Bypass needed at 28

[igixxn2]

To make a long story short, I've been going through the typical CAD tests as a precautionary measure since my brother who is 30 just had a heart attack. (I'm 28) Well, after my cholesterol was found to be 505, I scheduled a Cardiolite Stress Test and made it through the exercise portion okay with no chest pain, even though my EKG showed some signs that I might have blockage. The images taken after the stress test showed even more evidence of blockage. My at rest images were normal and the after stress images were abnormal. I was thin reluctantly scheduled for a left heart catheterization, which was done last week.
The results were not good. Three blockages were found, 100%, 75%, and another 95%. The only reason I'm alive (and with no pain) is I've grown collateral arteries to supply blood to the blocked areas of my heart. The cardiologists was not interested in attempting to treat these with angioplasty and has recommended that I have a quadruple bypass.
You can imagine the shock to find this out at the age of 28.
Is bypass my best option? This whole thing would be easier to swallow if I at least had some sort of symptom. I'm in better shape now than I've been in a long time and I feel great.... are there any decent alternatives?

[CCF-M.D.-KE]

Dear Igixxn2,

I am sorry to hear that you have  severe coronary artery disease at such an early age. This is likely in part due to an undiscovered genetic abnormality. Without knowing the location of the blockages and reviewing the catheterization films, I can not make a definitive recommendation.  However, the blockages are significant and may be best treated with coronary artery bypass grafting. If you are concerned about your best option you should seek a second opinion.  I would soon schedule an appointment with a cardiologist at a nearby university based medical center.  Take all of your medical records to this appointment, including a digital copy of your heart catheterization. Also consider making an appointment here at the Cleveland Clinic if possible. The appointment desk can be reached at 1-800-CCF-CARE and our website is www.ccf.org.  
I hope everything works out well for you.


Thanks for your question,


CCF-MD-KE

[hbp702]

That is terrible.

I am wondering why, if they said you had 3 blockages, that they are recommending a quadruple (4) bypass, which would be used if there were 4 blockages. Sounds like a miscommunication.

Make sure you get everything in writing when dealing with doctors about such a serious matter.

[beebug]

I do think that when you have blockage that severe that they always do bypasses.  You are awful young to have that kind of blockage.  My brother in law had to have 7 bypasses done. His blockage was bad like that too.  But he wasn't as young as you. I would not put this off!  You need to do something pronto! Good luck!

[paulus]

Hi igixxn2

Sorry to hear of your problems.  In my case I identified problems at 42 via a UBCT scan which showed extensive calcification in my arteries - although as in your case no symtoms.

I was lucky enough to be referred to a fairly prominent (and perhaps a little controversial) Preventative Cardiologist who is a firm believer in using the best of traditional and alternatve medicine to treat our type of problem. He is a believer in surgery only as a last resort - and I think only rarely in people who have no symptoms.  I think if you do some research you'll find that surgery is a pretty effective medium term (average 7 years)treatment for folk with symptoms but fairly unproven in it's ability to head of a critical event such as a heart attack.

I think my Cardiologist would be fairly horrified that a young guy of 28 (with no symptoms) should be recommended major by-pass surgery without first attempting to control his condition via lifestyle/medication.  After all your real problem is less "blocked arteries" and more an underlying problem with your lipid/sugar/chol etc profile which causes the clogging to occour - this needs to be treated regardless of any by-pass otherwise the clogging will just continue.

I know that my Cardiologist would run a major blood profile so as to be certain as to what is causing your problem. With your Chol level so high that probably is the reason but he would also check for things such as CRP, lp(a), homocystiene, insullin/sugar levels and then devise a lifestyle program to address your underlying problem.

The lifestyle program would most likly include - excersice @ 30 mins 3 or 4 times per week: diet low in saturated fat, red meat and reffined carbs and high in fruit and veg/fish/olive oil/red wine/garlic/almond and walnuts. He would want to address your Chol with statin drugs and niacin and have you on vitimim C and E supplemets and possibly Ginko Biloba.

PLEASE try to seek a second opinion from a good preventative Cardiologist before undergoing any surgery. You may find that a good lifestyle program can stop your disease in it's tracks without surgery - it has to be worth exploring and if you body is already growing collateral viens then that should be a pretty good start.

It's your body and your future - your really should question these doctors hard.

Very best wishes to you - Paulus

[HealThySelf]

You would be very foolish to have bypass surgery at age 28 and the physicians who recommend it should have an ethics review.

You have to live a long life and the average lifespan of venous grafts is 7 years.  What are you going to do when your in a worse boat at age 35?

You need to get on a very aggressive cholesterol reduction, exercise, and weight control program.  You can get your total cholesterol below 150 with a combination of multiple drugs.  That will take the risk our of your situation.  It's not the blockages that kill you, it's the rupture of lipid rich plaques.  Dry out the lipids and you dramatically reduce the risk.

Sure you have a genetic predisposition to the early onset of CAD, but you can override that with drugs, exercise, and lifestyle changes.  In 5 years you could have normal health, if you are serious about it.

Best of luck to you and don't fall for the cardiac surgeons sales pitch.  Seven years from now, when you are hosed up again they will have your fee and will not remember your name.  It's up to you to turn this situation around.

[roland]

I've said it before and I'll say it again. The heart is the most screwed up organ in the human body. Look at the problems that you hear about nowadays concerning the heart. It seems like everything a person does is bad for the heart. You can't eat anything good and you have to exercise like a maniac...and then you hope and pray that you will be okay even then. Most of us have to work for a living and that leaves very little time for good quality exercise. For those that try to exercise after work...you are too tired to do anything productive. Yes, millions of people have to be worried and tormented throughout their lives worrying about heart disease. We all have friends or relatives who have had heart problems. In my opinion, heredity is the number one risk factor. I have an uncle who is a big fat lazy couch potato. His only "exercise" is going from the couch to either the refrigerator or bathroom. He is 73 years old and has no heart problems...no blockages. He has been recently checked. He has no hereditary risk factors. No one in his paternal or maternal family has heart disease. He eats eggs and sausage for breakfast everyday without ill effects. It's all about heredity. I've seen this first hand...I've seen the proof. Hundreds of years from now through evolution there will be no more heart disease as we know it today. The human body will evolve and correct itself. Heart disease is the number one killer...the heart is one screwed up organ. Trust me!

[HealThySelf]

I disagree -- the heart is a wonderful organ and the human body has the ability to maintain it's health for a century if we treat it well and give it a little work to do.  In many people, The body can even endure lifelong abuse, as in your uncle's case.  With care the body can rebound from life threatening disease, as in my case, and become healthy again.

My dog will never have coronary artery disease because of genetics, but she will also never do calculus because of genetics.

True, the natural selection process would probably eliminate all of the family lines genetically predisposed to coronary artery disease over several thousand years, but I don't know of anyone who wants to be in the group eliminated.

I am predisposed to coronary artery disease because of something labeled "familial hdl deficiency".  In twenty years there will be a genetic treatment for this.  I knew that I had this problem in my family, but never took any care, somehow believing that the bullet would miss me.  

Now, if I want to live, the reality is that I need to use the best medications available today and provide an environent where my body can maintain it's health.

This is not a problem of my body failing me, but of me not making health a priority.  After you have a health crises, you may get to a point where health and life has a higher priority than work and other things.  This means walking before work and/or before lunch in my case.  Taking more time off even though it means less income.  

There is a beach and lighthouse on Puget Sound only a few miles from my work.  I doubt that any of the other people in my office have ever seen it.  I walk 2 miles down to the beach and back every day before lunch.  It's not a chore.  It's a wonderful break from work.  The tide is different every day.  There are different birds and animals such as sea lions.  Some days the Olympic mountains are clearly visible, other days they can't be seen.  There is always some interesting boats and shipping.  It's a wonderful break from work, gives me the exercise that I need and totally relaxes me.  I find something like this where-ever I am -- I think everyone can if they look for it.

Best Wishes

[SRBKING]

Do not due the bypass at this early of an age. Your heart is self sufficient enough to survive without the bypass for another 20-30 years, but you can improve yourself even though ur slim.  Start taking Flax seed oil to reduce cholesterol.  Drink a lot of Garlic tablets and jog 20 minutes 4 days a week for the next 3 years.  You will clean out those blockages you have.  

Bob

[Firehawk734]

It really is amazing though how his body did adapt to that situation isnt it??? REgrew new pipes to fulfill the plumbing.

[Denver Padre]

I have CAD and am trying to find out if taking multi-vitamins with ginko biloa is contra indicated.  Thanks for the help>

[Snap]

hmmm.. I don't know how much Natural Selection will weed out heart problems. Most heart problems develop later in life, AFTER you have kids. Natural selection is only good for genetic problems that kill us young.