Hello,
My grandad passed away Aged 35 of a heart attack, my uncle recently passed away aged 54 of a heart attack and my mum has high blood pressure and high cholesterol.
Because of all of this I’m assuming there is a family history of heart problems, I’m 25... is this something I should be concerned about and looking in to further? It’s hard enough to get a GP appointment as is it so I don’t know how seriously it should be taken? Any advice on this would be great,
Thank you!
Hi, sorry to hear all your bad news...you really need to go to your GP and explain your family history. It is clear that there is a family history hear and you need support and investigation from your GP, just explain the problem to the receptionist and I'm sure once they are aware of your history they will secure you an appointment. Good luck 😃
I would raise it with the GP, as family history should always be taken into account, but a word of caution that it isn’t always treated as seriously as it should be: in my case, both grandads died of heart attacks sub 50, my maternal grandma needed a pacemaker pre 60, my mum ignored angina and extremely high bp from the age of 45 before having a heart attack last year (aged 64, needed 4 stents, had a total blockage of a major artery and was lucky not to drop down dead according to the consultant), and my dad has coronary heart disease. I’ve had an arrhythmia requiring treatment since the age of 26 (ten years) have two non-cardiac conditions that increase the risk of heart attack and stroke, and also take a med for something else that does the same, have discovered in the last 2 weeks that my cholesterol has gone high over the last 12 months despite a consistently low sat fat diet, exercise, and a healthy lifestyle generally, and have other potentially cardiac symptoms that have been getting worse for a while, but I’ve struggled to get a GP to refer me for review. On the list now, but whilst I hope you won’t, you may need to push to get anyone interested in checking you out and hopefully putting your mind a bit more at rest.
I would agree that it isn't always easy to get GPs to take family history seriously. My paternal grandfather was the youngest of 13 children. He was the only one to get past 50. All the others died of what was then called dropsy ( Heart failure). When I saw my GP about constant breathlessness he completely ignored it. It was only when I saw an out of hours young doctor via 111 that he asked about family and immediately booked me to the rapid access clinic. I had a heart attack before I ever got hat appointment and my GP had been suggesting even cancelling it. So yes, do talk to your GP. I doubt you would have any problems yet but better safe than sorry and early tests can radically reduce the chance of problems later. You may have to be very firm with your GP.
You need to be persistent with the GP which I know is not always easy. My gran died at 49 after her 3rd heart event- my brother 35 years later had 2 heart attacks by 40. I went to the docs & was told I had no risk factors - then ended up having a quadruple heart bypass a few years later at 51- which we now know is due to genetics. It’s difficult because some things just don’t show up - LPa is my issue & there is a blood test for that- but only by asking. Good luck- the earlier you know about things like cholesterol etc the more good choices you can make.
Hi Gail1967 - how/where did you get the LPa tested please? I live in London, and my LDL was 4.55 before the stents x 3 plus high-dose atorvastatin 80mg daily (now LDL is 1.7 only). But I too want to be tested for LPa. I want the know my LPa risk.
I also want to have an insulin study but don't know where/how to get it done/analysed. This is a sophisticated way to confirm how your response to a fixed dose of oral glucose drink. Your blood is taken at intervals up to 2 hours after drinking it, and is tested not only for glucose but for insulin too. They can chart the pattern of how your insulin rises during the 2 hours after the glucose challenge, and can tell you if/how much one is insulin resistant. This has a direct correlation with risk of coronary artery disease. If you know where/how to get this test too, I'd be grateful. THanks!
Hi- I think I was just lucky to have my heart attack in London!!! - I live in Suffolk but was there for the day- so I ended up in barts & because I had no “risk factors” expected of someone needing a quadruple heart attack at age 51 other than family history, they referred me to a hereditary expert who did the LPa test. It made a lot more sense after that but as others have said there is so little known. I had a review in nov & the cardiologist said they are at the limit of current understanding- so it’s just managing ldl- but mine is only around 1.4. So a lipid clinic is prob best bet for test- no idea if this is an easy thing to get referred to. It’s interesting to read about the insulin etc- good luck
Thanks! I am actually appalled by the overall lack of understanding of cardiologists about the pathogenetic factors that propel the disease process of plaque build up. As you say, they tell you that they are the limit of current understanding. Well, this level of understanding is the same as 30 years ago, and has hardly progressed in 3 decades! They simply keep inserting stents for the past 30 yrs (which is a work-around, not a permanent cessation of the disease process allowing further plaque to form), and they aim to eradicate all LDL until it is obliterated from our bodies.
Well, how come despite their aim to depress everyone's LDL to the extreme, patients continue to develop blockages elsewhere in the vessels, and they keep inserting more and more stents? If lowering LDL really is effective, then people ought NOT to be getting more plaque and blocking these vessels! Clearly LDL isn't the whole cause. But they don't know what else is the problem, and the research efforts in the last 30 yrs have not been directed properly. Hence they still say we are at the limits of understanding the disease, and how to actually stop it in its tracks effectively. In the same 30 yrs, HIV has been transformed from a fatal death sentence to a chronic disease with almost normal life expectancy - that is because research efforts are correctly directed to understanding the infection and viral targets identified for drug development. And yet atherosclerosis affects far far more people worldwide than HIV, but the management of atherosclerosis is comparatively infantile when we look at the progress with something like HIV. There are other diseases where progress is also far superior compared to atherosclerosis.
I will make enquiries and push to get seen at a lipid clinic until I get a LPa test. I know I will have to be tenacious, demanding and patient in doing so. We have to be ACTIVE patients in order to get what investigations we need. Otherwise, the system (which is cash-strapped and rationed) conspires against our needs. Thank you for confirming about the lipid clinic!
I was going to mention lp(a) a known independent factor for HA. I only found out about mine because I got referred to a lipid clinic. The cardiologists said it wasn’t their field despite its link to my angina and CTO. My immediate family are all being tested. My mum had her first HA at 55 and died at 63 which is now believed to be related to lp(a). It’s untreatable except I’m now on v high statins to try and reduce my LDL, which the only approach they can take. But this was all through the lipid clinic not cardiology.
Hi JennyRxThanks for revealing that you only got a LPa test via your lipid clinic. I think it is disgraceful that cardiologists have no understanding about the pathogenesis of a disease which they stent (saying its not their field)! It is like having blinkers, with no idea of anything else relevant (e.g. the need for LPa test) except inserting stents over and over again. Shame on them as they ought to at least see the importance of helping a heart patient get fully investigated for the things that would reveal knowledge and understanding about the heart disease that resulted in a HA.
I also want to have an insulin study but don't know where/how to get it done/analysed. This is a sophisticated way to confirm how your response to a fixed dose of oral glucose drink. Your blood is taken at intervals up to 2 hours after drinking it, and is tested not only for glucose but for insulin too. They can chart the pattern of how your insulin rises during the 2 hours after the glucose challenge, and can tell you if/how much one is insulin resistant. This has a direct correlation with risk of coronary artery disease. If you know where/how to get this test too, I'd be grateful. THanks!
That’s a glucose tolerance test. First of all you need to have HBA1c tested and probably monitor fasting blood glucose at home. If FBG is consistently high it would indicate possible insulin resistance. HBA1c indicates how your body deals with sugar over the previous three months. These two will indicate diabetes or prediabetes. I have prediabetes and possibly insulin resistance but I am reversing it with low carb diet as promoted by David Unwin, Gary Taubes and others. Didn’t need a glucose tolerance test to know that something had to be done. The HBA1c was more than enough. As my HBA1c comes down so will my insulin resistance. And that will support my heart health.
I’m not too worried that the cardiologist wasn’t involved with my lp(a) as the lipidologist is definitely the expert. However specialisms within the nhs are increasingly operating in silos and we’re moving further away from a holistic health approach
You need to get a referral to a lipid clinic to have lp(a) tested. As your LDL is 1.7 you’re below the level that is target for high lp(a). Apart from exercise, diet, weight loss and smoking cessation currently the only treatment for lp(a) is lowering LDL below 1.8. Which is not actually a treatment for lp(a). My lipidologist describes it as an aggressive attack on all the other cardiac risks.
Being so young, have you considered contacting CRY (Cardiac Risk in the Young) to see when they are next testing? They may have testing sessions in your area . Worth looking into if you get no help from your GP.
Just echoing all of the comments here.
What you are feeling is both logical and natural, so I recommend that you get yourself checked out for all risk factors via your GP.
I myself had a very strong familial link to heart problems, which finally surfaced earlier this year when I had a heart attack and stent surgery.
For years I was advised by my Dr’s that because of my family history there was very little I could go except take pills, which I did but they made no difference, so I stopped.
Having now had a heart attack my cardiac specialists (not my GP) told me everything I could have done to have prevented my heart attack ever happening in the first place, which was contrary to the GP advice. If only I knew, ..... hindsight is always a wonderful thing.
So my advice to you is to push your GP to get a full check up to get access to the experts and let them advise you what you need to do.
It may actually turn out that you are absolutely fine, at which point you will have piece of mind. If however they discover potential problems, you will then have the very best possible advice, to enable you to proactively take control of the situation.
I hope this helps
I think I mentioned in one of my posts anyone with a family of history of HA should have an angiogram in the same way that other people get pre testing for other diseases like cancer . I had pains for two years but because I was fit I was told it was muscular. I was 76. I had numerous blood tests and ECG’s and all came back normal. Now after my bypass all my “muscular pains “ have disappeared . Although many of my family had heart attacks I grew up in an age whereby nobody thought twice about full fat milk, butter, and all those horrors that can slowly build up plaque . It was some years ago when it became the norm to have a preventative diet which may have delayed my heart mild heart attack .
Heart attacks took my dad when I was 16, and my mum when I was 37. At the age of 38, I had 4 heart attacks of my own.
One of the first questions they ask you when you're in the A&E for chest pain is "do you have a family history?" - in my case, it was a definite "yes". Yours seems to be the same, so my advice would be to get checked out and have any issues worked on NOW, so that you can continue to live your life uninterrupted.
Push and push until you get all the tests to clarify your own heart health status. In the NHS via GPs, a lot of pushing might be needed. Even through the private sector (if you are fortunate to have access to private care), you will still have to push for it - the only difference is you won't need as much patience since the test results in the private sector come back faster than in NHS system. YOu also get the tests quicker in the private sector than via the NHS, of course.
But basically, you got to push and push, whether NHS or private care. Gone are the days where patients can sit back and expect the system will ensure they get the tests that they need for their particular clinical situation. We have all to be Active patients, educating ourselves and pushing for the tests that we know we need for our own best interests
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