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What Do You Suggest For Left Dominant Circulation With Hypoplastic RCA?

Posted on Tue, 4 Mar 2014

Question: I have got my CTscan done .The report is JPG file .Is it alarming.Left dominant circulation with hypoplastic RCA 2.Patent LAD stent with good distal flow 3.Soft palques in proximal D1 with 30-40% luminal narrowing 4.Soft calcified plaques in proximal and mid D2 with 30-40% luninal narrowing

Answered by Dr. Sukhvinder Singh (21 hours later)

Brief Answer: please see details. Detailed Answer: Dear Sir 1. No. It is not alarming on the face of it. Can you detail me; Why was this scan ordered ? What was the problem and clinical scenario? 2. The stent in mid LAD is patent with good distal flow. You have a left dominant circulation, so RCA is likely to be hypoplastic. Lesions of 30-40% severity are not clinically relevant and you are supposed to take all the preventive measures which are usually advised "post stenting" including use of statins and other relevant drugs and low fat diet. Hope this helps. Feel free to discuss further. Sincerely Sukhvinder

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sukhvinder Singh (2 hours later)

I got the ctscan done on my own , albeit expressed my wish to a doctor to write ctscan for me ,Inspite of no apprent problem on this field.I remain on tour so i wanted no surprises on heart front. The questions are 1.since softplaque breaks easily and causes heart attack , how can I prevent such possibility 2. If Rca is non functional along with others., does it not affect functioning of heart ? Thanks for answering XXXXXXX XXXXXXX

Answered by Dr. Sukhvinder Singh (19 hours later)

Brief Answer: please see details Detailed Answer: Dear Sir 1. Yes, A plaque of 30-40% severity can break and invite clot formation , leading to heart attack. But there are no specific therapeutic options for this situation. You have stick to fundamental of coronary artery disease prevention. They are No smoking/ no worries/ Good control of diabetes and hypertension/ daily exercise/ optimal cholesterol and statin therapy/ aspirin, beta-blockers etc for secondary prevention/ optimal weight. I am afraid there is no sure-shot way of preventing an episode. 2. RCA is hypoplastic because left circulation is dominant and taking care for RCA's responsibilities by supplying PDA. Sincerely Sukhvinder

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar