Q: I am a 73 years old diabetic taking insulin for the past 15 years. I have triple vessel disease and while walking I get slight choking. I have been advised bypass surgery, but I am scared of the invasive procedure. Can I ignore the operation and continue with medications?

A:The major risk of not operating in a situation of triple vessel coronary artery disease is the risk of developing heart attack and the attendant complications of heart attack. Not only heart attack is a serious problem and carries the risk of life, but even if one survives, the heart gets damaged and the quality of life suffers. One starts getting breathless initially on exertion and as the heart damage continues, the breathlessness may occur even in day to day activities and in last stages, even at rest. Besides that, blocked arteries some time give rise to irregular rhythms of the heart and heart failure. It is therefore important that one should undergo bypass surgery at the earliest and this is more important in diabetic patients, who may not get symptoms in form of chest pain but may have atypical symptoms in form of either breathing difficulty or choking or some times just feeling of being unwell and most times diagnosis may be delayed. Therefore, it is important to go in for timely intervention.