Pawan Agarwal, 55, from Ludhiana has had a heart problem since the last 6 months. He has had diabetes for the last 18 years and underwent an angiography on 13 August, three weeks ago.
He presented with a complaint of left arm pain on walking about 500 metres. This was progressively increasing for the last 6 months. He also complained of excessive perspiration in the first week of August. No complaint of chest pain/giddiness/syncope. Patient consulted diabetologist who referred him to cardiologist where ECG & CAG revealed triple vessel coronary artery disease with left main disease. He underwent CABG+LAD endartectomy on 20/8/12.
Case history given by relative- Mr. Pawan Agarwal has a hosiery business. He has 4 sons and is a resident of Ludhiana. He suffers from diabetes from 15-20 years but did not suffer from any other problem. He came to Mumbai in the first week of August. Here he started experiencing severe palpitation. His family took him to a regular GP who suggested that he visit a cardiologist. After going back to Ludhiana he visited a cardiologist and underwent angiography. The cardiologists said that the patient could not undergo angioplasty or bypass surgery because he had 2 critical 90% blocks and 1 arterial damage. The family was referred to Dr. Panda through a relative. They consulted Dr. Panda on 14th Aug. Dr. Panda said that the case was challenging and that the patient needed immediate surgery,which was possible. The family went back to Ludhiana and came back on 16th Aug. The patient underwent bypass surgery with 10 arterial grafts and endartectomy (cleaning of the artery). The patient has always lived a very active lifestyle and is doing very well now.
Surgery undergone: CABG+LAD endartectomy on 20/8/12
What is interesting in the case?
- The patient needed a bypass surgery with 10 grafts- which itself is possibly the first time it has been done
- The patient also underwent an endartectomy (cleaning of the artery prcoedure)
- The cardiologists at Ludhiana had said that the patient cant undergo either angioplasty/ bypass surgery as it was a challenging case considering 100% blockage. Not doing any procedure would have proved fatal for the patient at any moment.