Q: A year back I felt a choking sensation in the lower jaw. The ECG showed NSTEMI. I used to chew tobacco earlier. I am a non-vegetarian. The CAG done showed DVD - RCA 100% Mid, LAD Prox 90%. PTCA was done and a Cypher Stent in LAD done. PTCA to RCA attempted. But lesion could not be crossed, hence the procedure was abandoned. Now there is no discomfort. I am on the following medication -clavix, nitrocontin 6.4, dilzem sr, ecosprin150 and cholecheck mb10. Are the medicines okay for me? Should I undergo a TMT? Whether any significant risks are associated with TMT? What should I do for opening the RCA?

A:If attempts have been made for opening the RCA which were unsuccessful then I do not think, re attempting to open the RCA is indicated unless and until you have incapacitating symptoms from it. The other way the artery could be opened is by bypass surgery but bypass surgery is not indicated for single right coronary artery blockage if you have no symptoms. TMT should be done annually under the supervision of a cardiologist as a part of regular check. The medication that you have mentioned seem quite adequate, prescribing medicine or corroborating use of a particular medicine on email is not advisable and I feel very strongly that you should consult your cardiologist and be on his regular follow up. The decision regarding medication should be taken by the cardiologist.