Last week I took care of two patients with very significant heart disease.
1. 34 year-old male with a strong history of premature coronary heart disease presented with a large acute heart attack. I took him emergently to the cath lab and an angiogram revealed that he had a totally blocked proximal LAD (the most important artery feeding the heart muscle). He required an angioplasty and stent to open the artery.
2. A 29 year old (just one day shy of his 30th birthday) presented with chest pain, shortness of breath and swelling in his ankles. He was clearly in heart failure on exam. He also had evidence of a leaky aortic valve. With the aid of a STAT echocardiogram in the ER, I diagnosed him with an acute proximal thoracic aortic dissection (a tear in his aorta), a huge thoracic aortic aneurysm, severe aortic insufficiency and a large, boggy, poorly functioning heart. He was taken emergently to the operating room where Dr Coady replaced his aorta and his aortic valve.
Both patients did remarkably well and walked out of the hospital.
Nevertheless, it gives me pause when time and again I am reminded that you are never to young to escape the rath of heart disease.