Is Angiogram necessary before PM fitted

Hi Everyone Windway here after a little difficulty logging in but helped by the marvellous Blake (Thanks Blake)
Friday 30th June 2006, I went to my GP (doctors) on a regular three monthly blood pressure check with the nurse. It was fine but heart rate under 50. She did ECG and called the doctor to the room who repeated the ECG. She read it, said "Don't move" dialled 999 (America 911) for an ambulance which took me to the University Hospital of Wales, Cardiff. I had had no symptoms of heart trouble whatsoever My poor wife had been outside in the car with the dog, we were going for a picnic.Anyway I was Holter monitiored over the weekend in hospital. On Monday 3rd July,2006, I was told I needed a pacemaker I had heart block type 11. It was a shock as I keep fit, I was going to the Gym at least three times a week for the passed 6 years. I ran 10K in just under the hour (not too bad for 59 year old) at least twice a month, and thought I was healthy. Tuesday 1st July 2006 Neway DR pacemaker and two leads fitted, discharged from hospital following day. No other tests other than heart ultra scan.
Following the proceedure I felt "flutters" and sudden heart beat rushes. I thought PM could be "running in". First check up October 2006, technician a waste of time very unresponsive more interested in teaching young lady with him how to use the equipment.Left feeling like a mushroom not knowing anything about what had really been wrong. But I thought "Well you are alive thanks to the intervention of that nurse, you are lucky"
I had resumed exercise in the Gym trying to regain my fitness but found it a struggle. Following some chest pain in the Gym and whilst in bed; on Thursday 1st March 2007, I went again to my GP who referred me straight away to hospital.Again at the UHW, Cardiff , they eventually decided I needed an angiogram, which I had on Monday 12th March,2007. Surprise surprise I had FIVE blockages in my arteries (2 x 90% 2x 80% 1x 70%).
This was my second lucky break, I could have suffered a heart attack at anytime, particularly in the Gym!! I had FIVE stents fitted to ease the blockages. Further tests revealed that I now had complete heart block.
I have reliable information from a medical source that heart block type11 is indicitive of coronary heart disease, and most hospitals perform angiogram to check before fitting a PM.
I have had no contact with any other PM users and I am really looking forward to finding out what others have experienced.
When I asked why I wasn't given an angiogram first time, they replied that I had shown no symptoms of coronary artery disease.
Anybody had similar trouble or anybody with information please reply.



by luckyloo - 2007-08-24 02:08:31

dear windway,

in my city, where there is a heart center at the hospital, you would have had an angio first. in my opinion, you should have at least had an exercise treadmill test or echo done ASAP even. what happened to you happened to my neighbor....young man in his 40's, routine check up, something showed on ECG, they did an exercise treadmill test which showed definate block, next thing you know he's having bypass surgery! it doesn't matter that you are in great physical shape, unfortunately genetics will trump that! you are lucky nothing happened to you while they were putting in the probably didn't even need it! your heart was beating the way it was because of the blockages!

your family should get their cholesterols checked, treadmill tests and even echos preventatively. you may find some bad arteries run in the family...assuming you're not a smoker or bad eater.

i hope you're recovering well.


Hi Windway

by Vicki - 2007-08-24 03:08:43

I went to ER feeling strange. Turns out I had 3rd degree heart block. No history of any serious problems in the past. They kept me for three days to monitor me because I take a beta-blocker for rapid and irregular heartbeat and Toprol lowers the pulse. Nothing changed without the betablocker. They told me that they can tell from the EKG if there is suspected blockages. None showed up on mine. On the 4th day I got a PM. No angio, no echo, no stress test. Went to my cardio one month later for the echo,stress and holter. These are tests that I get every two years anyway. So...guess what I am saying is that I don't think they do further testing lots of time for electrical problems to the heart. Not sure.

Good luck.


need for pm

by luckyloo - 2007-08-24 06:08:46

hi windway,

sorry i couldn't chat. i only had a couple minutes before i had to take my daughter to get her haircut.

i thought about what i had said....maybe you needed the pm in addition to your blockage but my first thought was your blockages caused the electrical problem. i'm not a dr though. i had a few uncles with severe blockages and theirs showed up on ECG. did your dr.'s ever say you suffered a mild heart attack ever?

i don't know...just doesn't sound right to me. again, i'm not a dr. though. i would certainly have some questions ready for your dr. hopefully he/she will be honest with you and admit if they reacted too quickly putting a pm in.

take care,

second degree heart block

by belly321 - 2007-08-24 07:08:32

hi windway
i was interested to see you live in wales i am on the welsh border also
i also had a pm for second degree heart block and although i had an echo which was clear i never had an angiogram
i was iconcerned about your comments about second degree heart block being an indicator of coranary heart disease because i was told it was an electrical problem and not indicative of heart disease
i would be grateful if you had any further info on this
you can private message me if you want

causes of heart block

by luckyloo - 2007-08-25 10:08:06

hi windway,

i found this for lists causes of heart block..diseased arteries being one of them. looks like you needed the pm but it's too bad they didn't find the bad arteries first...

HEART BLOCK Heart block is when the heart beats too slowly because of a problem with the conduction of electrical impulses (from the sinoatrial node) that tell the heart when to contract. There are varying degrees of heart block. In complete heart block (or third degree heart block) the electrical impulses stop completely and the ventricles beat at their slow base rate of 20-40 beats per minute (versus a healthy average of 70 beats per minute). Causes of heart block include congenital heart disease, death of heart muscle (myocardial infarction), myocarditis, diseased valves, and scarring of the electrical conductive tissue of the heart. An artificial pacemaker can restore the heart's rhythm


like belly321

by rosep - 2007-08-29 04:08:39

I live in East Yorkshire and had my pm fitted for 2nd degree heart block in March. I was admitted to hospital within an hour of having an ECG, spent a week on heart monitor, had a scan, then had pm fittted. Like belly321 I was told it was an electrical fault, no underlying cause in my case could be found, and I did not have an angiogram prior to fitting. I was told my scan showed no other problems with my heart, I have been fine with my pm and quickly got back to work and all my usual activities including sport.
Abit disconcerted about all the different info that we all seem to be given by different drs but will go on how I feel and just be more aware for any other signs of problems in the future.

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I am just thankful that I am alive and that even though I have this pacemaker it is not the end of the world.