Update 3 Jan 2015: Med students, heart patients, and interested people, here is an actual post written detailing the signs and symptoms felt while I was suffering what was later diagnosed by a cardiologist as a major heart attack. If you’re up for kicking in a few bucks to help with spiraling healthcare costs due to heart attack and poverty level disability pay, my paypal email is posted above.
So I got the cath results: It wasn’t a minor heart attack folks. It was a full blown widow maker where a primary coronary artery got blocked 100%, and that blockage was right at the top, high enough up that the bottom two-thirds of my entire heart could have been deader than fried chicken. I would have been dead before my body hit the floor.
How am I still alive, much less able to spend the last several hours running up and down stairs, straying all over the hospital, flirting with night nurses (Oh man, the brains on these gals, I can’t stop talking to them, their science-y minds are so incredibly hot!) just a few hours after the cath that confirmed a massive myocardial infarction? Well, it’s not a miracle …
Now take this with a grain of salt, this is highly educated guesswork, I might have misunderstood or over simplified some of it. But to the best of my knowledge this is a viable theory on what probably happened and why I survived.
They tell me part of it is genetics and part of it is aerobic conditioning. Some people are more or less vascular than others, meaning they have a little more or a little less blood carrying capillaries per unit volume of cardiac muscle. The cath and other results suggest that my heart naturally leans toward a little more. On top of that I’ve been working out like a demon ever since I recovered from a broken back last year. For the last six months in particular my usual routine was to run three to five miles, then either lift weights or do a spinning class. I lost almost 40 pounds doing this over the last six months.
The thing is, this blockage was probably forming for a long time. It may have initially set up on an old minor infection site, it could have been a factory defect or some kind of weird injury that encouraged it to set up where it did, but like a deep nick in an otherwise smooth pipe, that’s where plaque is more likely to start congregating. It builds and builds, and sooner or later a clot or a loose piece of plaque comes along that plugs the final gap, and BAM! Major heart attack. This is probably what happened to me. Two other arteries had some plaque, but nowhere near what this one had and those two were easily taken care of with angioplasty.
I was probably, literally, unknowingly, training my heart to survive a major heart attack. Working out real hard increases capacity anyway, doing it with a major artery blocking up probably speeds the process, lots of cross connecting capillaries from other, viable vessels form. So when the big one came, those much smaller caps were able to keep the cardiac muscle infused with enough oxygen that the tissue survived in pretty good shape. That’s probably why it didn’t hurt much or radiate or cause any traditional symptoms like crushing pressure.
I’m told this isn’t an ideal situation, the heart and arterioles crank the pressure up through the roof to try and push oxygen into the heart. Those little tiny vessels now filling in for a big coronary artery can’t handle that pressure and load for long (My unmedicated blood pressure before the cath was 180/120). They were probably already starting to fail. I was weeks, maybe only days away, from another attack, and it probably would have been one I couldn’t walk away from quite so easily. One tech told me flat out that had this gone on untreated for a few months, it probably would have resulted in a series of heart attacks causing permanent loss of cardiac function, unrecoverable and substantial loss at that, and possibly bad enough that I would be an invalid for the few remaining years of my life or even a transplant candidate. Assuming I survived at all.
The clogged artery was ballooned and took a stent like it was custom made for me. Even under serious twilight sedation, when that balloon was done and they put the stent in, all the sudden it was like I had been holding my breath for three weeks and could suddenly breathe again. It was amazing. Within hours, as soon as they were sure the cath wound on my femoral artery was sealed and the seds wore off, I couldn’t sit still. It was almost like being high I felt so good.
I don’t know what I’ll be able to do at the gym after I finish cardiac rehab – I’ll be on disability and a special heart conditioning program for a few weeks just to be safe. But I can tell just walking around the hospital, I’m going to have the aerobic capacity of a fucking marathon athlete when this is all said and done! And oh baby, I am going to live the rest of my life large and loud and sloppy.