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Heart Disease Hits Home!

July 2007
Heart Disease Hits Home!

It is now determined that Asian Indians have the highest rate of heart disease in the world. Many of us read this and comprehend it but cannot fully understand the devastating effects until it affects someone in our home.

My husband Pankaj (age 48 years) has over the last seven years improved his lifestyle tremendously. After his dad died of a sudden heart attack at age 58 and younger brother of a brain aneurysm at 41, Pankaj, who also suffers from hypertension and recently diagnosed sleep apnea, began an exercise program of walking/running and weight lifting. Along with this, he also made dietary changes which resulted in a 40 lb weight loss. Having followed this healthy lifestyle for many years, a few weeks back he began experiencing an unusual feeling of tiredness and extreme pressure in his jaw and face upon exertion. This pressure was mainly during exercise—walking on the treadmill, lifting something, or climbing steps.

One day, a week after the initial symptoms had begun, he started to walk on the treadmill and immediately got off within a minute, complaining of severe, jaw crushing pain. Later on that day he called his internist for an appointment for a complete physical. We assumed that the pressure in his face was probably due to sinuses, and didn't think much about it. A couple of days before his appointment with the internist, Pankaj was unable to climb several steps without getting completely out of breath and having to hold onto the handrail and stoop over. This he felt was very unusual for a physically fit individual who could walk fast on the treadmill and lift weights. I was a little nervous at this point and wondered if he had a tumor that was preventing blood flow to his head and face.

During the appointment with his internist, an EKG was performed which had normal results. All his lab work also had normal values along with his cholesterol levels. In spite of this, the internist appeared urgent in his manner and suggested a nuclear stress test with a cardiologist the following morning. Upon meeting with the cardiologist, we were told that given Pankaj's family history and his previous smoking history (he had quit for the last thirteen years but had smoked for about twenty years), it would be best to have a cardiac catheterization done instead of the stress test. He further told us that Pankaj was probably experiencing symptoms of angina. Classic symptoms of angina, I had always thought were experienced as pain in the chest, shoulder, and back—not really the face and jaw. The cardiologist also informed us that if they were to find any blockage, they would take care of this during the catheterization. I sat and waited the next morning as they wheeled him away for the cardiac catheterization. As I waited for over an hour flipping through a magazine, I had plenty of time to think. Surely, he could not have clogged arteries as he was physically fit, had perfect cholesterol values and normal lab values, and ate healthy (I always made sure of that). Also, I said to myself, since the pain was mostly in his jaw and face, it couldn't be his heart. The only comforting thought I had was that he had walked into the hospital looking normal and healthy and was not transported to the hospital via an ambulance. My thoughts were interrupted as the cardiologist came in to update me.

"We found one of his major arteries—the left anterior descending (LAD)—to be 80 percent blocked, along with several others that were 30-50 percent blocked and some small ones that were 100 percent blocked," he said. "The symptoms that he was experiencing were that of a heart attack which was probably going to happen soon. Your husband is fortunate that he acted quickly and sought medical care!" He further informed me that they were going to place a stent (a tubular wire mesh) in the LAD artery to open it up and would be prescribing Plavix to prevent further blockage of arteries. You can only imagine my horror and disbelief! The cardiologist explained that it was my husband's family history and previous smoking history that contributed to his situation, and even though diet and exercise helped to delay the process, it's sometimes not enough for someone who has a history of heart disease in their family.

I now understood the enormity of heart disease being "a silent killer." As I brought my children home that night after they visited their dad at the hospital, I faced a gloomy, quiet home. I couldn't help but think about how serious, even fatal, his outcome could have been. Lifestyle changes and early detection had saved Pankaj's life. What if he had not made those lifestyle changes? What if he had had that heart attack, was alone, and wasn't able to get help? What if he had not started exercising? If he had not been exercising, Pankaj had said to me earlier at the hospital, he would have brushed the symptoms off as being tired, out of shape, or just simply getting old, and probably would not have contacted his doctor in such a hurry. What would our lives have been like then?

The WHO estimates that 60 percent of the world's heart disease patients will be Asian Indian by the year 2010. Numerous studies now indicate that Indian men develop heart disease more than any other group and are victims of a sudden heart attack at a younger age. Countless articles have been written about the high rates of heart disease in the Indian population. To the majority of us, however, these statistics do not mean anything as we continue to live our lives oblivious to the fact that our arteries may be clogging due to the food we consume, or the sedentary lifestyle we lead, or even certain genes that our parents have blessed us with. We must not ignore family history and must realize with urgency that this statistic could soon, suddenly, and unexpectedly become a loved one in our home and, therefore, we must make the necessary lifestyle changes now. Unfortunately, when heart disease does strike someone close to us, only then do we sadly realize that it is not really a matter of numbers and statistics anymore, but a matter of a cherished heart.

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