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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience:  Emergency Medicine Physician
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Had a MI in August 2012. Heart cath indicated coronary artery

Customer Question

Had a MI in August 2012. Heart cath indicated coronary artery ectasia and no blockages. The treatment regime has been Crestor, metropol, aspirin and Plavix. Since the 12 month course for. Plavix is about to expire I will been stop the Plavix at the advice of the doctor. Is this the right ourself treatment or should the plavix be continued long term? BP and cholesterol seems to be great.
Submitted: 1 year ago.
Category: Medical
Expert:  911DOC replied 1 year ago.

911DOC :

Are you being cared for by a cardiologist?

911DOC :

simply type in the box below and click 'reply'

911DOC :

standing by

Customer: Not since the heart cath. Saw internist on three occasions
911DOC :

I see

911DOC :

do they say your heart attack was due to the coronary ectasia, from arterial spasm? Do you have full heart function at present after the MI?

Customer: Mild damage. Not affecting quality of life
911DOC :

good

911DOC :

so this is a good question because there is an answer, but research is ongoing and when it gets to 'best' practice in your situation different doctors might choose different therapies

911DOC :

that being said

Customer: May have been a blood clot
911DOC :

and you are properly being stopped from the plavix

911DOC :

I see

911DOC :

the reason is that the added benefit of plavix with aspirin

911DOC :

is small

911DOC :

and the added risk of bleeding is high

911DOC :

so it IS a balancing act

911DOC :

Aspirin is the workhorse here

911DOC :

and your physician is following the most recent guidelines in discontinuing your plavix after twelve months.

911DOC :

standing by

Customer: Should the Plavix be phased out? Every second day and then every third.
911DOC :

no

911DOC :

it should simply be stopped

Customer: Should aspirin be taken just once a day or in Am and Pm?
911DOC :

once a day

Customer: What is the usual cause of ectasia? Is it a progressive disease?
911DOC :

it's congenital... meaning... you have likely had it since birth

911DOC :

it simply means a narrowing and twisting of the coronary artery

Customer: What might have caused the blot clot and MI now given its might have originated at birth?
Customer: I guess I am asking what can I do going forward to avoid another event
911DOC :

there is no way for me to answer that without seeing your records. arterial spasm can cause some infarcts. the usual cause is a plaque of cholesterol that ruptures and then clots, but it doesn't sound like that was the case in your situation.

911DOC :

as far as what you can do to prevent another event that's pretty simple. take your aspirin, keep your cholesterol low, don't smoke, and keep in good shape. if you have high blood pressure make sure it is treated, if you have diabetes keep it under tight control. that's about it.

Customer: Cholesterol around 1, Bp 110/75, very active, eats heathy no extra weight, pulse less than 60. Thank you for your thoughts.
911DOC :

you are most welcome.

911DOC :

it sounds like you are being well cared for by a good physiican

911DOC :

these are all good questions for him/her as well

911DOC :

do you have any final questions for me?

Customer: I think so
911DOC :

anything else for me today?

911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience: Emergency Medicine Physician
911DOC and 4 other Medical Specialists are ready to help you

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