Will a heart bypass make me live longer?
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- Опубликовано: 22 янв 2022
- Recently a gentleman from India contacted me and asked me for some advice.
He told me that he was 75 years old and had been experiencing chest discomfort and therefore had to go to his local hospital in India where he was investigated and told that he had heart artery narrowings in all of blood vessels and he needed an urgent cardiac bypass operation. However since he had been started on some tablets, his pains had all gone and he was now back to being completely asymptomatic. So he was faced with a dilemma because he felt well but was being advised an urgent operation which was going to be both very expensive for him to fund but also a very invasive procedure (which understandably scared him).
So I asked him whether he had spoken to his doctor about his concerns. He told me that he had but at the mere prospect of being questioned, his doctor had become quite angry and told him that without the operation there was a very high likelihood that he would either have a massive heart attack or be dead within the next 3-6 months. This scared the patient even more and now he was really completely overwhelmed and lost as to what to do. Should he have the operation to live longer?
In this video I wanted to talk about how dangerous stable angina is and whether a heart bypass done for this condition does indeed prolong life.
Now before I start I would always urge that patients make important decisions like this in concert with their doctors and individual situations may be different and therefore anything i say in the video should never replace an honest and detailed discussion with your own doctor.
Firstly I will talk about angina and then i will talk about the treatments and finally about this very interesting study which was called the ISCHEMIA trial.
1. What is angina and what is stable angina
The heart is a muscle and therefore needs a blood supply and when the heart is called onto do more work such as during exercise, more blood is needed to match the increased demand. If for any reason, the demand does not match the supply, the heart muscles will not get the blood they need and start suffocating. As these heart muscles suffocate, the patient will manifest with chest discomfort and/or breathlessness and will be unable to keep going with whatever is causing the increased demand. The symptoms of chest discomfort which result from this demand supply mismatch is called Angina. Usually the supply doesn’t match the demand because of progressive narrowings within the vessels that develop due to increasing age, wear and tear and comorbidities such as diabetes and high blood pressure and therefore in most people who have angina, when you examine the vessels by a test called angiography, you will usually expect to find significant narrowings within the blood vessels.
Now any condition can only do two things to us - it can impact on our quality of life or impact on our length of life or both and therefore when we plan management, management has to be geared towards improving quality of life by removing symptoms and we also want to give patients those treatments that would prolong life.
Assessing the benefit of an intervention designed to improve quality of life is easy. You administer the intervention and the patient will tell you if their quality of life has improved as a consequence.
Assessment of the benefit of an intervention designed to improve length of life in an individual Is very difficult because there is no real way to be certain that you have prolonged life and therefore the only way to know whether what you are doing is worth doing is to rely on data from studies done in populations of patients that are similar to the individual that is sat in from the of you.
In angina, both quality of life and length of life can be affected and in terms of quality of life, we know that there are 3 main options depending on the severity and complexity of the narrowing causing the angina.
The 3 options are
Pills eg Aspirin, beta blockers, nitrates and statins
Stents
Bypass operations
Whilst pills are an inconvenience, stents and particularly heart bypasses are pretty big and scary interventions.
Had my triple bypass in 2022 at White Plains (NY) hospital age 68 I feel terrific and consider myself a lucky man to have such fine surgeons.
A quadrupal bypass gave my hubby 26 extra years
@keithworley6222: I personally know several people who have had heart bypasses:
48years old: Currently still alive at age 78.
52 years old: Past away at age 84 from cancer.
59 years old: Currently still alive at 80 years old.
62 years old: Currently still alive at 84 years old.
It seems it has increased peoples life span based on my anecdotal evidence 😅.
A brilliant mind, an exceptional communicator, an immense heart and a man of vision! Witnessing such genuine qualities eases my own heart. May all your projects bloom Dr Gupta!
As a former nurse in the USA, now semi-retirement, I totally agree with you. You are a shining example of how a doctor should educate and also respect their patients. A doctor may have a skill set that I do not have, yet that does not mean I do not have some knowledge of a given situation. When money is the motivating factor in treating illness, I would be very suspicious of an all-or-nothing approach. Many thanks for all the knowledge you share with us.
All treatments are now money driven...because we are a money driven society...to change medical field, you need to change the society and it is not going to happen any time soon... doctors are paid by insurance companies for doing elective surgeries and by pharma companies for prescribing questionnable drugs
Jennifer Lee as an RN in USA also I agree with everything you’ve said. I like all of the Doctors videos. He is excellent !!!!
I found this VERY useful and educative. I have learned a lot from you Doctor. I have had a STEMI and two stents placed. I have had to do a crash course on cardiology, and you have explained things to me and helped me tremedously. Thank you for sharing your knowledge. You are a very gifted teacher!
Had a bypass in 2017 after having an angio investigation which I know caused some damage. One of my arteries was found to be a different round way to 98% of people. I did have stable angina which got a bit worse after the angio procedure. I still suffer PTSD some 5 years later. Am 82 now, Asian, with other health issues and very petite. But I am still here and grateful. My surgeon did say to me after the surgery” l’ve given you another 10 years”
I take my pills everyday and I feel fine but I now feel much better after hearing you say that medication is sometime better than going through the physical act of a stent or open heart surgery and I am 90 years old so those pills have extended my life. Thanks for such a good description of what angina is...
How long ago did you start treatment by medication only?
Why not go on a plant base diet, that suppose to reverse heart disease. When pres. Clinton went to the Cleveland clinic they put him on a plant base diet an he is doing very well. You basically have to be a vegan for a shot time until you improve.
Always questions, but never answers
Hi Dr. Gupta, I always look forward to seeing your educational videos. You are a blessing to this world. I really wish you were easily accessible to all of us for consultation. Your patients are so lucky to have a doctor who is so smart,kind and such humble gentleman. May God bless you always. Really adore you Dr.Gupta
As always, I am grateful for the education you offer to us. Heart disease is a family problem for me, but I am "managed" well with the current approach. So reassuring to have your input as well. Thank you.
Excellent. As so many commenting on your videos have said, we need more doctors like you ! Both caring and informative. They exist but it is far from standard these days.
I wish I had seen this before my triple bypass surgery. I would have probably held off having this for a while, or maybe never have done it .But I WAS tiring more easily than usual; a deer in the headlights moment! Five months after the procedure, I am having chest discomfort due to the wires in my sternum. Maybe this will go away in time. Thanks for your insight! I'm 74 now, and plan to watch more of your videos to go for 84, at least! I appreciate your educated opinion and honesty!
Oh thank you, thank you! You are what health care should be, truth and genuine interest in what is best for the patient. You are a mighty fine doctor, extremely capable and your videos are delivering a lot of understanding and relief to those of us with heart conditions.
Brilliantly communicated. Thank you for the clarity about treatment options and the study reference.
I just wanted to come here and say THANK YOU! you have helped me with the ectopics that i started having this past 3 months and i took your advice on taking magnesium it has changed my life back around these past weeks. I cried tears of joy feeling like im not going to die every day .you have truly taught me so many things and i am really from the bottom of my heart Thankful that you use your time to help us with your knowledge and spread it to those who need it.
Excellent discussion and perfectly illustrates "do no harm" in patient management. Always look forward to your insightful discussions.
You sure are informative. I wish there were more Doctors like you. We would live in a much safer world. Thank you for all that you do.
I am 13 days out of the modified Bentall procedure with the konect bovine tissue valve. Was in great shape when I went in with minimal damage and classified as Stage C: A Symptomatic. I am 60 years old and made the decision to have surgery one year after the diagnosis of severe aorta valve stenosis. Took me that long to get my nerve up. I was working, and I felt great, what the heck? Third opinion I said let's do it because I didn't want the recovery to be ridiculously long and/or my heart to be irreversibly damaged by my own hand because of my cowardness. The first week out of general anesthesia is NO JOKE and it does hurt. I've been home for three days and begin warfarin tomorrow evening for three months. Feeling very good. Surgery is not the problem it is the solution. 02/28/24
Thank you, Dr. for taking the time to share needed information for we who are at the mercy of the medical system here in the USA. The information you offer is life-saving, thank you, thank you, thank you. You give so many of us hope, who otherwise would be hopeless.
Thanks doctor for your informative videos. My dad had a major heart attack and was angiogram with a stent operation at 57. I started following your videos few months back and you're one in a million. Please do educate us with more videos to reduce heart attack and cardiac arrests. Thanks in advance
This is a wonderful presentation. I am a seventy-two-year-old Sri Lankan who was asked by my cardiologist to undergo an angiogram three years ago without any symptoms. After the angiogram, I was asked to go for an 'immediate' heart bypass surgery and even went as far as saying that she could not guarantee my life if I don't accede to her request. However, I consulted another cardiologist for a second opinion. I am still asymptomatic and continue with pills without any hindrance to my normal activities of life. You have stressed a very important point that, unless I have symptoms of angina, it really doesn't make any difference whether I continue with pills or go for a CABG. Thanks for your enlightening video, doctor.
You explain it with your usual patience and clarity. My first stent lasted 12 years, now replaced in urgence and I am fine, with a good Cardiologe who talks like you and I live a happy life and accept the side effects from the pils better and no additional stents, thanks to doctors who cares about the well-being of their patients. (76 years old) 🙏🇩🇰🤗
I absolutely love your philosophy of what a doctor should be. My mother was a wonderful nurse and she had quite similar views about medical professionals. Bravo!
Your final remark encapsulates exactly what is so important when we entrust our lives to a doctor.
Thank you so much for all your advice and help. Much appreciated. You “ clear the mist” for us and help us to see what’s what much better.
Thanks so much Pamela
Id be so grateful if you'd consider sharing and subscribing:-)
I think this depends on the age of the person. I just had a bypass with a 90% blocked. I had a stable angina and asymptomatic. I’m only 42, therefore I think it was the right decision. A 75 year old doesn’t have that many years left anyways and have a higher chance of dying from the surgery than a young person.
Without doubt this is the most informative and helpful video I've ever seen on RUclips. As my hubby faces this exact dilemma the information given here, at least gives him a sound basis for further discussion with his cardiologist. Thank you.
Thanks for the truth and compassion you convey.👍
I feel vindicated after watching this video Dr. I was diagnosed with 3 very serious blocks in my right (100%), centre (99%) & left (80%) arteries in an angiogram in 2016. I was asymptomatic then until now. I went against Dr advice then to do a bypass. However, I still follow up with regular visits to my Dr. including the Cardiotorasic Dr. Bypass is a very major surgery and the chances is 50:50 especially with my past stroke in 2012. I do my morning walk daily and it includes walking up & down 3.5m high staircase 5 times each way. I do not pant. I’ve stopped excessive strenuous sports like golf since my stroke in 2012 where I lost control of my right limbs and blurry speech. However, through very discipline physiotherapy at home ( 10 hrs per day, 5 each on my hand and leg ) I regained control ( 85%) of my limbs within a month. I’m thankful that I’m independent and does not require any help in eating and mobility including driving. I accept that I’ll never be able to regain 100% thus have been adjusting the things I do.
Recently, I’ve learnt that our national heart institute can do a procedure like angioplasty where it drilled the plaques in the arteries before inserting the stents. I’ll be talking to my Dr in Feb appointment.
Thank You so much for taking the time to make your informative vidio's. Really very helpfull. You are an exceptional Consultant cardiologist. Kind and generous person... you explainations so easy to understand..I hope you realise how special you are. How much we appreciate you. Thank You so much.
I couldn't agree more regarding unscrupulous doctors. I am a diabetic and I was hospitalized for unstable blood sugar. A. Cardiologist came to visit and suggested that I have a blockage and needed to have an angioplasty done. I was rather surprised because I have never had any problems with my heart other than a murmur that was diagnosed 30 years prior, but had complaints about anything else in that regard. I was not buying it. I told him that I need to go home and secure my pets and my home, and he told me that it was urgent and I could die if I did not have it immediately. 1) He was not my PC, and I have no symptoms and never had. It's been nine years, I am now 65 and I have not had any problems with my heart. Now I do have some narrowing of vessel (s) but I have no symptoms of any kind.
Did you ever consult and have testing done with another cardiologist of your own choosing? I wonder WHY that cardio doctor decided that you needed emergency surgery bc of a blockage?🤔 (And are you also saying that you never had the surgery at all?)
You are such a nice and caring doctor. Look forward to seeing you.
Brilliant! I am constantly informed and reassured by this wonderful Dr. Gupta.
Thank you for breaking the societal mis conception that cardiac surgery is a long term fix in all cases and extends life in all cases. Especially when ones vitals and symptoms are manageable on medication. Thank you for giving us case studies and your opinion as you see it truly honestly.
It can be stressful as a patient to get frustration from a personal support system (friends family etc.) that sometimes view heart surgery in a “fix it “manor as if it is like a car engine. Unfortunate that the human body does not work that way. But true 💯.
Beautifully said Dr. Gupta that’s why you rock
Super vidio 👍👋🇪🇸 only people with an old soul, would say such wonderful words...[...], God bless you & keep up your outstanding work 🙏🙏🙏👍🇪🇸
Excellent explanations and thank you for sharing your expertise. As a health professional I am very grateful for your honesty.
Great video and an honest summary from an honest Doctor Well done
Do no harm is the rule - it us so scary to hear you telling us about these unscrupulous doctors in these countries. We are so fortunate here in the UK aren’t we? Thank you for this explanation, it is extremely interesting to hear about the ‘no advantage’ of stents or bypass if the symptoms are controlled with pills - what a surprise!
Thank you so much Dr. Gupta. You are God sent to the mankind.
Stay safe! ❤️🙏
What a great explanations ! Doctors should always empower patients after giving a good explanation. Wish you can be my doctor! ❤
Thank you Dr. GUPTA for talking about it. I'm a Cardiologist trained in the U.S. and practiced there for more than four decades. I retired and permanently returned to India.
I don't practice here. I, now and then, some one coming to me for a second opinion regarding the very problem you discussed. I don't charge them any fees.
I see so many people being frightened by saying that if they didn't get the Stent or a bypass they will die or get a massive heart attack! They all have stable angina well controlled by medications alone. I advise them to stay away from such enethical doctors and continue with their medical therapy. They all are doing well. This is a wide spread problem in India and I feel sorry for some patients who have to sell everything they own or borrow to pay the doctors. Unethical practice is very wide-spread here.
Your integrity and compassion are characteristics of a good doctor and good person. May your God bless you eternally!
Superb comments Doctor. Can I contact you sometime? I live in Bangalore.
I wish there were more doctors like you, here in the U.S.
Thank You for your excellent advice from a heart patient!
Another good presentation, thank you. Rationality and sympathetic understanding are necessary and essential parts of medical practice.
Thank you for such an educational and interesting video.
Such a problems run in my family and Im always interested in knowing more about it.
You are the best.
Omg this has helped so much ! I was just told I have to see a vascular specialist because of build up of plague in one of my arteries… had a CABG 3 1/2 years ago . This will help with what they throw at me next . Thank you
OMG thank you so much for confirming my prevalent intuitions. My case is identical and I had my angiogram last Friday and have been weighing up wether to have a by pass performed or not - at present my echo gram showed an improvement and I was actually feeling very strong and accepting of the medicines which I eventually adjusted to. I feel I made the right decision yesterday pretty much on the same logic you tendered here. Thank you so much for uploading this video.
I had a heart attack and the cardiologist said, i don't know you got up off the floor. Had to have 4 bypasses, 12 yrs ago now, through narrowing of the arteries. I never had any angina at all. But people notice i was slower at doing things.
But 6 mths ago they found an old blood clot in the heart, that was laminated, and won't move. I think the clot is caused by the damage bit of the heart. One thing i will say, that fish oil has helped me in keeping blood pressure down and in general, just doing good things for the body. After bypasses i thought i would live maybe 2-5 yrs, but still kicking on and i think walking every day a Kilometre helps. Cheers.
another great video Sanjay very helpful, thank you
Excellent sharing, Dr Gupta..we need such expertly input so we can make better choice n live with less fear, uncertainty n more freedom
Amazing information/advice from a Doctor...
And not coercion from the Government
Great communicator!. Something rarely seen in the medical field nowdays
Oh my gosh, I found this video exceptionally useful. Both my mom and dad had bypass surgeries and I often wondered what would happen if they didn’t go through all that. So, thank you, thank you, thank you as it may be my turn in the future to decide on this type of surgery.🙏
My father had a stable angina, he was 57 years old, he went to cardiologist specialist in India, he performed ECG said everything is fine in ECG, no blood work or angiography done or referred. Only pills were given for fifteen days. On next day (22 January 2023) he passed away with cardiac arrest.
Later we showed ECG to other doctors they said he had a MI. But I was shocked why doctor didn’t suggest or guide him, so I went to his clinic asked him if he had a problem in ECG why he was not referred for angioplasty and doctor replied stents or biopsy will not likely do anything and he didn't want to scare a patient by telling him that he is having a heart attacks already. I'm so sad because of doctor's malpractice. I lost my father. even if could save him for another 1 year, I would have spent my all money. but sudden loss has broken me and my family. he was a hardworking person, father of two daughters, non smoker non alcoholic for whole life.
we will miss him in our marriages, family functions, his grandchildren will never able to see how great thier grandfather was💔
You are just amazing..you inspire educate and empower all who listen to you..therefore you are a brilliant Doctor..thank you again
Well explained.Thank you so much . You are a great human resource
genius!!! please continue your fabulous talks !!!
Great, thank you again.
Thanks for being back to work.
You have the most caring nature. Love your videos.
There so informative👍
Thank you for Serving with Love. Great health tips awesome
Very I formative, I have stable angina, i understand it much better Now, thank You, God bless and keep on putting out these information for people like us
Thanks very much. Excellent explanation.
Fantastic logical analysis! Wish I could get you here in Kolkata for one to one consultation!
God bless you ❤You have answered my questions at the perfect time❣️💝👌
Very reassuring and honest thank you so much.
Love How You Educate Empower and Liberate Us 👑
I watched this vid and was totally impressed your discussion how to work with your doctor. Which I had done. My result is a slightly different technique. I was judged high risk PCI and offered open heart traditional for my RM, LM, LAD. I declined since my wife had open heart for aerobic valve and judged mini-strokes which gave cognitive difficulties. 2nd opinion to include totally endoscopic CAB but that would not address my blockages. Subsequently went to original Dr for stentimg with Impella blood flow assist. Wonderful quality of life from the day after the procedure. It's now a year later. I am not complaining; just reinforcing your words from this video for others. Miss you on CNN. (Should note I avoided the typical 7-10 days recovery in hospital and 4-8 weeks recovery at home. I am 80 a widower and retired engineer. I love and appreciate the medical advances!)
Thanks. im 54 live in England and have been told to have a double bypass...soon...infact by taking the additional medication for blood thinners has made a significant improvement in my life.
Wonderful explanation and thank you doctor for such inputs... 👍
That is a very sensible n sound advice, salute to the doctor 🙏🙏🙏
Thank you 😷. Doctor. You will be blessed. Clean and precis explanation. Tq
Dear Doctor,
Please know that I found this video extremely useful and I thank you very much for it. My mom, dad and sister had bypass and stents put in and I am assuming at some point I too will have to make some sort of decision regarding my heart. So again thank you so very much. I watch every one of your videos and feel more educated and empowered with each.🙏❤️
Doctor Sanjay you are a gift from Heaven especially for those who are confronted by Greedy Heart Surgeons
My Uncle and my Landlord both had a heart bypass in the same month. The Doctors had to harvest vein from their legs. Both of them said that was much more painful than the heart site and they both wanted to die from the discomfort. After a few weeks they both felt better but it was an eye opener in that heart health should be on everyone's mind when they eat.
I think that's the usual place that they harvest veins for heart bypass surgery? The lower legs?🤔
Never knew it caused so much pain at the harvest site!😩#Yikes!
But yeah, I'm sure they both felt a lot better once they fully recovered!!😉
@@gloriamaryhaywood2217 They both were cut from upper crotch to ankle. both of them had several bypass sites and I was told that was done so they could match up the best section of vein for each area needed. They were both in their 70's at the time and both lived into their 90's
@@Swift-Prospecting Good to know!😉 Thanks for the speedy reply!
I had a triple bypass operation two years ago and experienced no pain whatsoever in any parts of my body. The saphenous vein removal does not create any pain as far as I can tell.
@@g.e.b.8159 That's what I thought! I have never heard where somebody has pain, much less a lot of lasting pain, where the vein was removed from the leg!? Hmmmm?🤔
Thank you!!
Very reassuring doctor. Thank you very much. God bless you.
Thank you Dr. Gupta, amazing information
Thank you, Dr. Gupta. I am an Australian former nurse. I have three stents LAD, Circumflex. I started to worry about chest pains after 8 years of pain-free. I wanted a change so consulted Dr. Omar Farouk, he ordered a medical stress test. positive, angiogram, stretched a thickening instead of stenting as the previous dr had done. The chest pains continued- Rx microvascular angina, so no unnecessary stenting. I love my new cardiologist.
DR Gupta Yes I found it very educational and very proud of you for standing up for the patient with being threatened by the doctor a patient should never be yelled at from a doctor they should remember moral integrity and oaths made by contract with the job patients stability treating patients with respect because of fears and lack of knowledge or be little people for their benefit doctors should have patients with the patient Thank you Dr Gupta for sharing this story with the world
You r excellent Dr, loves from Curacao, stay blessed
Hats off to this Doctor ...God bless you doctor
Dr Gupta provides thorough information that provides people the ability to ask the right questions and make decisions for their situations without fear or pressure. A service money cannot buy. Sending love and thankfulness.
Quack.
Thank you for this video.much information gained.
Very helpful. Wish I had seen the video before the bypass surgery. I had shortness of breath and still do after 4 months. Interesting.
Your videos are very informative and easy to understand.Really very helpful because i did an angiogram and i have a few blockage .Have to go talk to my cardiologist and see what he recommends.Thanks for all the helpful information.❤❤
Wonderful and honest dr!!
They should clone you dear sir. I can tell you truly care and follow the "Do no harm". Thanks for all the time you take to put these together.
Thank you! Any excellent video.
A cardiolo doctor took an isotope examination of my heart in mars 2018. I sat on a cykle for five minutes with the isotope in my body, doctor and nurses checked my ECG all the time. Then I had to walk and wait 20 minutes before I layed in a machine that took pictures of my heart for 20-25 minutes. I could watch a monitor where my heart was "glowing" by the isotope.
It showed that I my heart, the vessels was clear, no blockages. I wonder if I have heart problems now. Chestpain every day. Heart rate 120-140, I take betablockers. Ultrasound of my heart in october 2021 showed nothing was wrong. I don't know what to think. Thank you for your videos. You really educate us so much.
You won’t believe it Dr. Sanjay how badly an award winning Cardiac surgeon here in Bangalore had me scared about my brother’s life if not operated. His manner of speaking, denigrating and berating his “customers” was downright criminal. Very powerful individual with powerful political connections. Luckily we smelled rat and walked out.
I have meant doctors like this!
Nice of you . You videos are so interesting &lifesaver for patient and their relatives as malintent is rampant in India and good advice is not readily available
i was diabetic in 1989 when i was 27 years of age. i had a heart attack in 2005 and had an angiography i was then 42 years of age. docs in 2005 advised me a heart bypass but i went for chelation therapy instead where they inject vitamin c and EDTA sol this procedure went on for 2 months and i was put on beta blockers n aspirin.
now i am 58 years and going well.
i feel this gentleman is 75 years of age and already beyond average age by indian standard. so my advise to him is have pills n just chill. ❤
and love to you doc and the blue bell 🙂
Such great information. Many thanks
Thank you for such an informative video🙏🏻🙏🏻
I think getting a second opinion might be a good idea as I had a heart murmur from my early years and it progressed more in my late 6ixties! Went to Mass General Hospital for second opinion and they were very thorough with my heart condition and after an angiogram found a 80 and 100 percent blockage.Also I needed to have a mitral valve repair as I was slowing down from exertion! That said I went through the surgery on April 3rd and I am glad I did because I feel strongly that if I hadn’t my life expectancy would be significantly lower! So I’m a strong believer in a second opinion with a top notch Medical Center and also doing your part to lower your risk from surgery by getting in shape to the best of your ability! I lost 13 lbs prior to surgery and I was trying to lose another 6lbs but they moved my surgery date up by a month! With that said I feel 20 years younger after surgery and am looking forward to seeing another 20 years added to my life thanks to Mass General Hospital!
Always refreshing and honest.
Thank you Angie:-)
Id be so grateful if you'd consider sharing and subscribing:-)
@@YorkCardiology I have been subscribed for years. You are wonderful, don't misinterpret science but in the same time try not to scare people. I really appreciate your videos. I have shared a few also because I am a Psychologist (prof) with specialty in panic disorder. Thank you for all you do.
Excellent presentation Dr thank you
Excellent evaluation.
Thank u doctor really know now how important it to things what what to do .really making us know more .God blessed u.