Q: Recently I had sudden chest pain which I took it as gastric reflux since I had suffered due to this about 3 years ago. I also found that if I exert even a little bit, I have chest pain, which subsides after rest. I was a heavy smoker, and regular alcohol consumer. I went for an angiogram in India, and was told that about 95% block in LAD at one place. Simultaneously, I underwent ballooning angioplasty with PTCA and Stenting. I am told that it is drug eluting stent. I am fine and extremely well. I stopped smoking and drinking 100%, and took up walking about 4 Km, both in the morning and evening. My food habits have changed to low sodium and low or no fat foods. I am taking clopidogrel 75 mg, aspirin 100 mg (both twice a day), Nicoran 5 mg, Atenolol 25 mg (1/2 tab both times), and Tonact 40 mg once a day. What are the chances of re-blocking of the arteries and are there any possibilities of other arteries are also getting affected?

A:Your symptoms were clearly angina. The culprit being a severe block in the LAD artery. Drug eluting stents have a very low incidence of recurrence at the site of previous disease. You need to take all the measures to minimise the possibility of a new blockage coming at some other place in your coronary tree. The changed diet habits must continue (low fat, low calorie diet with fresh vegetables and fruits). Tobacco totally forbidden and alcohol in moderation. Keep your LDL cholesterol less than 70 mgs and triglycerides less than 150 mgs. Clopidogrel should be taken for at least 1 year (one tab is adequate). Aspirin indefinitely, statins which you are on must continue. In addition beta blocker metoprolol is better than atenolol. You are not on any ace inhibitor. Ace inhibitor group of drugs (ramipril, perindopril etc) in proper dose is also an important drug for you. You should get in touch with your treating doctor regarding these suggestions. Continue the regular exercise programme and maintain an ideal weight.