Hairy Situation

Nurses General Nursing

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With a 100% occluded LAD & with his RCA partially occluded, does he have 3-4 weeks to wait? A 50yo is too young too have so much collateral circulation that it bypasses the LAD. I agree with the others, you may want too seek another opinion. I was also thinking about the IABP too. He could stay on the IABP 1-2 days, do an ECHO to see if the heart is stronger with it, PTCA & possibly CABG.

I wish you, your friend & her father all the best with this & pray for a quick recovery. Let us know how it goes! :)

rjflyn, ASN, RN

1,240 Posts

Specializes in Emergency.

I wanted to all something to this thread as well. SHe noted that he has a EF of 15%. The importance of doing something sooner rather than later is the therory of stunned myocardium, that some of the heart muscle is not dead just not functioning as it should due to lack of blood flow. I've acctually seen pts with EF this low recover a significant portion of LV function after having blockages open- abeit this is risky but so is being 50 with a occluded LAD. The other thing to also remember is that a siginificant portion of the population is RCA dominate and that tx the right blockages may improve things as well.

Rj

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