Feel slightly fraudulent as I’m fit and healthy, after a bypass in 2016, but I’m just curious for any insights / opinions re one niggling question.
I do fairly intense cardio every other day (mostly) and my BMI’s at the top end of normal. For my age - 61 - I’m fairly fit. My question is: do those repurposed leg-veins now moonlighting as coronary arteries withstand this kind of regime well?
We’re all accustomed to a fitter-the-better mindset, but given we know these grafts have a shelf life, am I effectively bringing closer the date of my second CABG by wearing them out, or am I keeping them in good nick and pushing it further into the future?
I take meds and have annual bloods done, but I’ve had no contact with a cardiologist since seven weeks after my op, when I was discharged, hence the question to a wider community.
Thanks.
NTB.
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NotTB
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Although not able to answer- I’m 4 years post so will be interested in replies. I still think it’s unnerving that we don’t see a cardiologist. I did pay to see one privately just for reassurance- although he says I don’t really need to- which I found refreshing as he could carry on charging me!!! Hope you get some sensible replies.
My CABG was 2015 vein and artery used to bypass Circumflex and LAD, RCA was 100% blocked so nothing they could do. In 2018 I was experiencing left arm pain when walking so Cardiogist suggested a further Angiogram when doing this he asked could he put a couple of stents at the bottom of my LAD to increase blood flow to that area, go ahead was my reply.
Arm pain disappeared, result.
Fast forward to 2022 arm pain was back, (arm pain severe like almost needing a sling when walking ) no chest pain though !! so an MRI followed by another Angiogram. During this Angiogram, Cardiologists two of them suggested opening my already bypassed LAD why not.
So a stent was put into the native LAD to open it up I was told it was a big stent lol. So since then no further arm pain touch wood, and as a bonus I am less Breathless, about the only thing I can't do is bend over to tie my Shoe Laces oh and Run mind you I don't need to Run and have slip on shoes so that's overcome !!
I do have Heart Failure due to the fact I had a Heart Attack in 1982 with about 24% of my heart muscle beyond repair ( per Cardiology ) On the Heart Failure my EF is 38% which I think is reasonable considering.
I am at Max for Meds for me , Bisoprolol 7.5mg, Entrezto 49/51 two a day, Aspirin 75mg, Pravastatin 20mg, Dapaliflozin 10mg, Lansoprazole 15mg, Eplerenone 25mg every other day due to Low Blood Pressure.
My HF Nurse told me I am at the limit for Meds and to Old for a Transplant, and there is every chance something else will get me before HF reassuring lol !! I filled in a Questionaire for Stem Cell research the other day and put down I would voulnteer for anything going !
I have wrote this just to show these heart issues are for the long term, I am now 76 and I have had a great life. I was told life span of a vein and artery is approx how long you live, as we all have them until the end !
When I pass if the Uni is not on summer break my body will go for research afterall I will be done with it. So Enjoy the moment the most important Med is a Positive View of the Future no matter how long it will be. I have been lucky with my Journey and wish you well on yours.
I think it is a good idea to donate your body for medical research and I am thinking about it myself because it seems to be the right thing to do and I don't want friends and family getting upset at a graveside or in a crematorium when I won't be feeling anything myself. I am not at all religious by the way.
Legs and chest operated on as most people have with this procedure.
I’m also amazed that no cardiologist ever wants to see you again but I’ve been fine up until recently.
My original diagnosis was discovered by arm pain, never chest pain and after the op my recovery was seamless and very successful.
Having said that recently I’ve had arm pain again. Told by my GP that I should go straight to A and E where my troponin level was 45 and I was told I had probably had a heart attack and I was kept in for 2 nights with no confirmation and discharged with no further tests.
My GP was unhappy with this and has referred me to the rapid chest clinic so more tests maybe on the way.
I’ve always been really happy with the way my condition was dealt with originally and hopefully I will get some positive results this time.
I have never ever spoken to anyone with arm pain prior to their diagnosis, I thought I was an odd one out!
The average life duration of a veinous graft is 15-20 years before further intervention is needed. Of course this is only an average, there are people who get less and people who get more. This by the way is for the veins from your leg. The mammary artery that is often used for the LAD artery is more durable, but I've never been able to find stats giving the actual expected service years.
These grafts don't "wear out" as such, the most common problem is re-stenosis, ie they become blocked as our underlying (and incurable) atherosclerosis continues to deposit additional plaque throughout all our arteries.
The bottom line is that exercise, far from wearing out your grafts, will actually keep you healthier for longer as it significantly slows down the rate of fat plaque build up.
So, keep right on exercising and good luck for the future!
Note, opinions and suggestions only, always check for interactions, and check with your doctor first before embarking on any changes. This is not medical advice
A lot of people think like this that I am fit and healthy and then bam they have heart attack and re-evaluate, I don't know your exact condition but I will summarize some key thoughts, its all about risk factors such as genetics and lifestyles, and let me give one example, it could be that you have perfect genetics and are extremely fit, and then one day in your 20's you have a heavy fat and carbo meal and do some extreme exercise, the high blood pressure causes a small tear in your intimal layer and for want of another word it's pasted in with cholesterol, remember the exact mechanism is not 100% proven but we understand it and model it exceptionally well at this stage. So it could be random event that started the disease process, and completely not your fault.
The disease mechanisms that follow, involving lipoprotein retention, inflammatory cell recruitment, foam cell formation, apoptosis and necrosis, smooth muscle cell (SMC) proliferation and matrix synthesis, calcification, angiogenesis, arterial remodeling, fibrous cap rupture, thrombosis, and more.
Then the process kicks in and the plaque grows exponentially at 30% a year and then in your 60's you have a heart attack despite being fit and healthy, and having no genetic deposition. TOFI, Thin on the outside, Fat on the inside.
I believe that we should be more pro active in our health and CAC's scans should begin at 40, we screen for bowel cancers, breast cancers, so why then when it comes to the number 1 killer , instead of screening, we use the Framlingham scoring, an out of date hit or miss guide. One to ask the cardiologists for sure.
You will see my top note, that this is not medical advice, but let's delve into the science issues now in your question.
Exercise is good, it releases nitric oxide which relaxes the cardio vascular system and improves the health of the endothelial lining, think of the endothelial lining as the life jacket surrounding all arteries, the blood pressure goes up and a reasonable rises allows a little extra squeeze and compression on the arteries giving them a work out.
Now here comes the difficult bit, the more your work out the more the blood pressure rises, the harder the heart works, and the more inflammation you suffer after the exercise, so if you push to hard, toxins are released and you inflame your cardio vascular network. There are numerous studies that show athletes suffer from high levels of plaque and faster rates of plaque progression.
Therefore if you are working out too hard you will accelerate the plaque growth in your coronary arteries, ( in my opinion)
But specifically you asked about your Veins that have been inserted, it is the injury to the vein itself when inserted that begins the inflammation process, leading to VSMC migration and plaque progression, that may or may not one day lead to the CABG failing, this process is not well understood , and it may or may not occur.
But in my opinion if you are on all the right medicines, right diet, right exercises , right supplements, you can stop this process from occurring or slow the progression of the disease process.
So in a nutshell, exercise is good just don't overdo it, and its all individual as to this gauge.
Bags more science and expertise there than I’m used to - or truly capable of digesting - but the only thing I’d add to my first post is that I’ve a strong genetic predisposition to CHD from my Dad and his (and no one would ever describe me as thin, hence only just squeezing in to the very top of ‘normal’ BMI range).
Note, opinions and suggestions only, always check for interactions, and check with your doctor first before embarking on any changes. This is not medical advice
You are welcome, I get a strong sense of positive thought when reading your posts, and I think that is wonderful, sorry that you had a heart attack, we live in an age with more medicines and knowledge than ever before, so I wish you the best.
For example I usually go to my health club 4 times a week, in the afternoon, I do 30 minutes fast walking on an incline, rest for 20 minutes, bicycle for 30 minutes, rest for 20 mins, and then 4 weight machines, 3 sets 8 reps, and waiting 5 minutes between each set, this will maximize muscle growth.
All the waiting allows my cardiovascular system to normalise, HR and BP.
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