The patient was seen seven years later, and the cardiologist reported the patient was doing quite well with occasional shortness of breath upon exertion. The LAD remained totally occluded, the circumflex was a small vessel and it was not possible to do an angioplasty on that vessel. The patient returned to the cardiologist two years later for a repeat cardiac catheterization. He was discharged without further procedures under medical therapy. This catheterization showed a totally occluded left anterior descending coronary artery no advancement in the 40% to 50% narrowing of the circumflex some evidence of re-stenosis in the proximal one-third of the very large coronary artery which was diffusely diseased and a 50% to 70% lesion at the site of the previous angioplasty. Nine months later, the patient returned to the cardiologist for repeat cardiac catheterization. The patient had right and left heart catheterization, coronary arteriography, and percutaneous translumenal coronary angioplasty. His ejection fraction was less than 20%, and he had unstable angina. Four years after the first MI, he came to a new cardiologist, the defendant in this case.Ī cardiac catheterization showed 99% proximal right coronary artery disease with a 90% circumflex lesion, a 70% diagonal branch and total occlusion of the left anterior descending coronary artery.
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He was treated medically without invasive procedures. He had recurrent chest pain a year later and underwent a work up to rule out MI. Texas Medical Liability Trust Resource HubĪ patient had a long-standing history of coronary artery disease, suffering his first myocardial infarction (MI) at age 47.