I recently watched these videos. In them, cardiologist Dr. S. Ramasamy shares clear explanations about heart attacks and their treatment options such as angioplasty, stents, bypass surgery, blood vessel blockages, and blood clots that may result from them. He also discusses how to approach doctors’ advice when blockages are found in the coronary arteries. These are not my recommendations—I'm merely sharing the information. At times, I’ve also added my personal opinions, but they should not be considered medical advice—only my personal thoughts.
In general, when a patient has over 70% blockage in three arteries, most cardiologists will recommend bypass surgery without hesitation. If not, they may suggest angioplasty and placing a stent.Based on Dr. Ramasamy’s advice, here’s what I’ve understood:
Even if there are blockages in the coronary arteries, if they don’t cause symptoms like chest pain or breathlessness, and if blood flow to the heart is not significantly reduced, and the EF (ejection fraction) ratio is above 55%, then stents or bypass surgery may not be necessary. However, regular exercise, prescribed medications, and a heart-healthy diet are essential. Smoking and alcohol should be avoided as much as possible.
If the EF ratio falls below 40% and blood flow to the heart is significantly reduced, leading to weakened heart muscles and uncontrollable chest pain, only then might surgical interventions like bypass or stenting be required.
(According to Dr. Pradip Jamnadas, MD, a renowned U.S.-based cardiologist, regardless of the percentage of blockage, the critical factor is how much blood is flowing through the blocked artery, measured using FFR (Fractional Flow Reserve). Only if the FFR value is less than 0.8, a stent should be considered. If it is above 0.8, a stent is not necessary. In such cases, lifestyle modifications like exercise, medication, healthy diet, and avoiding smoking are the best ways to manage it.)
Because I find this advice reasonable, I am sharing the videos.
I also believe that automatically opting for bypass surgery just because three arteries are blocked is not the right approach. Only if all three are major arteries, the blood flow is significantly reduced, and the heart's pumping efficiency is below 40%, should bypass be considered essential—to restore blood flow, strengthen heart function, and maintain heart health.
(Also worth noting: even if there’s a blockage in one major artery and two minor branches, some doctors still label it as a triple-vessel disease, which I now believe is incorrect—something I learned from a conversation with ChatGPT.)
Bypass surgery cannot prevent a heart attack. A heart attack occurs when a blockage ruptures, forming a clot that completely stops blood flow (100%).
Mental stress is a major contributor to heart attacks.
Studies show that young individuals under 40 can also suffer heart attacks even with mild blockages. The reason: these blockages are not stable or solid. When they rupture and form clots, they can cause 100% blockages—leading to heart attacks.
These are the key points I learned from the interviews:
Dr. S. Ramasamy’s Interview (in Tamil): https://www.youtube.com/watch?v=D3YknuwKLnE
Dr. Pradip Jamnadas, MD’s Video (in English): https://www.youtube.com/watch?v=buzfmeTpyCw
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