five times in one year. Each time the chest pressure just went away and I continued on with whatever I was doing. Blood work x-rays all came back good but the stress test was abnormal. Cardiac catheter identified the problem. I exercise 3 to 5 days a week with the encouragement of my cardiologist. I was diagnosed with bradycardia (slow heart rate) at the same time. I checked my Garmin watch heart rate data and my heart rate lowered about six months before.
Fascinating. I have controlled hypertension but a high diastolic and av nicking on my retina although systolic is good my diastolic is stubbornly at 85-90. It's not uncommon after exercise for my pulse pressure to be low as my systolic falls more than diastolic. I think this all points to stiffening of my smaller arteries and arterioles.
This is encouraging if i take regular exercise i can reduce my resting heart rate (increase the length of diastole) and create a bit of oxygen insufficiency in my body to encourage collateral growth.. and even if it doesn't happen its still the right thing to do.
Really well presented thank you
Dr. Gupta, Love your channel, thanks for sharing so many amazing insights. I had a heart attack Acute MI 3 months ago, Was released from hospital the next day, thought I had a second one very mild if at all a month later, but the hospital could not find evidence I had one, and said I was good To Go, possibly anxiety and stress? I had covid when the heart attack hit and have also been under tremendous stress since my sister passed away in November 2022. I Lost my mother in 2020 as well. Checked out good on Echocardiogram and several other tests, only the stress test was negative. Now my cardiologist wants me to do an angiogram with possible/probable stenting. I have no Angina at all and can exercise pretty well, only on an aspirin a day and a statin. With no symptoms since would I be considered stable? And do you think I really need the angiogram and stenting, since I feel, no symptoms and have been doing very well in the medications and have no symptoms? Would greatly appreciate any feedback. Thanks, Rob... Cardiologist never showed me any test results either, is that common?
Thank you doctor im going in for a triple by pass ive always exercised but got angina .its got better on medication i was scared to exercise since but will carry on slowly now
Woooow….. looking real good with that beard. 😉
I have inherited HCM and was diagnosed with mild left ventricle hypertrophy last year after my usual 3 yearly scan. I was notified by letter and haven’t heard a peep since about it. I do worry about my health as my dad had multiple heart attacks.
Thank you so much for your detailed explanation about our precious hearts. I watch so many of your videos and am amazed at your dedication and caring. I wonder if someone can answer this, is having what the cardiologist terms a "very large Ramus" which is a "variant" artery a collateral artery? I have such artery and understand that it emanates from the left main in the space between the LCx and LAD. My other question is, having this artery is it protective in the event of an occlusion in the LAD? Thank you!
Thank you for you posts, ive learned so much from them. Youve given me alot of peace concerning my health, and life. I had a heart attack in 2018 i believe the RCA was blocked ( i was a hard cigar smoker, was) they stinted the artery, The doctor said the LAD was also blocked 69%, but did not stint. For the last 5 years ive been worried about the LAD. My Cardiologist gives me no answers. What should i do? Should i push for a heart cath? I have no symptoms, i stopped smoking the day of the event. I do drink. though. and i try to get exercise, but this is often on my mind.
Stop drinking. Or not. It is your choice. The latest medical guidance is no amount of drinking is safe. It is up to you.
It is pointless to be "worried" and complaining that doctors are not giving you answers when there are major factors that are completely under your control.
Dr Sanjay gupta sir very important and some thing new for me it enhances my knowledge about aur body and heart in particulars thanks 06/05/2023
Give a briefing on Calcium Score and the severity of the CAD and modes of any possible reversal
I'm so glad you mentioned that cardiac patients "are terrified of exercise." That hit home with me. I try to ask myself, "what's the worst that could happen?" And, to go forward in faith that I'm in the right place at the right time doing the right thing - divine order of things. You sparked a bit of hope for/to me. Bless you...
It is understandable that heart patients are fearful of exercise. I think the key point is that exercise does not increase the risk of plaque rupturing and causing a heart attack. That plaque can rupture while you are sitting on the couch doing nothing. And indeed, that is the most common scenario. Exercise, in moderation, does not put you at greater risk.
Hmm never thought of it like that before.
What games do you play? I can see the controller! Interesting video by the way.
I was getting a much needed hernia repair. Bad ecg sent me to cardiologist. More tests and was denied the surgery. Recommended double bypass surgery. I feel great except for large painful hernia. I'm 76 workout(just weights now, because cardio has become too painful with hernia and work full-time standing at my shop. Even with bypass he said he might not approve hernia repair. I am totally asymptomatic and enjoy a good quality of life. I feel even with the invasive bypass procedure, I will be in more danger of stroke etc. because I'm unable to walk any distance painfree(because of the hernia). I wish I had more say so over my health at this point in my life. I'm more concerned about quality of life than tacking on a couple of years. Thanks for at least looking at the big picture.
Many years ago I was told I had angina. A swelling became of a bad couch I had. I will probably get it checked.
Thank you so much for sharing. Have you heard about the Medical Medium? I’m very curious to hear your take on his info
I read an article on the New Atlas website the other day which seems promising! I don't think CZcams allows links in comments, so I can tell you the article title is: Technique reverses heart attack damage by reprogramming scar cells. The study is being overseen by Conrad Hodgkinson, an associate professor of medicine and pathology at Duke University in Australia. I thought it might be of interest to you :)
Do you ever use HBOT?
Would you please do a video on the ‘Franks’ sign the diagonal line on the ear lobe) as a marker for heart disease?
Dr. Gupta, could you please provide your recommendations on what tests can be performed to check for coronary artery disease?
What exercises are best for better collateral flow
Thank God, I've never had a heart attack (I'm 67, never smoked, nondrinker) but I do have a question: the heart, as you stated, is a muscle. But when you bruise a muscle (which a heart attack has been described as) it eventually heals and becomes good as new. But why doesn't the heart heal? Is it a different type of muscle that prevents it from healing like any other muscle in the body? Thanks ❤
Hi Doctor. Is there any way to get referred to yourself on the NHS for a tilt table test to diagnose pots? It seems to not be a very understood illness. I could email you more information on what caused my problems and what test results I have thus far, cardiac MRI etc.
Thank you doctor.
Thanks Doctor. Can you please tell, how long it takes collateral to develop, for a 60 year old, 3 VD & calcification (so cannot put stent), male (avoided CABG) , who has made lifestyle changes & does exercise , including walking twice a day & takes necessary Cardiologist advised medicines.
Anyone had a bubbling feeling in their heart? :(
Hi Sanjay. hope you are well, we spoke 2 years ago about a heart topic and i respect your work, i,ve been on propranolol for 3 years for anxiety which keeps my heart rate down, is this damaging my heart, i still excersice a bit and walk regular and don,t get out of breath easy so does this mean my heart is still benefitting whilst on this medication, dosage is 80 mgs, would love your view
Would BFR (blood flow restriction ) bands during workout create the same collateralization as EECP?
Thankssss
Sir
Which test to see collaterals???
If it wasn’t for collateral I would not be around today. I had 2 blockages in my RCA. One was a 100% CTO at the top of the RCA and the other was 95% blockage lower down. These were not seen on any of the stress test I had. But were found after a Cath was done. 3 stents later I’m doing better.
Im 70% through this video and with all the talk about improved auxilary flow options we havent gotten to te part where im to learn how to do this. At this pointbid ratherbdie than listen to more.
Can you share your experience with coronary artery artasia? I just got diagnosed with this. My EKG was abnormal but an echo and angiogram showed me in the clear except for increased artery size
Dr. Gupta, would you please explain arrhythmias such as inverted T-waves and ST depressions? Are they evidence of past heart attacks or an indication of one to come? Thank you.
Do you have a video on What's the best diet for Afib?
Thanks Dr Sanjay . What’s your opinion on tiny arteries being blocked and that’s causing chest pain and breathlessness? What’s the solution for that?
A friend of mine , two years ago was told that two of his main arteries were 30% blocked ( Each one was 30% blocked) . He was told nothing could be done until they were 80% blocked. He was given yet another anti - cholesterol tablet. He then got a second opinion at another hospital. There he was told to give him a better quality of life they’d put in 2 stents! He now feels much better and no longer suffers from angina and feels very well .
What’s your opinion on that Dr Sanjay?
"What’s your opinion on tiny arteries being blocked and that’s causing chest pain and breathlessness? "
That would be a good topic for the Doctor to discuss. I suspect that scenario scenario would be highly unlikely if not impossible. Symptoms of chest pain almost certainly means the root cause of chest pain is blockage in the main arteries (your friend had 30% blockage) rather than an issue of tiny artery blockage.
You said the first hospital said there was nothing that could be done until there was 80% blockage. What was their proposed treatment plan for 80% blockage? Stents? Bypass?
I’m surprised they gave your friend 2 stents with only 30% blockages. I’m also surprised insurance paid for it. Good for your friend though if they are doing better.
I am 65, and had whats called CTO ( Chronic Total Obstruction) in the right coronary artery and also narrowing of LAD artery, I underwent stents, all that before 5 years. After the stent by 6 to 7 months I started strenghts exercises with dumbbells and barbell, but mostly dumbbells and some days in between I do walking and also do HIIT exercises. I like to watch your videos. I am diabetic and take Metformin and heart medicines( almlodipine and bisoprolol). For how long should I exercise?❤❤
Third, wait I'm fourth. Thanks Doc.
sir can CILNIDIPINE be used for variant angina???? Please shed some light sir. Am in india and diltiazem and verapamil aint suiting me! God bless you.