After a long period of doctors trying to diagnose a very active, fit & healthy man, my husband (with basically the ideal healthy lifestyle), transpired he had a LAD 90% stenosis. Since then he’s continued his healthy lifestyle & takes all the medications offered but now 3 years later following CT has another build up & needs a further angiogram & stent. We thought the first time was just bad luck but it now seems there’s nothing that can reduce this problem & we now have a very tiny baby which came along just before that latest bit of bad news that the first time wasn’t just a freak occurrence. Just wondered if there are others out there & how you manage? Last time the treatment happened within weeks but this time he’s on a long waiting list (seems slightly crazy as we have a newborn). Anyway he seems to be feeling less & less well & it’s hard to distinguish between anxiety & his so far very accurate judgement on something being seriously wrong. We are still a young working family & I just don’t know whether we just need to deal with it or we should be pushing for a faster turnaround. I know they says stents don’t change prognosis but it’s all we have as they never found any risk factors or high cholesterol & statins don’t seem to be stopping it. Any support or advice would be great.
Stent at 35 another one due 3yrs late... - British Heart Fou...
Stent at 35 another one due 3yrs later, anyone else have experiences of Heart disease at young age that medication/lifestyle haven’t stopped
Hello and welcome to the forum! Is the new blockage with the stent or elsewhere in the LAD? Also any indication of stenosis elsewhere. Whilst my LAD was 85% three other arteries, including the RCS, were over 70%. These figures are all approximate as not perfectly circular and plaque does not form as annular rings.
Next to last stent first blockage was proximal to the heart this one is even closer both in LAD... No signs of stenosis elsewhere always a silver lining right?
Morning... I have read the other posts and the various replies. The situation does nor seem ideal. For now I think the second stent is best in the short term but the two of you should raise the question of a bypass going forward (LIMA to LAD probably so no leg veins are required). One thing has he been checked for a fatty liver? One friend, same height but two stone lighter, has been diagnosed with one. It increase the chances of both Type II diabetes and CVD.
Hi Rh2205. I’d be pushing for a faster turnaround especially as it’s making you (and by the sound of it) him anxious. It’s tough to have this at such a young age but it really is better to know. In terms of what happens after the surgery (and if he has chest pains etc on exercise then he needs to be careful) the thing I found difficult in the family years before my heart attack was doing sufficient exercise (150 mins a week of heart rate raising stuff) and getting an appropriate work/life balance with a stressful job where I needed to prove myself. And I also had what I thought was a reasonable diet. But I was able to make changes. I’m saying that because maybe there are some changes he can make even though he is fit, active and healthy?
As well as filling up on the heart issue you husband could also ask the Doc for a counselling referral to help with his anxiety. Anxiety does a really good job of causing real pain and it would be good to resolve this aspect if possible. Good luck to you both. Stay in touch with this forum.
Hi thanks for the advice. He is going through the system now for counselling but there really is nothing we can see he can do to better his situation? Unfortunately he’s been living the ideal lifestyle, exercising every day since 16 never eaten a McDonalds, or drunk tea or coffee in his life, he’s not even touched a cigarette before it really couldn’t be more ironic! His passion is/was sport & he works in the sports rehab industry so you can see why he has always had such a good lifestyle history. Obviously diet is as good you can get, who else eats cottage cheese, spinach in a whole meal pitta for breakfast? Lots of all the good stuff pulses & veg, no red meat only small quantities of lean meat, limited cheese, no processed food, no sugar we haven’t added any salt to our food in 3yrs, we even home make things like hummus. He still exercises most days since his diagnosis but doesn’t do competitive sport anymore for obvious reasons.
The cardiologist seemed surprised they found anything this time & I remember last time when he went in for surgery they still weren’t sure they’d find anything as his symptoms were not the norm, but because he’s so fit & healthy & basically is a body is my temple sort of person he always picks up on them. This time he just felt a little run down with slight twinges in armpits so it’s hard to say that it wasn’t anxiety & all in his head otherwise he probably would of already had something very bad happen. He only wanted the CT scan for peace of mind thinking that maybe it was anxiety and again it wasn’t. Just feels like things are a bit hopeless now & when he keeps coming home from work saying I dont know if I’m feeling that well I can’t exactly fob it off given his history, think we thought things would happen a bit faster like last time especially when they called him back the same day as scan with a meeting planned in less then a week on Xmas eve. It’s just really crappy the whole situation.
Totally empathise with you both. It’s a rubbish situation. Have you had a look at the BHF advice on diet (but sounds like you’re already doing it) just to see if you can make any tweaks? I see from your message below that he only takes statins? Can I ask what dose and what type? Is he also on Aspirin?
All the diet tweaks were made 3yrs ago, but that clearly hasn’t worked! He could go vegetarian but he’s struggled to not lose too much weight with the diet changes last time. He is one of those people that has always loved eating healthy & lots of veg too.
He takes atorvastatin 40mg, his cholesterol is 2 it was 4 before. He also has aspirin & latest diagnosis means he’s back on clopidogrel.
Might add that he was skinny before so really don’t think extreme diets are going to work, I really don’t see how his diet could be healthier without removing the remaining lean meat & healthy single milk cottage cheese dairy now, he even remove 3 egg yolks out of 4. He already made every change in the book if you get what I mean :(.
The Clopidogrel could be making him feel a bit rubbish. I was on Ticagrelor that does the same thing and I noticed an improvement when I came off them. It’s a good job he’s so in tune with his body and got the CT scan.
Do you think Ticagrelor has less symptoms than clopidogrel? He’s been liaising with gp to change from it as he thinks it’s the cause of the upset stomach every day. I won’t tell him you haven’t found this drug symptom free!
I think it might be stronger. When I had my heart attack it was given to the HA patients whereas Clopidogrel was given to Angina then stent hearties. It could well be causing stomach issues. Quite often Docs prescribe a PPI like Lansoprazole to counteract the acid caused by the irritation that Aspirin + Clop/Tic causes. By the way - congrats for the baby. They’re tiring too from what I can remember (my youngest is now 23). Flies by.
Hi
Sorry to hear about the situation especially with the newborn having arrived. I know this may sound dramatic but I followed a fairly strict diet, exercise regime etc but still had a HA at 54. I discovered following an angiogram that my LAD was 95% blocked. The HA occurred as a result of a thrombosis in my RCA which was otherwise pretty clear!
I decided that the best option was for CABG. I was told as someone who is fit, fairly young etc that it would provide a better long term solution. With 95% blockage a stent would potentially only alleviate the problem temporarily and restenosis was a high risk. That made sense to me. I had the CABG just over 4 months ago and despite the niggles from having OHS my latest echo, blood results, exercise tests have shown exceptional results. I feel that I took the right course for the long term. Just a thought 🤔
I did wonder about this but the cardiologist seems to think avoiding CABG is best for him given age etc, he was so fit and healthy first time round they found his resting heart rate at night was 26BPM.. he only takes statins given all his results on fitness &BP are so good he’s obviously not as athletic 3yrs on but still well above average. When the cardiologists did the stent last time they commented on how big his arteries were probably as a result of his level of fitness and I guess we’d be massively concerned more invasive surgery would have lasting effects on his fitness but at the same time we don’t want him to have an MI. Really tough to know what to do or if we should seek another opinion.
Hi my brother had his 1st stent at 35- his second at 38. I waited until I was 51 and just went in straight for bypass!!! No high cholesterol or BP or risk factors I knew of before- very fit & healthy. However now know I have high lipoprotein A in my blood- which helped explain it perfectly to me- it’s not a routine test in uk but you can ask for it. I was lucky as I got referred to hereditary specialist so they did that test. May be worth exploring or not related but it rules something in or out!!
This is interesting. He has hyperbilirubinemia and spherocytosis (circular blood cells), they genetically tested him for the gene which causes spherocytes & thus high levels of bilirubin but it wasn’t genetic. We sort of gave up with that route as we weren’t sure it would provide any answers. Or maybe circular blood cells does something slightly strange, we don’t know why they’re circular still but I’ve not read anywhere that these things are linked only that high bilirubin offers a protective factor against atherosclerosis... but maybe there are other things he can get checked for like you’ve suggested.
Don’t suppose your husband had a splenectomy for the Spherocytosis?
No I’m not even sure what that is or would show? It was probably a bit silly looking back as we should of followed up more about the spherocytosis at the time after the genetics testing confirmed it wasn’t hereditary. Few other odd things occurred in last year, had blood in urine (before the latest CT and clopidogrel), had some investigations & they couldn’t find anything with urology tests in bladder but didn’t do a CT due to upcoming heart CT & radiation exposure, it was left that if it started happening again he would get a kidney CT. He did have some ultrasounds of his abdomen when the spherocytosis was investigated all organs normal size, not sure if these things are linked. Starting to wonder if he has premature ageing if it exists as he urinates multiple times a night now & has very low body temp, that of an over 60... maybe I’m ready into things too much I obviously don’t tell him about all these things I read as probably wouldn’t help.. guess I’m just trying to find answers to what’s going on.
I’m not a medical person so take what I say with a huge pinch of salt. But... the removal of the spleen can impact on atherosclerosis. A treatment for Spherocytosis (which is also linked to Hyperbilirubinemia) is removal of the spleen (it’s to do with the shape of the blood cells) as it can be enlarged (hence ultrasound. I’m guessing also guessing he still has his spleen as you’d probably know). A question I’d ask the Doctor is: ‘is it possible for the Spherocytosis to damage the spleen in such a way that it could cause atherosclerosis?’ So could damage have the same impact as removal in terms of athersosclerosis? Might be barking up totally the wrong tree. But there is a physiological link between everything that you’ve said. A damaged spleen can also cause blood in urine and frequent urination.
Just out of interest did your brother have CABG in the end? Or has the second time lucky implant worked?
not young age..had stent at 52 ie last August..MI and stint while wlaking in Spain..
struggling with affects of the drugs... anyways good to hear your improving
My brother had a heart attack at 36 and 40 which was followed by a CABG. This was in 1995. He is now 64 and has had no further heart issues but now has emphysema as he continued to smoke until recently. He has never restricted his diet and enjoys beer and his sport is darts so I am amazed he his made it this far. Our father had heart attacks at 34,38,48 and died at 52. So not a great family history. I managed to make it to 61 before gaining 2 stents and would consider myself fairly fit and average healthy eater.
Hi there. I had a HA from a 100% blocked LAD and a 75% LCX at 45 last year. Turns out after the start of investigating what my genetic history through a lipid consultant I have very high Lipoprotein A. I’m not sure yet if this is the cause but it seems there isn’t anything that can be done drugs or food wise to change it. So your husband understanding his own body is what’s key. I’m going to be more vigilant now. I’m no where near as healthy as he sounds with his diet. Worth asking for all the genetics tests.
Is high lipoprotein a something which is seen in blood tests? He never had high readings on anything before he started statins I guess that doesn’t mean he didn’t have this issue but it’s hard to know as his diet was really healthy when he was first diagnosed so maybe he suppressed some of these readings from a healthier lifestyle than average anyway? Maybe we should have tried to get more answers at 1st diagnosis but because he was so far from the norm we put it down to a freak event eg some tiny build up which had a domino effect from his high fitness levels as he was playing national level sport at that time so his heart would of been getting a lot of action. This is the reason they spent ages investigating electrical heart issues as he has a slightly unusual ecg and bradycardia from athletic fitness before realising a lot later it was atherosclerosis.
Very hard to get the correct diet when you don't know what is causing the disease progression but a diet high in saturated fat is not good and he seems to eat a lot of dairy, which is the greatest source of dietary saturated fat in the USA, from what you have said. Just a thought, but maybe on a genetic level he has a problem with dairy intake.
The entire pot of cottage cheese he uses has 8% of RDA saturates. He obviously doesn’t eat an entire pot a day or even have it every day. He is very careful about food labels and properly looks at all the numbers to see if what you’re eating is any good before using different foods. He’s undertaken extended food diaries before & is well below RDA for things like saturates and salt but because is very active he does need some dairy products to ensure he gets enough protein in his diet easily otherwise he’d waste away!! I think diet being a contributor now in his case is a myth there’s obviously non lifestyle factors but he’s done what he can to make sure it’s as healthy as possible. This is why we home cook everything as it’s so difficult to remove bad foods without going back to basic ingredients, our meals are very bland but there’s worse things in life, it’s lucky he’s always treated food as sustenance rather than enjoyment his whole life otherwise worse things may of happened & he’d be very miserable. I have to have a secret Mars bar stash to cope with his healthy eating habits :)!!
Hi me and my brother have very high cholesterol and are now both referred and under the UCL hospital Euston, a specialist Dr Lunken has put us both on different statins to the norm, and me being 10 years older are now being considered for the PCSK9 as I continue to stay high to what I should be, so maybe see if your gp would recommend you if that is a better course for you. Good luck.
Sorry to hear about the diagnosis at such an early age. It is clear that CVD is caused by a complex set of factors, not always linked to Cholesterol and diet.
Stress - is another important contributor. Not sure which Dr told me, but he said that high level of stress is the equivalent to smoking 10 cigarettes/day. So, keeping stress in check - is also important.
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