My brother is the third generation of my family to have died without warning of heart disease at a relatively young age (my brother was 66; my dad and some of his cousins died in their 50s and my grandmother died in her 40s). My brother's death has been a real wake up call for me, and I'm now feeling like a ticking time bomb!!
His post-mortem gave his cause of death as coronary artery atheroma, stating that one coronary artery was severely blocked and the other two were moderately blocked. Although there was no scarring to be seen visually, microscopically there was some fibrosis (scarring) to the myocardium, indicative of previous (silent) heart attacks, which would have rendered him susceptible to potentially fatal arrhythmias, which would explain his sudden death.
Are there any test(s) that could be carried out on me that would be able to reliably pick up this sort of insidious heart disease. Looking online, it appears that the gold standard test is an angiogram, which I know is quite invasive, but I would be prepared to undergo this if it is the only reliable test.
I'd be grateful for any advice. I'm almost 65; moderately over-weight; work as a community staff nurse; on a Simvastatin for raised cholesterol (as was my brother).
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Judthepud
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Have you spoken to your GP? With a family history like that I'd have thought your doctor would want to investigate further, perhaps starting with less invasive things but ratcheting up the tests if there's any concerning evidence.
In the meantime surely "moderately over-weight" needs addressing?
I had bypass surgery a couple of years ago and decided on a root and branch lifestyle reform. I wasn't obese, but I was definitely overweight. I lost two stones and so many good things flowed from that. My blood pressure dropped and from previously being perilously close to the "pre-diabetic" stage according to my HbA1c tests I'm now right back in the healthy/normal range.
I suspect there's also other important benefits from weight loss, for example I'm a similar age to you and joint problems were probably on the agenda. But since losing weight I can feel real benefits around my knees, back and hips. So much so that I enjoy far more regular exercise which feeds right back in keeping the weight off.
But as amedical professional I guess don't need to tell you any of this!
Well done for losing so much weight. I've no doubt that helps with most health related issues. I think having to undergo by-pass surgery does give people a wake up call. Unfortunately, some of my family haven't had any warning before literally dropping dead. That's why I wonder if there's any reliable testing for silent heart problems. I have been tested for familial hypercholesterolaemia, and no known gene for the condition was found (although I was told that I still may have the condition). However my brother's cholesterol was under control for quite a few years prior to his death, and he wasn't over weight and led a healthy lifestyle - out walking and cycling every day.
I don't think the NHS would be prepared to carry out an angiogram on anyone not showing any obvious symptoms, but I would be prepared to go privately if signs could be reliably picked up and dealt with.
Good luck with your health. Looks like your heading towards a ripe old age!
My grandmother passed at around 63. My mother at 56, both with heart disease of some kind. I'm just short of 55 and now have symptoms of heart disease (at the moment, they think coronary artery disease).
Any heart disease can develop unnoticed, over a long period of time. It can also come on very suddenly, and is possibly too late to fix.
I am waiting for an angiogram too. It's really the only way the surgeon can see any blockages.
It's minimally invasive, usually through an artery in the arm or groin. You'll be in hospital for about a day.
I currently have aspirin, statins (for extremely high cholesterol), beta blockers and nitrates (vasodilators).
Please talk to your gp for a referral to a cardiologist for an initial assessment. Make sure you tell them of the family history.
Thanks for your reply Mark. Hope you don't have to wait too long for your angiogram. I think I may have to go privately for an angiogram as I don't have any clear symptoms.
After my heart attack and discovery of congenital problem three of my four siblings were checked out. There was no problem - they went and told the doctor what had happened to me and were rapidly seen. The fourth? Head in sand and didn't want to know......
Ask before paying; you could be pleasantly surprised.
I’d wander up the the GP and let them know your family history.
My mother iwas one Of 8. 4 died of a Stroke/vascular dementia, cardiac arrest, heart attack and heart failure. I developed heart failure and arrhythmia at55 following a viral infection although personally I think stress had a lot to do with my problems . Oh forgot about my regurgitate valve
Anyway my sister goes to the GP for something not heart related and in the history taking all the family issues came out. As a result her GP monitors her heart function , nothing invasive yet, and she was put statins straight away
I am a retired RN and share a similar family history, my maternal grandfather died with HA at 48 and my father and brother both had HA’s in their 30’ s. My brother and my younger 1st cousin (female) have both had CABG’s for CAD
I have a normal cholesterol and BP, slightly overweight but exercise regularly.
I would suggest having a treadmill stress test If you don’t meet NHS criteria I believe it is around £300 to have it done privately. You can be referred back to the NHS if needed.
Mine was positive and the following angio showed 80% and 90% blockage which were stented. My younger sister’s stress test was negative. ☢️
I was 68 when I first saw the GP after experiencing mild tightness in my chest. I ended up with a triple heart bypass a few months later! I had a CT scan and then received a letter from the cardiologist informing me about 'widespread calcified coronary atheroma resulting in multiple moderate/severe stenoses ... ' etc, etc. This inluded one blockage of 100%, two of 90% and one 70%. Subsequently, I had an echocardiogram followed up by an angiogram which confirmed that stents wouldn't be worthwhile and that bypasses were neccesary. The surgeon who carried out the operation told me that the atheroma was mostly 'familial' as I was not overweight, reasonably fit and low cholesterol.
Looking back now, it's clear to me that if I'd ignored the tightness, I'd have dropped dead within weeks.
So my advice is to talk to your GP and request a CT scan as that will show up any blockages. Your family history ought to be enough to trigger initial tests. Good luck and don't delay.
15 months ago, after having had several heart tests which showed nothing wrong with my heart over several years and also having been diagnosed with ectopic heartbeats as I was getting a type of palpitations that are said to be unharmful, I started with chest problems in the night. I called 111 who sent an ambulance which couldn’t find any problems but took me to hospital A&E to be checked over. I spent the whole day having tests which proved inconclusive until the final test a traponin blood test. I was ready to go home but then a cardiologist came and told me the blood test proved I’d had an Nstemi heart attack due a genetic disorder called familial hypercholesterolemia which none of my family were aware of. I had to stay in hospital where an angiogram found I had extensive coronary artery disease due to the condition and needed a CABG x 3. I had a reasonably healthy lifestyle was moderately overweight and didn’t smoke or drink and was working on raised cholesterol through diet. My mum, grandma and brother all had had diabetes ( which I never have)but had smoked and it had been thought by the go thought lifestyle had been responsible. My grandma died suddenly at 64, mum had a CABG at 55 and lived a further 10years (but statins weren’t available then so may have lived longer these days) and my brother died suddenly with heart problems (despite having had tests on his heart that didn’t show problems so it must have been arterial) at 59. At no time was any of us aware of a genetic problem until my shocking discovery. Since my operation mine and my brother’s immediate children have had to have tests and my brother’s eldest daughter has the same condition and is being treated with statins to keep it at bay but, as the condition is direct from generation to generation, she has also had to have her 3 children tested. Fortunately, my children’s tests seem clear. It is a real shock to discover at 58 that you and your family (many of whom may have died from this undiscovered condition). If it hadn’t been for the traponin blood test and the angiogram I would never have found the condition even though I was seeing the GP quite often and had had a heart monitor test via the hospital only six month prior. It may be worth having a word with your GP and asking him about the possibility of genetic problems such as familial hypercholesterolemia so that he can look into it for you.
Thanks for your response Trog, you've had a difficult time. Hopefully your CABG has sorted you out. I was interested to hear about your brother who had died suddenly at 59 despite having had tests for heart disease. My father too died suddenly of a heart attack at 59 and the week before he died he had passed his private pilot licence medical examination, so an impending fatal heart attack is clearly difficult to detect.
I was tested for familial hypercholesterolaemia a couple of years ago (due to my family history), but the known genes were not isolated (although I was told that this doesn't mean that I don't have it as there might be other, as yet, unknown genes causing the condition).
Since my brother died (he was on a statin and apparently his cholesterol was within normal range) I have been seen again at the Lipid Clinic and I've now been tested for Lipoprotein(a), which is a type of cholesterol that isn't routinely tested for, but is present in some individuals. This protein attaches to the LDL molecules and causes them to become sticky, thus clogging up blood vessels, even when LDL is reasonably low. Apparently this is known to be hereditary. I await the results in a couple of weeks.
In the meantime, the doctor at the Lipid Clinic said he would write to a Cardiologist and ask if it would be possible to have cardiac imaging done (e.g. a CT angiogram) on the NHS, but he doesn't hold out much hope as I don't have any coronary symptoms.
It might be worth your while being checked for LP(a) just to cover all bases, because apparently it can be treated.
Thanks for your response and advice. My CABG has been a wake up call. As the surgeon said at the hospital I am mended but must look after myself as advised. So I have an extremely healthy, low fat and sugar diet and have lost approx 2.5 stones and also exercise as advised by my cardiologist and can walk quite briskly for 3 to 5miles without getting really breathless and generally fell healthier. The shock of everything caused great anxiety and I do unfortunately get AF now but it is treated with anticoagulant meds and I am monitored every 5 to 6 months including a regular cholesterol test which has reduced with medication to well within the healthy range and my GP is really pleased with my progress. However, when I have my next test I will ask about LPs just to be on the safe side. Hope all goes well with your tests and you are soon feeling much better. Best wishes.
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