Does my husband really have a death sentence?
Hi Doctor.
My husband, 43 years old, had a heart attack 2 weeks ago. We were told he had only mild heart muscle damage, but that there were 3 areas of serious blockage in the heart arteries. He had angioplasty and stents done.
Before his heart attack, he had "cold like symptoms", which I now feel were cardiac symptoms off and on over the past year or so. But he never had what the doctor called angina.
My main question is, what do we have to look forward to? I tend to be optimistic, but my husband feels he's been handed a death sentence. This morning his cousin told him that as many as 50% of heart attack patients die within 6 months. He's sick with worry. Is this 6-month statistic true?
Worriedly,
Agnes
DrRich replies:
Agnes,
Your husband's cousin is wrong.
Your husband holds his future in his own hands. In his case, his ultimate outcome to a large extent depends on his actions and attitude. His ace in the hole is that the extent of muscle damage is only "mild." This means that as long as he can avoid further heart attacks (and thus further muscle damage), he can live to a normal life expectancy. So what he needs to do is this: avoid tobacco, eat a good cardiac diet, control his weight, exercise regularly, and become meticulous in getting his cholesterol as low as possible. If he does these things, his prognosis (given his well-preserved cardiac function) is likely to be excellent.
On the other hand, if he allows himself to become depressed or to give up, he's letting himself in for some very bad problems in the future. People who take control of their lives through an exercise and diet program (no matter who they are)work wonders on their psyche.
By the way, the cholesterol issue is becoming more and more important with each passing month. It now appears that "the lower the better" may be true, especially in people who already have coronary artery disease. Recent studies suggest that with the use of high-dose statin drugs, the progression of coronary artery disease can be completely arrested in many patients. This is something, by the way, many cardiologists fail to focus on - cardiologists tend to concentrate on invasive procedures, and often neglect the medical treatment of coronary artery disease. Make sure his doctor is paying very close attention to his cholesterol, and is setting his/her cholesterol-lowering goals high enough.
Radical diets, such as proposed by Dean Ornish, may also be able to arrest or reverse coronary artery disease, but few people can stick to these diets.
The other thing to keep in mind is that new and revolutionary treatment for coronary artery disease is probably closer than many think. Gene therapy for growing new blood vessels, or for arresting the progression of coronary disease, is likely to be available while your husband is still a young man. So there is good reason for optimism, as long as he takes an active role in arresting the progression of disease. I would urge you both to keep up with the latest research on arresting/preventing coronary artery disese. Things are changing rapidly, and especially with the Internet, often patients need to tell their doctors what's new.
The only other thing I should mention - and I'm sure you are well tuned to this already - is that if those cold-like symptoms should ever return, he needs medical help ASAP. Those were almost certainly occult cardiac symptoms.
Best of luck,
DrRich
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