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I had a heart attack this weekend... (1 Viewer)

I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
 
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Another thing - when going to the hospital make sure someone is with you to hear what the medical people are saying to you. You'll hear one thing, but might not hear/remember it like someone else will because you're busy being sick.

Thank goodness for my wife. Her insistence on knowing EVERY SINGLE DETAIL sometimes annoys the crap out of me, but having her at the hospital was invaluable. She actually diagnosed "gallbladder" way before it came out of the doctors' mouths. She had experiences if her own and learned a ton helping her parents with their similar health issues. The doctors were impressed with the questions she asked. And now setting up the post hospital follow up stuff - well I wouldn't have even known where to start.

But I'm still not going to eat more vegetables. :yucky:
 
My dad's heart attack manifested as belching. He didn't feel well, so off to the hospital he went. Go early on and prevent something worse.
Strangely enough, I noticed the same during my walks. I was belching more than normal but didn't see anything online that connected the two, so I thought it was just a coincidence. Maybe not?
Not a coincidence. It's just not something that is mentioned a lot.
 
I’d also ask about having a Lipoprotein a checked. It’s a blood test for a specific type of cholesterol that's implicated in early vascular disease. FTR, 54 isn’t actually considered early by all definitions of “young” heart attack, whose cut-offs range from 45-55 years old. This may just be a “normal” middle-aged heart attack. Anyway, if Lp a ends up being elevated, you may qualify for other lipid-lowering meds, as statins don’t work.
There are a bunch of Lp(a)-lowering drugs currently in the pipeline, so in about 2 years there will be a lot more options for people with high Lp(a) than there are now.

The other big aspect of "residual risk" is inflammation -- LDL-lowering and blood pressure-lowering drugs don't address it. If you have high levels of C-reactive protein, then you probably also have inflammation-related risk for a heart attack or stroke. Right now that's being addressed with colchicine (normally a gout drug), but other treatments are on the way.
 
I'm 54 years old, 6'2", 240 lb. I walk 4 miles daily and have been doing that for the past 5+ years. My diet is good, not great. I eat all of the right things (fruits, veggies, fiber, lean meats, etc.), but I also eat plenty of bad ones (red meat, carbs, sweets, etc). I don't smoke and drink moderately ie. 4-5 drinks/week.

My last blood panel I took a few months ago showed elevated cholesterol and triglycerides, but not crazy high. At the advice of my PCP (who also happens to be a cardiologist), I started taking a statin about 3 months ago.

While I can't say I never thought about the possibility of having a heart attack at some point, I certainly didn't think it was going to happen when I was 54.

I start every morning with the 4-mile walk. It usually takes 1 hour and 10 minutes. On Friday, I worked from home, so I set out as usual, around 6:30a. About 15 minutes in, I started feeling a slight pain in my upper left chest area. It wasn't too painful, maybe a 3 out of 10 on my pain scale. Noticeable but not concerning. I thought I may have slept wrong and irritated a muscle, so I didn't think about it too much. About 40 minutes through the walk, I stopped at a bench along the water to have a seat and do my daily Wordle. Once I started going again, I didn't feel the pain anymore. That was it, so I thought.

Saturday morning, I did the same thing. I woke up, although I slept in a little bit and didn't leave until around 7:30a or so. At about the same time along my walk, I noticed the pain flare up again. Same spot, same intensity. Same duration, for the most part. I thought it was strange, but after it went away at about the same time as the day before, I didn't think much about it.

Saturday evening, my wife and I headed over to our friend's wine bar. It was their grand opening, and since we have been helping them with the business side of things to get it started, we planned on working that night to help things run smoothly. My wife and I were there for about 6 hours and left around midnight. Probably around 11:45p, while I was sitting and waiting for my wife to finish up, I started getting those same chest pains again. Plus I was hot (it was pretty warm and humid in Miami for this time of year) and starting to get a little cranky because I was getting pretty tired. It was past my bedtime! We started walking to the car, and the pain continued. Again, it had a similar intensity, maybe closer to a 4/10. We hopped in the car and started driving home, and the pain subsided. It probably lasted 20 minutes or so total At this point, my concern level started rising a bit as it was the third time in two days. I sensed something wasn't right but as a typical guy, I was brushing it off somewhat, albeit with a slightly higher anxiety level attached to it.

After I got home, I went upstairs to the bedroom to change clothes and lay on the bed. A few minutes later, my wife came upstairs, and we talked about how the night had gone. For some reason, she asked if I was feeling alright, and I told her I was having some slight chest pains. Maybe she sensed something was off? Without hesitation, she said, "We are going to the ER". I hemmed and hawed for about a minute before deciding something wasn't right. I got dressed, and off we went. The local ER is only about 10 minutes from our house. I walked in upon arrival (it wasn't busy) and mentioned to the person at the desk I was having chest pains. Within 2-3 minutes, I was hooked up to an EKG in one of the examination rooms. Shortly after that, the technician told me I was having a heart attack. I was a little shocked but calm. It certainly wasn't what I thought happened when someone was having a heart attack. I wasn't in a crazy amount of pain or felt the need to clutch my chest like you see on TV or in movies.

Five minutes later, I was being prepped for surgery, and 4-5 people were swarming around, getting me ready and shaving my wrists, shaving my groin area, drawing blood, and asking health questions. The on-call cardiologist and his team were also called in (thank god it was the middle of the night and not a high-traffic time in Miami). It was quite a site to see the choreography of everyone working together. After about 10 minutes, they wheeled me into the operating room, where I was further prepped. About 10 minutes later, the surgeon showed up, explained what he would do, asked if I understood, ensured I agreed to the procedure, and off we went.

I ended up getting three stents inserted. Two were on the right side and one on the left. Thankfully, the widowmaker (left anterior descending) LAD artery was "only" 50% blocked; otherwise, I probably would not have made it to the operating table. The two on the right that received stents were 76% and 100% blocked. The doctor went up through my right wrist versus having to go up through the pelvic artery (hence the reason they had to shave there also) , and I was awake through the whole process. It probably took 45 to 60 minutes tops.

I spent all of Sunday in the hospital for recovery and was discharged earlier today (Monday). I feel like nothing happened despite two small needle holes on the inside of my elbows where the IVs were connected and one small hole, almost imperceptible, on my right wrist where the catheter and balloon were inserted. It's truly amazing to think about the technology that exists to eliminate all three blockages, insert the stents, and allow me to come home the day after what could have been a fatal problem.

Going forward, I'm going to have to change my diet considerably. The doctor mentioned that if I hadn't walked as much as I do, this would have happened earlier as it's most likely genetic that the arteries were clogged as much as they were at such a young age. As mentioned earlier, my diet isn't bad; however, I'm going to have to severely reduce red meat consumption, salt intake, high-sugar items, etc. That's going to be a tough one as my wife and I both love cooking, trying new restaurants and just enjoy food. It's one of our passions that we will just have to enjoy differently now. I'm going from having to take one prescription per night (that I frequently forgot about) to taking five. I'm adding a higher dosage of Lipitor, multiple blood thinners, anti-coagulants, and a beta-blocker.

I typed all of this out to remind my fellow FBG'ers that these things are possible at an early age, at ANY age, and that you need to take care of your body. Even if you think you are, when you are pre-disposed to something, whether you know it or not, you may have negative results that you aren't expecting. I'm thankful that I am here and am blessed that I can continue with my life. My father passed away the day before Thanksgiving last year (2024), and damn, that would have sucked to have followed him to the grave only two short months afterward. He was 79 and had numerous other health issues that I have been able to avoid, so hopefully, I'm good for now. It took 54 years for my arteries to get clogged as much as they were, so hopefully, these stents are suitable for at least another 54, lol. I was thinking earlier today that I have already experienced cancer (skin cancer) and a heart attack at a relatively young age but I have so much more life to live. I owe it to myself, my wife, my son, and my mom to ensure that I do everything possible to allow for a good life for at least 25-30 more years. I won't let all of my hard-earned retirement money go to waste!

After my father passed, I have been thinking about how I can FIRE earlier (Financial Independence, Retire Early) so this incident may move up that projected timeframe a bit.

Alright, that's it. Thanks for listening. If you have any questions, fire away!
Man - we have a lot in common. I had a widowmaker 5 years ago. My ER and angio experience was exactly yours. LAD was 100% blocked. In November I had surgeries to cut out and repair invasive melanoma. Dodged 2 bullets. Every day is a blessing.

I’m 5 years in on the post heart attack journey so DM me anytime. We sound similar in that very active but carried a bit too much weight. For me blood pressure was harder to control than cholesterol. My blood pressure spiked when I had sciatica years ago and never regulated normally after that.

Good news, my cardiologist told me that for some people it’s a one time thing. Just do the right things and monitor. It is an absolute mind fvck at first. You go to cardiac rehab. Hooked to heart monitors all time. You’re afraid of going too hard and having another one. Same with sex. It just affects you mentally for months. But it goes away.

You’ll be shocked the people in cardiac rehab don’t look like you’d think. Half were petite women. Or guys that looked in good shape. Genetics do play a big part and an artery can go from 25% blocked to 100% in an instant if plaque breaks off.

My cardiologist is the same doctor who performed my emergency procedure. She’s great. We’ve worked on getting LDL to under 50. Put me on Repatha to help. Triglycerides under 100. And monitor blood pressure. Had to take readings daily and tweak meds. I was just at the dentist and BP was 125/75. I’ll take it.

Stick to your meds and be religious with rehab. I basically didn’t eat red meat for a year. Now in moderation. I don’t smoke (big no no for heart patients) and you have to watch drinking too (especially binge drinking). Don’t know what your A1C is but my doctor cares about that more than anything.
 
I do EKG/ultrasound and stress tests annually.
You can live well for another 40 years. It’s really scary to go through. More mental than physical. Knowing you could have left your family that day is a big wake up call. Thank God your wife insisted. For me it happened right after a vigorous Peloton class. Couldn’t stop sweating even after showering. Some chest pain but it felt like indigestion. But I knew something wasn’t right with the sweating and told the Mrs we have to go to the hospital. Same as you. 3 min from my house and the team had me on a board, EKG, shaved and wheeled in within minutes. Time is tissue with heart attacks. Glad you acted fast!
 
I’d also ask about having a Lipoprotein a checked. It’s a blood test for a specific type of cholesterol that's implicated in early vascular disease. FTR, 54 isn’t actually considered early by all definitions of “young” heart attack, whose cut-offs range from 45-55 years old. This may just be a “normal” middle-aged heart attack. Anyway, if Lp a ends up being elevated, you may qualify for other lipid-lowering meds, as statins don’t work.
There are a bunch of Lp(a)-lowering drugs currently in the pipeline, so in about 2 years there will be a lot more options for people with high Lp(a) than there are now.

The other big aspect of "residual risk" is inflammation -- LDL-lowering and blood pressure-lowering drugs don't address it. If you have high levels of C-reactive protein, then you probably also have inflammation-related risk for a heart attack or stroke. Right now that's being addressed with colchicine (normally a gout drug), but other treatments are on the way.
I’m aware elevated hs-CRP is an independent risk factor for CV events, but I didn’t know there was data in its role for treatment, primary or secondary prevention. To be fair, that data is emerging for Lp(a) as well.

Any good references you can recommend for the state-of-the-science?
 
close call……may i ask, family history? prior to 3 months when you started meds, take any other meds for BP or Cholesterol? i’m asking because i have family history and i’ve been taking BP meds and lipitor for close to 30 years now, i’m a bit older than you. is this out of the blue family wise?

also, to lighten the mood, you’d be a perfect fit for the fbg cake magic baseball league! what with the heart attack, hospitalization and all. ;)
No, I wasn't taking any medication. When I had my previous blood test in 2022, I was prescribed a statin however I wasn't very diligent in taking it. I think I may have taken it until the prescription ran out and then never got it filled again. When I went back for a follow-up blood test last year and the numbers were similar, the doctor prescribed the statin again and I was more diligent in taking it each day.

My dad had a myriad of health problems (kidney/diabetic/morbidly obese, etc.) however he has always had health issues, none of which seem to have been passed along. I am considered pre-diabetic also but that has been going on for quite a few years and hasn't blown up into full diabetes where I require insulin.
Just saw the last paragraph. Trust me on this. You need to drop weight and get your A1C down. Heart issues and diabetes are a terrible combination. You don’t want that. My A1C has been around 5.9 for last several years. I want low 5’s. I had my heart attack at 57. 6’1”, probably 220 at the time. All time high was 240 a decade earlier. I carried it well, was pretty fit, etc. I’m 208 now and committed to have a walking around weight of 190. If they offer you Ozempic I’d strongly consider it. Sure you’ll lose weight but the A1C lowering is the bigger prize. Those extra 20-40 pounds take such a toll on your health. Took me way too long to get real about that. I focused on limited red meat, no white flour, no added sugar, limited alcohol. It works and still enjoy great foods. Great news is you’re already active. Important to keep moving.
 
I’d also ask about having a Lipoprotein a checked. It’s a blood test for a specific type of cholesterol that's implicated in early vascular disease. FTR, 54 isn’t actually considered early by all definitions of “young” heart attack, whose cut-offs range from 45-55 years old. This may just be a “normal” middle-aged heart attack. Anyway, if Lp a ends up being elevated, you may qualify for other lipid-lowering meds, as statins don’t work.
There are a bunch of Lp(a)-lowering drugs currently in the pipeline, so in about 2 years there will be a lot more options for people with high Lp(a) than there are now.

The other big aspect of "residual risk" is inflammation -- LDL-lowering and blood pressure-lowering drugs don't address it. If you have high levels of C-reactive protein, then you probably also have inflammation-related risk for a heart attack or stroke. Right now that's being addressed with colchicine (normally a gout drug), but other treatments are on the way.
I’m aware elevated hs-CRP is an independent risk factor for CV events, but I didn’t know there was data in its role for treatment, primary or secondary prevention. To be fair, that data is emerging for Lp(a) as well.

Any good references you can recommend for the state-of-the-science?
Search Paul Ridker on PubMed, he’s the leading US voice on inflammation and cardiovascular risk.

The two most important trials supporting colchicine as a heart-related treatment are COLCOT and LoDoCo2.
 
Glad you caught it early. I don't think there's any way I could do the procedure awake though. Kudos!
They won’t put you under for that. It’s relatively painless. Fascinating to watch on the screen. You can see the stent going in and when it’s placed it’s instant relief as the blood starts flowing
I asked to be awake when they did my angiogram. Doc said ok, but if you move at all, night night. I saw the beginning but fell asleep. Or he put me under. It’s a trip to watch the monitors.
 
I’d also ask about having a Lipoprotein a checked. It’s a blood test for a specific type of cholesterol that's implicated in early vascular disease. FTR, 54 isn’t actually considered early by all definitions of “young” heart attack, whose cut-offs range from 45-55 years old. This may just be a “normal” middle-aged heart attack. Anyway, if Lp a ends up being elevated, you may qualify for other lipid-lowering meds, as statins don’t work.
There are a bunch of Lp(a)-lowering drugs currently in the pipeline, so in about 2 years there will be a lot more options for people with high Lp(a) than there are now.

The other big aspect of "residual risk" is inflammation -- LDL-lowering and blood pressure-lowering drugs don't address it. If you have high levels of C-reactive protein, then you probably also have inflammation-related risk for a heart attack or stroke. Right now that's being addressed with colchicine (normally a gout drug), but other treatments are on the way.
I’m aware elevated hs-CRP is an independent risk factor for CV events, but I didn’t know there was data in its role for treatment, primary or secondary prevention. To be fair, that data is emerging for Lp(a) as well.

Any good references you can recommend for the state-of-the-science?
Search Paul Ridker on PubMed, he’s the leading US voice on inflammation and cardiovascular risk.

The two most important trials supporting colchicine as a heart-related treatment are COLCOT and LoDoCo2.
One side effect I had when I went through a gout phase :lmao: and took colchicine, was nearly instant diarrhea. Not relevant I know but seeing this just made me remember that. :mellow:
 
I’d also ask about having a Lipoprotein a checked. It’s a blood test for a specific type of cholesterol that's implicated in early vascular disease. FTR, 54 isn’t actually considered early by all definitions of “young” heart attack, whose cut-offs range from 45-55 years old. This may just be a “normal” middle-aged heart attack. Anyway, if Lp a ends up being elevated, you may qualify for other lipid-lowering meds, as statins don’t work.
There are a bunch of Lp(a)-lowering drugs currently in the pipeline, so in about 2 years there will be a lot more options for people with high Lp(a) than there are now.

The other big aspect of "residual risk" is inflammation -- LDL-lowering and blood pressure-lowering drugs don't address it. If you have high levels of C-reactive protein, then you probably also have inflammation-related risk for a heart attack or stroke. Right now that's being addressed with colchicine (normally a gout drug), but other treatments are on the way.
I’m aware elevated hs-CRP is an independent risk factor for CV events, but I didn’t know there was data in its role for treatment, primary or secondary prevention. To be fair, that data is emerging for Lp(a) as well.

Any good references you can recommend for the state-of-the-science?
Search Paul Ridker on PubMed, he’s the leading US voice on inflammation and cardiovascular risk.

The two most important trials supporting colchicine as a heart-related treatment are COLCOT and LoDoCo2.
One side effect I had when I went through a gout phase :lmao: and took colchicine, was nearly instant diarrhea. Not relevant I know but seeing this just made me remember that. :mellow:
Yep. GI side effects very common from colchicine. I had no issues when I took it post ablation.
 
I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
Finally have my wife’s ear and she is going next week. I was on the bad side of my demographic when I had mine. I had several years where my cholesterol was over 300, so I’m assuming that’s when The damage was done. Since being on a low dose statin, it’s in the 130 area now. I’m not sure if the test is perfect or not but I think it’s a good start point to see if you have anything going on. Glad you’re okay.
 
I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
Finally have my wife’s ear and she is going next week. I was on the bad side of my demographic when I had mine. I had several years where my cholesterol was over 300, so I’m assuming that’s when The damage was done. Since being on a low dose statin, it’s in the 130 area now. I’m not sure if the test is perfect or not but I think it’s a good start point to see if you have anything going on. Glad you’re okay.
FTR, coronary calcium scoring, like all diagnostic tests, has specific indications. Insurers have started paying for them, so they're being ordered much more often, but also have risk associated with incidental findings in asymptomatic, low risk individuals. So they aren't universally recommended. American Heart Association summary: (emphasis added)
A CAC test can measure the amount of calcium in your heart arteries (“calcium score”). Your calcium score gives your health care team an idea of how much plaque is in your heart arteries and may help predict your risk of a future heart attack. Your CAC score can help you determine your risk of cardiovascular disease. It’s particularly helpful if you’re at “intermediate” risk.

CAC testing is useful for making treatment decisions, such as whether to start low-dose aspirin, statin therapy or other medications. These are some groups where it may be useful:
  • People reluctant to begin statin therapy and who want to understand their risk and potential benefit more precisely.
  • People concerned about restarting statin therapy after stopping treatment because of side effects.
  • Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
  • People ages 40 to 55 with an estimated 10-year risk for developing heart disease between 5% and 7.5%, and risk factors that increase their chances of heart disease.
Calcium scoring isn’t recommended for routine screening of people who don’t have symptoms of heart disease and have a low risk of heart attacks unless they have a strong family history of premature coronary heart disease. If you’ve already had a heart attack, coronary bypass surgery (PDF) or a coronary stent calcium scoring won’t provide additional information.
Pooled cohort equation for for determining risk of coronary artery disease
 
I don't know what @Senor Schmutzig's "not crazy high" cholesterol numbers were, but there's an argument made that we should all be targeting as low as possible, with LDL eg. "bad cholesterol" less than 70. Some of the longevity guys try to push it even lower. For reference, 100 is the typical upper limit of normal.

This accounts for the the high lifetime risk of coronary artery disease. For example, my current 10-year risk is "low" at 2% by the pooled risk equation, but lifetime risk still is 36%!

ETA Using the PREVENT calculator (thanks @Pip's Invitation) my 30 year risk is better, 11.4%.
 
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I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
Finally have my wife’s ear and she is going next week. I was on the bad side of my demographic when I had mine. I had several years where my cholesterol was over 300, so I’m assuming that’s when The damage was done. Since being on a low dose statin, it’s in the 130 area now. I’m not sure if the test is perfect or not but I think it’s a good start point to see if you have anything going on. Glad you’re okay.
FTR, coronary calcium scoring, like all diagnostic tests, has specific indications. Insurers have started paying for them, so they're being ordered much more often, but also have risk associated with incidental findings in asymptomatic, low risk individuals. So they aren't universally recommended. American Heart Association summary: (emphasis added)
A CAC test can measure the amount of calcium in your heart arteries (“calcium score”). Your calcium score gives your health care team an idea of how much plaque is in your heart arteries and may help predict your risk of a future heart attack. Your CAC score can help you determine your risk of cardiovascular disease. It’s particularly helpful if you’re at “intermediate” risk.

CAC testing is useful for making treatment decisions, such as whether to start low-dose aspirin, statin therapy or other medications. These are some groups where it may be useful:
  • People reluctant to begin statin therapy and who want to understand their risk and potential benefit more precisely.
  • People concerned about restarting statin therapy after stopping treatment because of side effects.
  • Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
  • People ages 40 to 55 with an estimated 10-year risk for developing heart disease between 5% and 7.5%, and risk factors that increase their chances of heart disease.
Calcium scoring isn’t recommended for routine screening of people who don’t have symptoms of heart disease and have a low risk of heart attacks unless they have a strong family history of premature coronary heart disease. If you’ve already had a heart attack, coronary bypass surgery (PDF) or a coronary stent calcium scoring won’t provide additional information.
Pooled cohort equation for for determining risk of coronary artery disease
The PREVENT equation was introduced in late 2023 and is designed to replace the PCE. It projects risk up to 30 years and includes risk for conditions beyond ischemic heart disease such as heart failure.

CAC scoring is generally considered for use as a “tiebreaker” if it’s not clear whether someone should be on a statin. For those people, if your CAC score is 0, you don’t need to be on a statin yet.
 
Another thing - when going to the hospital make sure someone is with you to hear what the medical people are saying to you. You'll hear one thing, but might not hear/remember it like someone else will because you're busy being sick.

Thank goodness for my wife. Her insistence on knowing EVERY SINGLE DETAIL sometimes annoys the crap out of me, but having her at the hospital was invaluable. She actually diagnosed "gallbladder" way before it came out of the doctors' mouths. She had experiences if her own and learned a ton helping her parents with their similar health issues. The doctors were impressed with the questions she asked. And now setting up the post hospital follow up stuff - well I wouldn't have even known where to start.

But I'm still not going to eat more vegetables. :yucky:
This is really good advice AD.

When my dad had a heart attack, he and my mom called to talk about it a day or two later. I asked “what happened? What’s the diagnosis?” My dad said “well, it was a minor cardiac thing, but at least they never used the words heart attack.” And my mom replied “yes, they did. That’s exactly what they called it and what it was, word for word. It was a heart attack.”

To this day it still amazes me. And I’m grateful she was there to a) make him go to the ER in the moment, b) hear the diagnosis.


As an aside, my dad tried to blame the heart attack on his decision to quit smoking a year earlier. He told his doctor “this is your fault for making me quit smoking.” His doctor replied: “you’re still alive though right? So shut up and take the win.”
 
I don't know what @Senor Schmutzig's "not crazy high" cholesterol numbers were, but there's an argument made that we should all be targeting as low as possible, with LDL eg. "bad cholesterol" less than 70. Some of the longevity guys try to push it even lower. For reference, 100 is the typical upper limit of normal.

This accounts for the the high lifetime risk of coronary artery disease. For example, my current 10-year risk is "low" at 2% by the pooled risk equation, but lifetime risk still is 36%!
LDL was at 105 on the lipid panel they took this weekend. It was 159 when I started taking the statin in October.
 
Thanks for posting this and glad you are ok @Senor Schmutzig .

Been fighting a sinus infection and went to the doctor yesterday. Been feeling like crap for 10 days. Blood pressure was crazy high, which has been "normal" when I go to the doctor (white coat syndrome).

I have a blood pressure monitor at home and I usually check it when I get home to make sure I'm back where it should be. Did it last night and I'm still running a little hot (but not as bad as at the doctor). Ran it again this morning and still a little high. Based on a blood pressure chart I'm in the elevated to hypertension stage 1 area.

Considering some life stress going on right now, I'm not surprised. BUT, your post certainly has given me another point of motivation to pain more attention to this. I have a pretty active lifestyle and eat pretty well, but there are certainly areas of improvement.

So thanks again for posting that.
 
I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
Finally have my wife’s ear and she is going next week. I was on the bad side of my demographic when I had mine. I had several years where my cholesterol was over 300, so I’m assuming that’s when The damage was done. Since being on a low dose statin, it’s in the 130 area now. I’m not sure if the test is perfect or not but I think it’s a good start point to see if you have anything going on. Glad you’re okay.
FTR, coronary calcium scoring, like all diagnostic tests, has specific indications. Insurers have started paying for them, so they're being ordered much more often, but also have risk associated with incidental findings in asymptomatic, low risk individuals. So they aren't universally recommended. American Heart Association summary: (emphasis added)
A CAC test can measure the amount of calcium in your heart arteries (“calcium score”). Your calcium score gives your health care team an idea of how much plaque is in your heart arteries and may help predict your risk of a future heart attack. Your CAC score can help you determine your risk of cardiovascular disease. It’s particularly helpful if you’re at “intermediate” risk.

CAC testing is useful for making treatment decisions, such as whether to start low-dose aspirin, statin therapy or other medications. These are some groups where it may be useful:
  • People reluctant to begin statin therapy and who want to understand their risk and potential benefit more precisely.
  • People concerned about restarting statin therapy after stopping treatment because of side effects.
  • Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
  • People ages 40 to 55 with an estimated 10-year risk for developing heart disease between 5% and 7.5%, and risk factors that increase their chances of heart disease.
Calcium scoring isn’t recommended for routine screening of people who don’t have symptoms of heart disease and have a low risk of heart attacks unless they have a strong family history of premature coronary heart disease. If you’ve already had a heart attack, coronary bypass surgery (PDF) or a coronary stent calcium scoring won’t provide additional information.
Pooled cohort equation for for determining risk of coronary artery disease
The PREVENT equation was introduced in late 2023 and is designed to replace the PCE. It projects risk up to 30 years and includes risk for conditions beyond ischemic heart disease such as heart failure.

CAC scoring is generally considered for use as a “tiebreaker” if it’s not clear whether someone should be on a statin. For those people, if your CAC score is 0, you don’t need to be on a statin yet.
Thanks for the updated risk equation.

You’re absolutely right about how CAC should be used used, but since insurers have been paying, they’re now being over-ordered imo, just like EKGs and conventional stress tests. Coronary CTAs seem to be better regulated.
 
Another thing - when going to the hospital make sure someone is with you to hear what the medical people are saying to you. You'll hear one thing, but might not hear/remember it like someone else will because you're busy being sick.

Thank goodness for my wife. Her insistence on knowing EVERY SINGLE DETAIL sometimes annoys the crap out of me, but having her at the hospital was invaluable. She actually diagnosed "gallbladder" way before it came out of the doctors' mouths. She had experiences if her own and learned a ton helping her parents with their similar health issues. The doctors were impressed with the questions she asked. And now setting up the post hospital follow up stuff - well I wouldn't have even known where to start.

But I'm still not going to eat more vegetables. :yucky:
This is really good advice AD.

When my dad had a heart attack, he and my mom called to talk about it a day or two later. I asked “what happened? What’s the diagnosis?” My dad said “well, it was a minor cardiac thing, but at least they never used the words heart attack.” And my mom replied “yes, they did. That’s exactly what they called it and what it was, word for word. It was a heart attack.”

To this day it still amazes me. And I’m grateful she was there to a) make him go to the ER in the moment, b) hear the diagnosis.


As an aside, my dad tried to blame the heart attack on his decision to quit smoking a year earlier. He told his doctor “this is your fault for making me quit smoking.” His doctor replied: “you’re still alive though right? So shut up and take the win.”
Another recommendation is to have a notebook to write down as much as you understand and then repeat back what you heard. They throw a lot of info at you quickly and it's nice to be able to go back and review.
 
Thanks for posting this and glad you are ok @Senor Schmutzig .

Been fighting a sinus infection and went to the doctor yesterday. Been feeling like crap for 10 days. Blood pressure was crazy high, which has been "normal" when I go to the doctor (white coat syndrome).

I have a blood pressure monitor at home and I usually check it when I get home to make sure I'm back where it should be. Did it last night and I'm still running a little hot (but not as bad as at the doctor). Ran it again this morning and still a little high. Based on a blood pressure chart I'm in the elevated to hypertension stage 1 area.

Considering some life stress going on right now, I'm not surprised. BUT, your post certainly has given me another point of motivation to pain more attention to this. I have a pretty active lifestyle and eat pretty well, but there are certainly areas of improvement.

So thanks again for posting that.
No problem. That's exactly the reason I wanted to make that post. Many of us are in the same age category +/- 10 years, so if my message helps a few of you to take some preventative measures now to save you from something similar down the road, then mission accomplished.
 
Hey SS, I just saw the title and have not even had a chance to read the entire OP but I wanted to immediately send out my best thoughts and prayers your way
I'm so sorry to hear this has happened to you, I turned 50 this year and I can feel changes in my body like I've never felt previously
Mostly in the recovery time be it from exercise/healthy choices to drinking/unhealthy choices, there's pain now associated on both sides

I hope you make a full recovery
I know many in here will benefit from this thread and take it as a warning, you did an amazing thing by sharing this with others.

Get well and please take care of yourself
Hugs Hugs and more Hugs for you

Be Strong!
 
Read the entire OP now...Mrs Schmutzig deserves a medal(new car)
I had to travel to North Carolina to help a 40 year old friend recover from open heart surgery (no stints) this past October
Worst week of my life...Ok not the worst but it certainly was nominated

-You are one lucky SOB!

Try the Baker and Barista in Miami, I know you gotta watch your diet but since you are going to be eating a lot more turkey sandwiches you might as well have the best sourdough
 
A couple other points:

1) While Senor and I were driven to the ER because we we were close it is not recommended. I got scolded and was told next time call 911. They have everything they need to treat you right away, and they are communicating with the hospital to ready the cardiac rapid response team.

2) One sign that is often overlooked is indigestion. Belching, acid reflux, etc that has some chest pain and tightening. Many just try to walk it off or lie down and it’s game over. It’s not always the signs you often hear about.

3) There is usually a forwarning. Often in blood pressure or bloodwork. You and your doctors need to be all over those changes. Take it very seriously. The event can happen quickly after those signs.
 
I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
Finally have my wife’s ear and she is going next week. I was on the bad side of my demographic when I had mine. I had several years where my cholesterol was over 300, so I’m assuming that’s when The damage was done. Since being on a low dose statin, it’s in the 130 area now. I’m not sure if the test is perfect or not but I think it’s a good start point to see if you have anything going on. Glad you’re okay.
FTR, coronary calcium scoring, like all diagnostic tests, has specific indications. Insurers have started paying for them, so they're being ordered much more often, but also have risk associated with incidental findings in asymptomatic, low risk individuals. So they aren't universally recommended. American Heart Association summary: (emphasis added)
A CAC test can measure the amount of calcium in your heart arteries (“calcium score”). Your calcium score gives your health care team an idea of how much plaque is in your heart arteries and may help predict your risk of a future heart attack. Your CAC score can help you determine your risk of cardiovascular disease. It’s particularly helpful if you’re at “intermediate” risk.

CAC testing is useful for making treatment decisions, such as whether to start low-dose aspirin, statin therapy or other medications. These are some groups where it may be useful:
  • People reluctant to begin statin therapy and who want to understand their risk and potential benefit more precisely.
  • People concerned about restarting statin therapy after stopping treatment because of side effects.
  • Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
  • People ages 40 to 55 with an estimated 10-year risk for developing heart disease between 5% and 7.5%, and risk factors that increase their chances of heart disease.
Calcium scoring isn’t recommended for routine screening of people who don’t have symptoms of heart disease and have a low risk of heart attacks unless they have a strong family history of premature coronary heart disease. If you’ve already had a heart attack, coronary bypass surgery (PDF) or a coronary stent calcium scoring won’t provide additional information.
Pooled cohort equation for for determining risk of coronary artery disease
The PREVENT equation was introduced in late 2023 and is designed to replace the PCE. It projects risk up to 30 years and includes risk for conditions beyond ischemic heart disease such as heart failure.

CAC scoring is generally considered for use as a “tiebreaker” if it’s not clear whether someone should be on a statin. For those people, if your CAC score is 0, you don’t need to be on a statin yet.
Thanks for the updated risk equation.

You’re absolutely right about how CAC should be used used, but since insurers have been paying, they’re now being over-ordered imo, just like EKGs and conventional stress tests. Coronary CTAs seem to be better regulated.
Really wish FFR-CT would gain more traction. We're out here putting people on treadmills when we could be getting far more accurate and useful information to help better diagnose CAD. It's 2025 for crying out loud...
 
I reminder to everyone, it’s heart healthy month and you can get a calcium scan that is not evasive and will only take 5 minutes of your time and cost you $100. It’s well worth it in my opinion.

I remember that my doctor mentioned this a while back, but I didn't pay it any heed, thinking it wasn't necessary at the time. If I had done it a couple of years ago when it was suggested, maybe I would have taken the results seriously.

I just suggested to my brother (3 years younger, similar height/weight, habits as I have without the walking) that he have it done, so hopefully, he will be able to deal with any potential problems sooner rather than later.
Finally have my wife’s ear and she is going next week. I was on the bad side of my demographic when I had mine. I had several years where my cholesterol was over 300, so I’m assuming that’s when The damage was done. Since being on a low dose statin, it’s in the 130 area now. I’m not sure if the test is perfect or not but I think it’s a good start point to see if you have anything going on. Glad you’re okay.
FTR, coronary calcium scoring, like all diagnostic tests, has specific indications. Insurers have started paying for them, so they're being ordered much more often, but also have risk associated with incidental findings in asymptomatic, low risk individuals. So they aren't universally recommended. American Heart Association summary: (emphasis added)
A CAC test can measure the amount of calcium in your heart arteries (“calcium score”). Your calcium score gives your health care team an idea of how much plaque is in your heart arteries and may help predict your risk of a future heart attack. Your CAC score can help you determine your risk of cardiovascular disease. It’s particularly helpful if you’re at “intermediate” risk.

CAC testing is useful for making treatment decisions, such as whether to start low-dose aspirin, statin therapy or other medications. These are some groups where it may be useful:
  • People reluctant to begin statin therapy and who want to understand their risk and potential benefit more precisely.
  • People concerned about restarting statin therapy after stopping treatment because of side effects.
  • Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
  • People ages 40 to 55 with an estimated 10-year risk for developing heart disease between 5% and 7.5%, and risk factors that increase their chances of heart disease.
Calcium scoring isn’t recommended for routine screening of people who don’t have symptoms of heart disease and have a low risk of heart attacks unless they have a strong family history of premature coronary heart disease. If you’ve already had a heart attack, coronary bypass surgery (PDF) or a coronary stent calcium scoring won’t provide additional information.
Pooled cohort equation for for determining risk of coronary artery disease
The PREVENT equation was introduced in late 2023 and is designed to replace the PCE. It projects risk up to 30 years and includes risk for conditions beyond ischemic heart disease such as heart failure.

CAC scoring is generally considered for use as a “tiebreaker” if it’s not clear whether someone should be on a statin. For those people, if your CAC score is 0, you don’t need to be on a statin yet.
Thanks for the updated risk equation.

You’re absolutely right about how CAC should be used used, but since insurers have been paying, they’re now being over-ordered imo, just like EKGs and conventional stress tests. Coronary CTAs seem to be better regulated.
Really wish FFR-CT would gain more traction. We're out here putting people on treadmills when we could be getting far more accurate and useful information to help better diagnose CAD. It's 2025 for crying out loud...
The logistical issue with FFR-CT is that the technology is proprietary and the analysis is done in a central repository under control by the company. Some hospitals don't want to play ball with that. Plus the nuclear cardiologists have fought it because they think it will eliminate their jobs.

The next thing coming down the pike is CaRi-Heart, which uses AI to detect plaque and other abnormalities that are not visible to the human eye, and can predict risk for future cardiac events based on that. https://www.caristo.com/cari-heart-technology/
 
2) One sign that is often overlooked is indigestion. Belching, acid reflux, etc that has some chest pain and tightening. Many just try to walk it off or lie down and it’s game over. It’s not always the signs you often hear about.
weirdly, and maybe it's coincidental for the handful of people i now know who wound up in the same scenario.. this is similar to what drove them to the doctor... resulting in having their gall bladders taken out.

so far i know 4 people in the last handful of years who described it as "thought i was having a heart attack" but it was their gall bladder.

not to say one shouldn't go to the doctor for these symptoms, or try to minimize and have people saying "furley said this is just a gall bladder problem".. it's just weird.
 
2) One sign that is often overlooked is indigestion. Belching, acid reflux, etc that has some chest pain and tightening. Many just try to walk it off or lie down and it’s game over. It’s not always the signs you often hear about.
weirdly, and maybe it's coincidental for the handful of people i now know who wound up in the same scenario.. this is similar to what drove them to the doctor... resulting in having their gall bladders taken out.

so far i know 4 people in the last handful of years who described it as "thought i was having a heart attack" but it was their gall bladder.

not to say one shouldn't go to the doctor for these symptoms, or try to minimize and have people saying "furley said this is just a gall bladder problem".. it's just weird.
If you ever feel like you have food poisoning but you're not throwing up much or not vomiting bile, you probably have a gallbladder and/or pancreas issue.

I thought I had food poisoning last week. I had it before when I was a kid at hockey camp and it was a major barf-o-rama. Can you imagine a cabin full (we were in northern Minnesota) of kids all throwing up all night long. But even when the dry heaves kicked in there was still some bile that came out.

Thinking back to a couple years ago, what I thought was FP was more likely a gallbladder problem. I remember now that I felt similar, but I didn't really throw up. My stomach was in knots but no vomiting.

Last week, very similar thing. But, speaking to Furley's topic, I think what people think is a tightening in their chest is actually their pancreas reacting to a gallbladder problem. My pancreas had a freak out and the pain went across my stomach, just between my stomach and sternum - where the pancreas is.

Your gallbladder and pancreas typically share an entry point into the same bile duct that drains stuff out. If your GB passes a stone, that gets clogged and can affect the pancreas.
 
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Scary stuff buddy. Glad you are ok.

You said you had a physical a few months ago back. Did they do an EKG then? Would it have showed anything if they did?
EKGs aren’t part of routine physicals, and generally aren’t indicated. They can show evidence of prior heart attacks though.
Hey term, I'm sure it's not totally conclusive, but I've had a couple of EKGs done for surgery prep and there's been no flags. Would it have shown any previous "events"?
 
Scary stuff buddy. Glad you are ok.

You said you had a physical a few months ago back. Did they do an EKG then? Would it have showed anything if they did?
EKGs aren’t part of routine physicals, and generally aren’t indicated. They can show evidence of prior heart attacks though.
Hey term, I'm sure it's not totally conclusive, but I've had a couple of EKGs done for surgery prep and there's been no flags. Would it have shown any previous "events"?
For heart attacks, EKG changes are really only helpful in concert with symptoms. Chronic nonspecific changes are too common to be useful, and even a stone cold normal EKG cannot rule out a prior myocardial infarction.

Preoperative EKGs are done routinely for middle aged patients, and those with risk factors undergoing moderate to high risk procedures (like other cardiac testing, they’re over-ordered in this context, btw). But they can show a lot more than evidence of heart attacks; arrhythmias, for example.
 

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