I am a healthy 47 year old Physiotherapist who has been involved in Sports & Athletics most of my life. In addition to my above average muscular build from decades of weight training, I am also blessed with good genetics so I have never worried about my weight one day of my life. I may be one of the last people you would suspect to have heart disease, but I do and following a series of events & tests in recent weeks lead to a confirmed diagnosis of Severe Coronary Artery Disease (CAD).
The image of the typical person with heart disease would be someone usually older in age, who is overweight, that is a smoker, and who perhaps has poor eating habits with lots of junk or fast food in their diet. I do not fall into any of these categories but yet my coronary arteries were significantly blocked to nearly 95% on aspects of the left main artery. How could this have happened? We need to first explore the risk factors that place people at higher risk for CAD before we answer this question.
Risk Factors for Coronary Artery Disease (CAD)
1. Age – The average age for heart attacks in Canada is about 70years old but it can happen at any age and the risk increases with age for both men and women.
2. Smoking – It increases the formation of plaque in blood vessels. CAD occurs when arteries that carry blood to the heart muscles are narrowed by plaque or blocked by clots. Chemicals in cigarette smoke cause the blood to thicken and form clots inside veins and arteries.
3. High Blood Pressure – People with high blood pressure are more likely to develop coronary artery disease because high blood pressure puts added force against the artery walls. Over time, this extra pressure can damage the arteries, making them more vulnerable to the narrowing and plaque buildup associated with atherosclerosis (narrowing of the arterial walls).
4. Diabetes – High blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop CAD.
5. High Cholesterol – When there is too much cholesterol in the blood, it increases the plaque build-up in the arterial walls leading to narrowing and decreased or blocked blood flow to the heart.
6. Family History – People with one or more close relatives who have or had early coronary artery disease (CAD) are at an increased risk for CAD. For men, early CAD is being diagnosed before age 55. For women, early CAD is being diagnosed before 65. These people may have a genetic predisposition the above listed CAD risk factors such as high blood pressure (Hypertension), high blood sugar (Diabetes), or high cholesterol (Hyperlipidemia).
My Story and Insight.
So to answer the question of how I as a healthy 47 year old male was diagnosed with severe Coronary Artery Disease, it came down to one major risk factor that was out of my control, Family History. While we can control or influence our CAD risk factors by eating well, exercising regularly and choosing not to smoke or to quit smoking, you cannot escape your genetic predisposition. I was first diagnosed with Hyperlipidemia or High Cholesterol in my 20’s. Although I knew that high cholesterol was a risk factor for plaque build-up in my arteries, I reassured myself that a single risk factor was not enough to lead to Heart Disease. I studied health sciences, understood the human body fairly well and had read many published articles and studies on the promience of Heart Disease in our society. I use to always say, ” There are no good studies on the risk of heart disease on 25 or 35 year old males with only high cholesterol and no other co-morbidities”. And this was the case, so I used that to convince myself that I did not need to start Statin drugs (Cholesterol medication), and just continue with my healthy lifestyle choices…. and I would be OK, but I was not!
6 months ago…
I began to feel unwell or a sense that I was choking or needed to stop to breath with a period of walking. I also felt the need to burp so I assumed that it was a Gastrointestinal (GI) issue and began to self treat with medication to reduce stomach acid production. It seemed to give me some relief, but my symptoms were still present with ups and downs week by week and day by day.
I finally consulted with a Walk-in physician over the phone due to COVID protocols (did not have a family doctor) to get to the root of the problem. This physician was thorough and sent me for bloodworks, H-Pylori testing, Echocardiogram and a Cardiac stress-test to determine if my issues were cardiac or gastrointestinal related. My stress-test returned with some abnomal signs