Do an Angioplasty with S4?

Alan4HER · June 13

Hello Friends,

My DW had a diagnostic heart calcium test showing “medium” elevated numbers, so we visited the cardiologist. She has no common heart problem symptoms and her echocardiogram was normal, but her following stress test revealed “some” reduced O2 absorption at the top and bottom of the heart. The cardiologist recommends an angioplasty procedure, where they insert a probe to look for potential artery blockage. He said they normally find issues ~85% of the time and then insert a stent. The procedure has risks and 1 in 400 people have problems or heart attacks from this procedure.

He is willing to proceed, but said they don’t recommend this for elderly people (she’s 73) or people with severe dementia. She’s stage 4 and said he’d understand if we chose not to do it.

Her health care directive states "she does not want her life prolonged if she has an incurable and irreversible condition that will result in her death in a relatively short time…”

I wrestling with the decision to proceed or not, so I wanted to ask if others have faced this and what advice you might share.

Thank you!

Michele P · June 13

https://alzconnected.org/discussion/76271/do-an-angioplasty-with-s4

Don’t put her through this. If she has a heart condition that is serious, she might not live through stage 7. That will be a blessing for both of you.

ronda b · June 13

I would not. I just had to make that decision. Listen to the dr. If he doesn't recommend it d/t age and dementia , I would not.

terei · June 13

I would never have a PWD have a treatment that would extend his/her life unless it was explicitly to control pain.

JDancer · June 13

I wouldn't. Early on I opted to only treat pain for my husband. If you choose to proceed, make sure they plan to enter at the wrist as a femoral entry usually requires several hours of flat bedrest afterwards

Jgirl57 · June 13

I agree, I would not . My DH has recently been diagnosed with CHF and potential Afib and we declined further testing and treatment. His previous hospital stay was a nightmare for all involved. The doctor signed an out of hospital DNR. Thanks for sharing, we all struggle with some of these difficult situations

Emily 123 · June 14

I would not—which seems to align with her wishes.

She isn't having any acute symptoms that need managed & her heart muscle is pumping normally (not weakened by any areas of restricted blood flow from the presumed calcium blockages).

You can specify to her providers that you want ''conservative'' treatment for her across the board, which may head them off. The calcium testing is becoming more common as part of routine cardiac screening, but it can entrain a person into a series of further tests.

harshedbuzz · June 14

@Alan4HER

Unless she is dealing with symptoms like chest pain or shortness of breath, I'd be inclined to try to manage this more conservatively. Even though this is a minimally invasive procedure, she would need anesthesia and might require an overnight stay as well as the use of a blood thinner which could mean regular blood draws and increased bleeding with falls as her disease progresses.

HB

JDancer · June 14

https://alzconnected.org/discussion/comment/274871#Comment_274871

Newer blood thinners don't require frequent blood work, but most are very expensive

Alan4HER · June 14

The optional calcium test led to six DR appts and a decision about this procedure, so I greatly appreciate everyone's feedback and wisdom. Due to no pain and no symptoms, it seems best to not proceed. Thank you for the advice…

harshedbuzz · June 14

@Alan4HER

With any routine testing, for my late dad with dementia and now my 88 year-old-mom, I ask myself what I am going to do with the information. You might consider stopping routine mammography, colonoscopies, DEXA scans, and skin checks unless there are symptoms.

HB

Quilting brings calm · 1:47AM

I had a cardiac ablation through the femoral artery. So I had to lay flat for four hours afterwards. I normally have to pee every hour. It was sheer torture - even with one of the new wick things that supposedly sucks your urine if you pee on it. I lasted 3.75 hours and I pulled off every lead and high tailed it to the bathroom. My mom was stage 4 for some time and she would have never been able to deal with it. We made a few ER trips and they were pure hell. For me, her, The staff and everyone in the waiting room.

Do an Angioplasty with S4?

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