Someone I know had a family member have a massive heart attack. They were saying how doctors said all four of his arteries were completely blocked.
From my understanding, when someone has all four heart arteries blocked, it takes time to get to that point. Meaning they couldn’t all have happened to clog at the same time. I could understand some gradual buildup in the arteries, but complete blockage in all four at the same time?? That just doesn’t sound right.
My question is wouldn’t they have had a heart attack when only one artery got blocked? Or can the heart continue to function when some arteries are blocked if there’s still one functioning? How were they even alive past the first blockage?
Maybe there was slight blood flow and partial blockage in the arteries so the heart was getting just enough flow to function until finally it got so blocked it couldn’t flow anymore. Do doctors just say the arteries were completely blocked as a general statement?
I’m just trying to understand how someone could even survive past a first single blockage. I’m sorry if it’s a stupid question, but I’m autistic so maybe I’m over analyzing a general statement that doctors might just say to people. I’m also going into nursing and I just am trying to understand because that statement just doesn’t make sense to me. I want to understand as completely as possible so I can be knowledgeable on it. Thank you 🙂
In: Biology
Yes, the heart can continue to function when multiple vessels are blocked. Cardiologists don’t typically place a stent in a vessel until it is considered 70% occluded (or more). If the blockage is not recognized and it continues to worsen, it can eventually become what’s called a chronic total occlusion, or CTO. In the case of a CTO, it means that there is absolutely no flow beyond the blockage. In this case, sometimes the heart develops alternate flow to compensate for the lack of flow through the blocked vessel. These new vessels can be referred to as collaterals.
Heart attacks are not CTOs. A heart attack is an acute condition, though there can be existing CTOs as well that require intervention as well. In a heart attack, the vessel is blocked by a clot or a sudden-appearing piece of calcium/plaque. Because it happens suddenly, patients experience a variety of symptoms including chest pain, nausea, sweating, etc. whereas a CTO is a gradual blockage and sometimes symptomless.
If it is a clot causing the heart attack, it is removed with a vacuum device and the procedure is called a thrombectomy. A stent is placed in the site of the clot after it is removed. If it is plaque, it can be stented and reopened without any extra intervention or they can use a drill device to push through the plaque if there is any plaque that has hardened and made it difficult to place the stent. This is called atherectomy.
I find it hard to believe they had all arteries completely blocked, unless they meant two major vessels and their branches. For example, the left anterior descending artery has branches called diagonals, and the left circumflex artery has branches called obtuse marginals. These can have multiple blockages throughout and other vessels will compensate to maintain a functioning heart. If all the major arteries become blocked, the heart cannot continue to function.
Not a doctor, and I don’t know this person’s full situation, but I am a cath lab nurse and this is the knowledge I have to offer. Let me know if you have any questions!
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