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Medical Forum / General / Cardiology / January 2006Heart Attack
Attack: I recently had a heart attack while exercising. My angiogram showed 100% blockage of the right coronary artery. The blockage was cleared and a stent inserted within about two hours. Damage was minimal and I could engage in normal activities and start strenuous exercise after only a few days. Background: I am a 66 years old male. I have had stable angina for about 9 years which was relieved by a beta-blocker. About two years ago I reduced my weight from about 200 pounds to 160 pounds and started strenuous daily exercise. A stent was placed about 15 months ago to clear a 60% blockage of another artery. The stent did not relieve the symptoms, but the beta-blocker continued to help. About 12 months ago, an angiogram showed continuing plaque buildup. After the stent was placed I went on 10 mg of Lipitor per day. This reduced my cholesterol from a little over 200 to under 140. It measured 107 the day after the attack. 1. Does anyone know why the damage was not more severe? What does it take to damage heart muscle and what mechanisms mitigate it. 2. It seems to me that it is likely I will have more attacks given the continuing plaque buildup with Lipitor. I am now taking 20 mg of Crestor a day instead of the Lipitor. Can this stop the build up of plaque? What options do I have? > Attack: I recently had a heart attack while exercising. My angiogram > showed 100% blockage of the right coronary artery. The blockage was [quoted text clipped - 21 lines] > Crestor a day instead of the Lipitor. Can this stop the build up of > plaque? What options do I have? I am not a doctor. I suggest that you continue the exercise program and to consider becoming a vegetarian. I also suggest that you read this book and start taking the "alternatives" mentioned in the book WHAT YOU MUST KNOW ABOUT STATIN DRUGS AND THEIR NATURAL ALTERNATIVES by Jay S. Cohen, M.D.  SignatureNEWSGROUP SUBSCRIBERS MOTTO We respect those subscribers that ask for advice or provide advice. We do NOT respect the subscribers that enjoy criticizing people. >> Attack: I recently had a heart attack while exercising. My angiogram >> showed 100% blockage of the right coronary artery. The blockage was [quoted text clipped - 16 lines] >> 1. Does anyone know why the damage was not more severe? What does it >> take to damage heart muscle and what mechanisms mitigate it. you stated that the blockage was cleared and stent placed within 2 hours....bingo... TIME is the key...usually takes about 4 hours for heart muscle to "die"...thus the rush to give you "clot busting " drugs and insert a stent asap >> 2. It seems to me that it is likely I will have more attacks given the >> continuing plaque buildup with Lipitor. I am now taking 20 mg of [quoted text clipped - 3 lines] > I am not a doctor. I suggest that you continue the exercise program and to > consider becoming a vegetarian. Please do not suggest anything Jason...you know only what you read in books... becoming a vegetarian might not help at all....it is not only ingested fats,,but those produced normally by the body.. the op needs to follow his health profesionall's advice...not Jason's ...not a book I also suggest that you read this book > and start taking the "alternatives" mentioned in the book > WHAT YOU MUST KNOW ABOUT STATIN DRUGS AND THEIR NATURAL ALTERNATIVES > by Jay S. Cohen, M.D. > >> Attack: I recently had a heart attack while exercising. My angiogram > >> showed 100% blockage of the right coronary artery. The blockage was [quoted text clipped - 22 lines] > TIME is the key...usually takes about 4 hours for heart muscle to > "die"... Actually, heart muscle starts to die after only about 20-30 minutes of no perfusion. My guess would be that good collateral circulation had developed lessening the impact of the complete occlusion. Please be aware that the sun will "turn black like sackcloth made of goat hair" (Revelation 6:12b) during the total solar eclipse that will happen in Turkey on Wednesday 03/29/2006 at around 14:00 hrs LT. http://tinyurl.com/dcj7w The order of darkening of the following ancient cities in Turkey: (1) Ephesus (2) Smyrna (3) Pergamum (4) Thyatira (5) Sardis (6) Philadelphia (7) Laodicea Will be the same order that Christ Jesus used to address the seven churches: "Write on a scroll what you see and send it to the seven churches: to Ephesus, Smyrna, Pergamum, Thyratira, Sardis, Philadelphia and Laodicea." (Revelation 1:11) Would be more than happy to "glow" and chat about this and other things like cardiology, diabetes, cooking and nutrition that interest those following this thread here during the next on-line chat (01/19/06) from 6 to 7 pm EST: http://tinyurl.com/cpayh For those who are put off by the signature, my advance apologies for how the LORD has reshaped me: http://tinyurl.com/bgfqt Prayerfully in Christ's love, Andrew http://tinyurl.com/b6xwk The plaque that builds up in our arteries is composed largely of dead "foam cells." Most foam cells are macrophages, large white blood cells. Macrophages are the garbage collectors of the immune system, and they wander through the body eating dead cells, germs, etc. They also eat little scraps of cholesterol that are left over from various bodily processes. Normally, the macrophage wraps the cholesterol up in a protein wrapper and expels it. The protein-wrapped cholesterol then circulates until it reaches the liver. The liver reads the proteins as a signal to destroy the protein/cholesterol package, and that is the end of the cholesterol. If a macrophage is infected with any one of several germs, it loses the ability to expel the cholesterol it ingests. It continues to ingest cholesterol as before, except that now it begins to swell up like a balloon. The macrophage has become a foam cell. Foam cells tend to die in clumps in our arteries. These clumps eventually become large enough to block our arteries. The standard treatment for this phenomenon is to lower cholesterol levels to such a low level that very few foam cells are created. Foam-cell creation cannot be completely stopped, however, except by curing the infections that cause them. Russ Farris http://www.potbellysyndrome.com > [I think it was "arnold2@comcast.net" <arnold2@comcast.net> who wrote: > Background: I am a 66 years old male. I have had stable angina for [quoted text clipped - 4 lines] > symptoms, but the beta-blocker continued to help. About 12 months ago, > an angiogram showed continuing plaque buildup. > The plaque that builds up in our arteries is composed largely of dead "foam > cells." Most foam cells are macrophages, large white blood cells. Foam cells are not specific for infection. The origins of inflammation associated with CAD are still being researched. There are many bacteria that benefit the human host that produce essential vitamins and nutrients. There is a fine balance between health and opportunistic chronic infections. They just don't know right now how to interpret the newer techniques such as DNA probes in finding microbial material that is culture negative. The institution of longer treatment times with antibiotics depending on PCR results would generate more resistance in the long run. The use of cytokines or hormones, agents is still being looked at. Like anything out there, a hype about the infectious connection which includes Alzheimer's and neurologic disease and just about any condition out there in order to generate revenue in their research. > Attack: I recently had a heart attack while exercising. My angiogram > showed 100% blockage of the right coronary artery. The blockage was [quoted text clipped - 16 lines] > 1. Does anyone know why the damage was not more severe? What does it > take to damage heart muscle and what mechanisms mitigate it. There are several possibilities. It may not have been 100% - maybe some blood got through. They say time is heart muscle - the longer part of the heart is denied blood the more likely it is that tissue dies. You got help quickly. Over time small vessels, called collaterals, will grow from one area of the heart that is normally served by a different artery to an area that is not getting enough blood. These help out when a complete blockage comes. > 2. It seems to me that it is likely I will have more attacks given the > continuing plaque buildup with Lipitor. I am now taking 20 mg of > Crestor a day instead of the Lipitor. Can this stop the build up of > plaque? What options do I have? It depends on the type of cholesterol. You need to describe the breakdown into types. Also, cholesterol is not the whole thing. Are you taking a daily aspirin? Bill - not a Dr. Bill: I was taking aspirin. My lipid profile right after the attack was as follows: Triglycerides 72 Cholesterol 107 HDL 49 LDL 44 VLDL 14 Arnold > > Attack: I recently had a heart attack while exercising. My angiogram > > showed 100% blockage of the right coronary artery. The blockage was [quoted text clipped - 34 lines] > > Bill - not a Dr. awefawe awefawe > Bill: > [quoted text clipped - 8 lines] > > Arnold First, you should be talking to someone who knows more about this than I do. The HDL could be a little higher - not that it is abnormally low. You could talk to your Dr. about niacin - which can raise HDL. But be sure to have blood tests and watch out for problems because niacin can exacerbate the side effects of statins. Also, a more recent lipid profile would be more relevant to what to do now. There are a large number of risk factors for heart problems which you can look up. These include diabetes, smoking, weight, stress, lack of exercise, family history and past history of MIs. Try to control everything you can. You said you were taking aspirin. I assume you are taking plavix now. Many people continue taking aspirin with plavix. Many people recommend taking a couple of capsules of fish oil a day to prevent heart attacks - unless you already eat a lot of fish. You might wish to check with your Dr. Bill - not a Dr. >> > Attack: I recently had a heart attack while exercising. My angiogram >> > showed 100% blockage of the right coronary artery. The blockage was [quoted text clipped - 37 lines] >> >> Bill - not a Dr. > > Bill: > > [quoted text clipped - 71 lines] > >> > >> Bill - not a Dr. The HDL could be a little higher - not that it is abnormally low. You could > talk to your Dr. about niacin - which can raise HDL. But be sure to have blood > tests and watch out for problems because niacin can exacerbate the side > effects of statins. Comment/Question.. HDL is a subset of total cholesterol. This patient's total cholesterol is only 107. Therefore his ratio is 2.18. This is an excellent ratio. Can this patient realistically get his HDL any higher, without raising his total cholesterol level? Is it desirable to raise the overall cholesterol level (as long as this stays below 200) in order to raise a normal HDL level? (49 is not necessarily considered low in this patinet's case, IMHO). Thanks for any thoughts, Sue (nondoctor) >> > Bill: >> > [quoted text clipped - 105 lines] > > Sue (nondoctor) As I said, the HDL was not abnormally low, but I have seen much higher. Niacin will tend to raise HDL and lower LDL and VLDL (So more good cholesterol going against the bad.) Niacin is fairly safe if you do the appropriate blood tests. So, it may help and is unlikely to hurt with lipids but you need to watch out for side effects. The OP was looking for alternatives since he was continuing to have plaque buildup despite the low numbers. Bill - not a Dr. |
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