Heart Month: A Tale of 14 Hours and 14 Aspirin Part Three

Heart Month: A Tale of 14 Hours and 14 Aspirin Part Three
Image courtesy of Mayo Clinic

To see the key for the above illustration, click here.  If you missed parts one and two of this story, I'll summarize them for you in a few quick sentences:

I didn't believe a fit 43 year-old cyclist could suffer a heart attack (despite a strong family history of heart disease).  I ignored two of the classic warning signs and postponed seeking treatment for 14 hours.  I had three blockages which required an angioplasty and three stents, but I had yet to find out the total damage done to my heart.

When I woke up lying flat on my back in a twin size bed on the morning of August 9, 2009, it took a moment or two for me to adjust to my surroundings.  Ordinarily, I'm not surprised to awaken in an unfamiliar room as I travel frequently for work.  But even the cheapest hotels I stay in don't have guardrails on the beds.

Slowly, it all came back to me.  My loved ones hovering over my bed, looking as if they had seen a ghost.  The phlebotomist who drew samples continually throughout the night.  The EKG tech who attached color-coded wires to the matching post-it patches that stretched from my neck to my feet.  The night nurse who woke me up to ask how I'd been sleeping.    Everywhere I turned there was evidence that I had, in fact, suffered a heart attack.

The only thing that didn't make sense was how and why this had happened to me.

The "how" part is actually pretty straightforward.  At some point in time, inflammation developed in an artery.  Cholesterol sped to the scene and applied itself as a band-aid to the wound.  More cholesterol piled on, causing a buildup of plaque and a narrowing of the artery.  While the plaque continued to build, blood vessels continued to grow within the plaque.  The plaque ruptured and a blood clot was formed.

The clot formed a blockage that prevented blood from flowing to the myocardium (heart muscle).  Deprived of oxygen where the blood flow had been cut off, heart muscle began to die.  While my heart continued to pump blood through a narrower opening, it also routed blood through smaller blood vessels, even forming new vessels to nourish the affected area.  This was when I began to experience chest and angina pain.

Had an electrical impulse (synapse) been interrupted by the disruption of blood flow to the heart muscle, I would have suffered cardiac arrest.  Until blood flow was restored through the reopening of the blocked artery during the emergency angioplasty, my heart muscle continued to die.

There is no question that the fourteen aspirin helped keep the blood flowing - although the cardiologist stated that one would have been sufficient.  He also concurred with me that had my heart muscle not been conditioned through nine years of bicycling, I may not have survived as long as I did.

So how long had there been plaque buildup in my arteries?  What caused the inflammation to begin with?  How could I have known that I was at risk?

When I arrived in the ER, a lipid profile was derived from a blood sample.  My HDL - the good cholesterol  - was low at 37 (should be greater than 40).  But my LDL - the bad cholesterol - was very low at 78 (well less than the <200 recommended).  The problem was with my triglycerides.  At 279, this level was nearly double the high end of the recommended range.

High triglycerides and low HDL is a deadly combination for heart disease.

Had I routinely taken advantage of discreet screenings offered by organizations like Life Line Screening, I may have become alerted to my risk factors.  I would have then had the opportunity to change my diet which likely would have prevented my heart attack.  My own health scare prompted my fiance, Nancy, to do just that.

Life Line offers a range of services from a basic lipid profile to C-Reactive Protein screening.  Nancy's experience with them was wonderful and she found out that she was in far better health than I had been even at my peak eight years earlier (she did receive preferred plus life insurance status).  It gave her peace of mind in planning our future together.

At this point, I understood how my heart attack occurred.  I also learned what I could have done to determine my risk factors and likely prevent it.  I still didn't know the answer to the all important question - why?  

It would take quite awhile into my recovery to begin to find the answer to this question.  It would also take a little more time to understand the full extent of the damage done to my heart muscle.

Read more in Part Four.

 

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