Premature CAD

[NMKC]

Hi everyone,

I'm new to here. I'm a 43 year old female who is healthy, fit, non smoker etc but have had high cholesterol all my life. My dad and many of his siblings had strokes in their 60s and above so I have spent many years asking doctors if I should be worried about my cholesterol which all (even a cardiologist) said no.

Fast forward to present time when I decide to pursue it with a private cardiologist who sent me to do a battery of tests including a ct scan and I'm told I have a calcium score of 285, 25-49% stenosis in my LAD and RCA plus calcified plaque obscuring the lumen of my PDA so they cannot discount a significant blockage there.

My cardio has put me on rosuvastatin 10mg and sent me off to do an MRI stress perfusion test to check how well the blood is pumping to decide whether I need to have a stent there or not. I speak to him on Wednesday.

In the meantime I have spent a good week or so with Dr Google driving myself crazy and my head is not in a great space. This has all just escalated so quickly and it's hard to reconcile this with the fact that I feel really healthy!

I guess I'm writing this to vent, hear from others that it's all going to be OK and keep me going until Wednesday! Also wondering if a stress perfusion is the right thing to do to identify a blockage or wouldn't an angiogram have been better? My cardiologist is fantastic but just wanted to hear others thoughts. Finally if I take my meds correctly and get my ldl super low what are the chances I can try and stop cad progressing?

Thanks for reading

[Chinkoflight]

Hi, it's clearly a lot to take in and with a family history too, then I think it's perfectly reasonable to be alarmed, not least because you have done the right things to stay healthy. But, are you in a better place for knowing or not not knowing? I'm fairly sure in time as you get adjusted to the knowledge and understand the risks, you will be glad you know.

If you are able to continue to fund the private care or have sufficient evidence, your consultant can of course refer you on to his/her NHS list for any ongoing treatment. The benefits to you are that you can plan around your future health interventions rather than being taken by surprise!

The statins will hopefully help and I guess you might discuss with your Consultant the benefits of going on antiplatelet meds to reduce the risk of a stroke.

I can't provide any other insights but I wish I had had a heads up before my stroke! I am more than happy to be taking all the medical help on offer now to reduce the future likelihood of a repeat and at the same time doing even more to engage with improving my own health fitness as much as possible.

Don't over think it would be my advice and be a touch sanguine about any feedback and the research you do. You clearly have great Consultant who has done all the learning for you!

[NMKC in reply to Chinkoflight]

Thank you for answering. I know it's best to know but sometimes it doesn't feel like that!

I'm fortunate to have private health insurance through work which I decided to make use of after waiting a year for a referral through nhs with no joy. Will make the most of it whilst I have it as he has been fantastic.

[Jerrahem]

Hello any update with your situation?

[NMKC]

Hello - I did a stress perfusion MRI which indicated that my heart was pumping blood normally which is a relief for now. My Cardiologist said that I basically have two arteries with around 30% stenosis in each and so now I have been left taking statins with an aim to reduce my ldl cholesterol to under 1.4 (50) to try and hold back progression as much as possible.

I have cut out a lot of animal fat and changed my diet quite radically. Have lost 3 kgs that I didn't really have to lose anyway and will be doing a 6 week blood test next week to see if ldl has reduced enough.

I feel better, less crazy. But I do feel so confused as to how I have even gotten to this point.

[Chinkoflight in reply to NMKC]

Thanks for the update. I think with the battery of tests you have had, your knowledge of your family history, you are probably in a relatively good place. The medics are providing advice and support, you are changing your lifestyle a bit, perhaps there is more you can do for yourself to make the lifestyle changes an opportunity to pursue enjoyable, feel good activities.I started running at 70, very sceptical as I'm not in any way a sporty person in terms of doing, using the NHS app Couch to 5k. I was gobsmacked at my progress and the sheer buzz of being able to run albeit slowly continuously for 30 minutes after 9 weeks. 18 months on I still feel the buzz and self esteem just writing about it.

Now, running is definitely not for everyone, and it may not be a fitness regime you are seeking but perhaps now is the time to start something new. Treat the health scare as a kick up the xxxx and get motivated.

[NMKC in reply to Chinkoflight]

You are right that it is a great motivator! I ran a few 10ks about 10 years ago but had to stop due to knee issues and even stamina wish I certainly couldn't do 30 minutes now! I do however work out most days with spinning sessions a few days a week and that has been great for my mental health.

I think the main change has been my diet. I've always loved cooking but now my focus is on filling my plate with vegetables. Cutting out most cheese and red meat and its been quite enjoyable trying new things. That has really helped me get a bit of joy back.

That said a friend of mine went to my Cardiologist off the back of my recommendation as her cholesterol, family history and lifestyle was far worse than mine and all her tests have come back clear! I'm obviously happy for her but just so confused too as to what on earth has triggered this in me! I guess I will never know and we just need to find acceptance and do what we can to find peace and happiness and gratitude in the situation we have been dealt.