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Monday, April 27, 2009

You're never to old for the "big one"

This past weekend I took care of a 47 year male in the early stages of a large heart attack. On the outside he appeared to be a healthy and fit guy. However, on the inside, he had a huge clot in his proximal left anterior descending artery -- a lesion we call the "widow maker." Think Tim Russert.

Heart attackes (myocardial infarctions/MI's) come in many different flavors. The ones that we all worry about are the acute ST elevation MI's (think Sanford and Son). This is when a cholesterol plaque ruptures and in the process of thrying to heal the crack in the innner lining of the wall of the artery -- a large clot froms. This clot can end up filling up the enite inside (lumen) of the artery and choke the heart muscle (myocardium). If not treated quickly, permanent damage will occur. Watch the animation below to see this process in action:


video

My job is to quickly and safely get in that artery and open it up with a balloon and a stent. Watch the animation below to view a stent being deployed.

video

How could this have been prevented?

My patient did have a family history of heart disease and high cholesterol.

In my patients, I help assess their risk of "cardiovascular events" with the following:

  • cholesterol levels
  • highly sensitive CRP (marker of inflammation)
  • stress test
  • carotid ultrasound
  • review of risk factors: smoking history, blood pressure, diabetes
  • family history
  • physical activity levels
  • eating habits

Please consult with your doctor to evaluate your risk of heart disease.

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