Heart Attack

I had a heart attack on 30 July 2009. My friends have been asking how I feel. So here it is ....

Well, heart-wise, I feel fine. Of course, "phantom heart attacks" seem to be constantly with me -- I am forever trying to check my pulse. I am now taking 8 medications daily, and I know I am having some side effects. I have been ordered into almost complete inaction. I am not allowed to drive until tomorrow. And can't fly for a month or more, depending on how I am doing.

As I have learned recently, the most common type of heart attack is called a "myocardial infarction" and is caused by some kind of clot or blockage in one or more of the arteries that supply blood to the heart muscle itself. Without a sufficient flow of blood, the heart muscle will start to die within minutes. These are very dangerous; death, of course, is a distinct possibility, but even if you survive, frequently the morbidity to the heart tissue is permanent, leaving one with lasting disabilities.

Fortunately, I didn't have a myocardial infarction. I had what is called "Acute Coronary Syndrome". ACS, as it's called, is much less common, even rare. ACS has the same "indicators", like abnormal EKG patterns and elevated levels of enzymes in the blood. BUT there are no significant blockages to the heart's arterial system. What causes ACS, then? After listening to my cardiologist go on and on about this, my guess is: they simply don't really know. Stress is just about their most intelligent guess. Somehow, when a person is under significant and sustained stress, the electrical impulses that control the heart's beating go haywire. Valves don't open and close as they should, and the heart pumps when valves are closed, etc.

The initial symptoms of a myocardial infarction can be very dramatic; sudden, intense pain in the chest, left arm, neck etc., gasping for breath, unconsciousness in a matter of minutes, and frequently death. Not so with ACS. I felt a SLIGHT tightness in my chest if I got up and walked around, especially if I went up stairs. If I sat down, these sensations disappeared in a few minutes, and I would feel fine. I struggled for hours trying to determine if there really was something going on, or whether I was imagining it. I only went to the hospital on the advice of my primary care physician's nurses, and I was struck dumb when the doctors in the hospital told me I had a heart attack. I suspect that ACS is so rare statistically because so many people miss the symptoms and never go for cardiac care. Perhaps for many of them, nothing much happens and they go on with life never suspecting they had any kind of event. Perhaps many later have the real thing, the big myocardial infarction and die. Who knows.

The latter is unfortunately a distinct possibility. One strange thing about ACS: almost by definition, a patient who has an ACS did NOT have a problem with cholesterol. When they "went into" my heart with a catheter, they found open and unblocked arteries, and my cholesterol readings have always been low to normal. BUT, after an ACS, many patients suddenly experience very elevated levels of cholesterol and plaque build-up in their arteries. No one knows why. That is one of the reasons I am taking all these pills.

I started cardiac rehab on Friday, 7 Aug. It is a combination of exercises to build up cardiac strength and continuous monitoring of your heart function to determine the optimal levels of exercise for recovery.

My cardiologist is confident I will have a complete recovery, as very little damage -- actually, no permanent damage to my heart took place. He put it this way: all I have to do to have a 100% recovery is to give up everything I love to eat and drink. Bad enough. BUT .... He said these things in front of MY WIFE!!! So there it is. I will never enjoy a hot buttered muffin again! No cheese, fat, sugar, salt, and so on and on. I am allowed 3 oz of some LEAN meat a day. 3 oz!!!! I used to consume 3 oz of meat PER BITE. Near as I can tell, 3 oz of meat is about the size of 3 or 4 thumbnails!

But ... I know there will be better times. Does this all let you know how I am feeling ......?

Bob