I have a few questions. First, concerning Daryl Kile, the pitcher who passed away over the weekend.
His preliminary autopsy showed an 80 to 90% blockage of his coronary artery. Team said he had physical including EKG during spring training. How could his obvious heart disease not have shown up during the physical? Would a stress echo pick up any blockage if the ECG did not? If not, what test would?
Also regarding heart rate. I am 6 ft 188 lb male. 37 yrs. Resting heart rate between 58 and 65.
Sitting heart rate between 68 and 78.
Standing heart rate 80 and 90.
Walking heart rate 90 and 100.
This was indeed a tragedy.
Unfortunately, stress tests and electrocardiograms (ECG) are not 100% sensitive. From time to time an ECG or stress test may be normal and a person may have significant coronary artery disease. Also even if a stress test is finally deamed normal it means that a person maybe a low risk not, no risk.
The heart rates you have listed above appear to be within the normal range for the activities listed.
The unfortunate early death of Daryl Kile shows that people can still have high physical ability with 80-90% coronary artery blockages.
Also pretty much all non-invasive testing is inconclusive in young otherwise healthy people.
It's really not the blockage that kills, but the rupture of a plaque followed by clotting within the coronary artery. I am somewhat suspicious of the cause of death because they didn't mention this.
It also goes to show that most people don't die during physical exersion, but at 5 am the following morning.
I would say that most young people with this level of disease could be saved with agressive pharmacological treatment of lipids. The problem is that most of us will never take it seriously until we have had a cardiac event.
I do think that low HDL would be the primary predictor in disease for someone in this age bracket. I would love to know what his last HDL reading was.
You are absolutley correct that none of the non-invasive tests are 100 % accurate. You appear very knowledgeable, as shown in your posts, on heart disease. Apparently, you do just as I do, and research all you can. My quest began in 1996, when, at age 36, I developed panic disorder with an immense fear of heart disease, tha still lingers with me somewhat to his day. I've gone to some of the country's top cardiologists, and still do to this day in an attempt to prevent heart disease. I have had stress tests, all the newest lipid tests, an ultrafast CT scan (which was reviewed by pioneer Dr. Ken Cooper, who assured me that my total score of 2 was fantastic.)
Has all of this convinced me that I'm healthy? Nope! Because of incidents like this where seemingly healthy men die suddenly from cardiac disease..just last week a friend of mine, age 45, no history of any problems, got chest pains, and the end result turned out to be a 6 vessel bypass! So, pay attention everybody...probably the only test that is certain is an angiogram, and they don't give them on request, plus, I'm apprehensive to even get one.
I would say that the best predictor of coronary artery disease is still your lipid readings, with HDL being the most important. Also as in Mr. Kile's case heredity is a large risk factor.
My mother had CAD with three heart attacks leading up to bypass surgery at 57 and death from heart failure at 64. I had total cholesterol readings of between 220 and 240 with HDL readings around 30, but never paid much attention to them. Somehow I thought that the bullet would miss me.
I was also overweight, ate a high fat diet, and was a workaholic - all high risk factors.
I would say that, with your test results, if your HDL is high-normal, your not overweight, and don't eat a high fat diet your risk is extremely low.
As for your friend getting a 6x bypass, remember that stents and bypass surgery doesn't stop the disease. They may last 15 years or they may last a year. There are also huge risks in either procedure, which are largely unaccounted for by the industry.
I had a heart attack at 50 which lead to the discovery that my RCA was 100% occluded (and had been for severeral years) and my circumflex 70-90% blocked.
A year in a half later, a subsequent attempt at angioplasty discovered that a large, prior undiscovered, plaque in my left main had "cratered" - that is the top had blown off and the shoulders were left flapping in the bloodstream. Although the attending cardiologist flipped out and aborted the procedure, I believe that this was the result of successful lipid therapy. I was given 40% odds of sudden death within 5 years by the cardiologist in his sales pitch for bypass surgery. Fortunately I really don't believe that estimate. I would give myself about a 2% chance of death within those 5 years, but of course he could be right.
Some people like Mr. Kyle die instantly when that happens, others like myself survive it. I think my left main popped the night after I climbed Mt. Adams for the first time after my heart attack. I felt a little bad the next day, but survived it.
I don't know if you will come to not worry about having a cardiac event or dieing suddenly, but I no longer do, even with the warnings that I have been given. Somehow I just came to resolution with it over a couple of years.
I just take my cholesterol and BP cocktail of meds, walk twice a day, and do some hiking or skiing on the weekends. I try to eat less saturated fat, but my motto is eat drink and be merry. Who knows you could worry a lot about it and a big rock could hit the earth tomorrow and wipe out all life.
I just treat it like any other chronic condition. I push up against it physically a couple of times per day, take my meds, and try to enjoy life. I monitor my BP and have a thallium test each year to check my LV size and EF for any sign of cardiomyopathy.
After quite a lot of study, I have come to believe that Stents and Bypass surgery are not the way to go unless there is no choice. Also drugs such as beta blockers, blood thinners, and nitrates are counterproductive to someone who is actively trying to push back the disease.
Thanks for sharing your knowledge. I have a question for you if you know - How do I raise my HDL significantly? Im overweight, so Im working on that and have lost 14 pounds so far - Im serious about getting right because I am only 37 and think I can turn this thing around before it's too late. My HDL is around 30 as yours was - my LDL isnt that bad - 140 and total around 200 / but with the low HDL - Im scared - now the Dr says I can only raise it 'a few points' on my own. I have read where people raise it 20-30 without meds / is this true? If I exercise, lose the 50 pounds that I need to lose, and eat low fat and eat right, how much do you think I can raise it? My parents are both ok - its my grandparents that had heart attacks in their 50's and 60's / I am also taking guggulipids as an herb - I read that it REALLY makes a difference - I take soy everyday and CoQ10. DAMNIT why doesnt that HDL want to move?? LOL! Anyway, any light you can shed on how I can raise my HDL would be really helpful! I really admire your outlook on life after what you have been through. Really makes us worry warts look like a bunch of babies! My dad was always thinking he was going to die and after many tests they say he is fine and probably wont die of a heart attack like his parents did - so I think that paranoia was passed onto me! :) Have a great day!
I think you should concentrate on getting as fit as you possibly can. First, start aerobic exercising everyday...start out slow and gradually build up. Maybe start out walking a bit at first. Then walk a little faster and farther, then keep building up to a slow jog in there as well. Do NOT overtrain yourself however. Go a bit hard one day...then go easy the next...then go easy-hard the next day...then go hard. The key is recovery time between the hard workouts. Also, some weight training as well 2-3 times a week...starting out with a few sets. Once you get fit, start doing activities that are fun plus a great workout like biking, rollerblading, swimming, hiking...just do it a bit more intensely...the key is to raise the heart rate enough to get the aerobic benefits. Plus, eat smaller, more frequest meals throughout the day with plenty of good foods...fruits, vegetables, whole grains, some nuts, some fish, maybe some low-fat milk. And plenty of water 8-10 glasses a day. The more body fat you drop, the fitter you will get and your HDL will go up...but it takes dedication, motivation and drive. But once you see results, you will stick with it...it's a total lifestyle change.
Start today and don't wait...your attitude will improve, believe me.
Thanks so much for your help! It helps a ton! I have been doing stuff too like working in the yard - mowing the lawn / working my moms house / its funner for me to do yardwork - and then Ill ride my bike 4 miles or so and then walk a mile the next day - is this what you mean but alter the intensity ? I n eed to lose about 40-50 pounds. If I do like you say - and really try hard and get to my target weight and eat well, do you think I will be ok with the HDL? I wont have to worry about it? my dr told me if I can raise it 10 (its 30 now ugg) I would be fine - but I have read its not optimal for women unless its over 60! Have you heard that being in the best shape I can be in will get it high? (more than 10 points?)
Thanks again for all your support! I love this forum!
It sounds like you are on the right track for lifelong habits to prevent cardiovascular disease.
I agree with the previous person on exercise. It's important to do at least 30 minutes of light cardiovascular exercise each day, but I wouldn't overstress yourself until you are very fit. I walk a hilly 2 mile course before work and before lunch to maintain tone and relieve stress during the week. Although good, walking on the flat doesn't do a lot for you. Going up and down a little gives you a little more of a workout.
There are currently only 3 things that raise HDL significantly:
The exercise will bring your HDL up perhaps 10 to 15%, but that is not enough. If you can drink a glass of red wine each evening and stop at one, that will help a little also. Perhaps between the 2 you could reach 40 or so.
The only substance that really makes an impact on HDL is high strength Niacin. Most people can't take off the shelf Niacin in high enough doses to help without experiencing flushing. The "No Flush" niacin has no effect on HDL, so don't bother with it.
I take the prescription drug Niaspan, which will raise your HDL to above normal levels. If I were you, I would ask your doctor for it.
I think that you should be at least at the 2 gram level for effectiveness, although they have a program to build you up slowly. I found it's best to take all of it at once at bedtime.
I wouldn't worry about toxicity, unless you have had hepatitus or have previous liver problems. You will need to have a liver enzyme check regularly on the drug, but I don't think that there is much risk.
I have taken a lot of different supplements including CoQ10, but discontinued it because I didn't think that it was doing anything. I do take a good multi-vitamin, folic Acid, Vit-E, L-Carnitine, Lutien, and Garlic. My list of supplements fluctuates from time to time and I don't really know which ones do you any good and which ones don't.
I also think that Fish Oil or Omega 3 supplements might help you build the HDL, considering that your LDL is low.
I believe that you can prevent CAD if you start working at it at your age and keep your good habits. Good luck to you.
Thank you SO much for your help! If it werent for people like you who have already been there, I wouldn't have anyone to help me. I certainly have faith in Dr's but Society is really not PREVENTATIVE oriented. Its more, once you have the heart attack, come see us. If you don't have any problems, or symptoms other than PVC's - you don't need the tests. My lipids are what alerted me, and my family history - so I don't want to sit around and let my dr tell me "your fine, relax" when I know in 5-10 years, I very well will not be. Thanks for the tips and I am definately going to ask my dr about the niacin drug - I was afraid of the liver thing - but I think Id rather monitor that and keep that in check than run the risk of a heart attack. My dr wanted me to come back in 4 months after trying some exercise etc. for more blood work - thanks again for your help. You sure are a strong person, you sound like you don't have much fear over it anymore - thats awesome! I need to keep faith in God and do the rest myself (get in shape etc) and be happy like you say! :)
I have only been on the NIASPAN since last October. My HDL had gone up to about 38 with exercise. After a few weeks on the initial dosage of NIASPAN it had moved up to 48. I haven't had it tested since but am hoping for about 60. I am having a little trouble getting an appointment with the lipids testing person at my doctors office with my summer vacation schedule.
Anything below 40 is considered dangerous on the new cholesterol standards. With your reading, there is no reason that you shouldn't be prescribed Niaspan unless you have liver problems. You need to get that up to about 60 to get completely out of the danger zone.
I said your LDL is low, but I mistakenly read 140 as your TC reading. a 140 ldl is borderline high and you should try to get that down to about 100 and your TC down to at least 160. The Niaspan should also help with that although you might need a low dose of Lipitor also.
I take Lipitor, Niaspan, and Welchol in combination, which works extremely well, but I am willing to take more risk because of my severe condition. I wouldn't recommend that much for a healthy person.
Unfortunately, it took me almost 2 years, after my heart attack, to get on, what I consider to be, the right cocktail of cholesterol and BP meds. It tooks some study, trial and error, and lobbying with the doctors to get where I am at now. But I wasted a lot of time where my disease was progressing. Neither my PCP or cardiologist was up to date on the right drugs to prescribe. My cardiologist now seems to have seen the light. Of course he makes his cash with a heart catheter, not on the drug scripts.
I would say that if you watch your diet, exercise religously each day, and get that HDL up, you should avoid a future cardiac event.
One more thing. You are good to be working at this now while you still have plenty of time.
Your lipid profile is in what I would call the "Watch Out!" category. The HDL/LDL ratio is a very reliable predictor of coronary artery disease. That's why the life insurance companies use it.
Also, I always tell the young overweight guys around the office, that you can eat anything that you want and do anything you want until you are about 50 and then the waiter will send the bill to your table. And when he does, it's going to be a whopper and it's going to hurt real bad!
If I could have gotten aware and been willing to do what you are doing when I was your age, I believe that I could have avoided the heart attack, 2 failed angioplasties, and the physical limitation that I now have.
My husband tried eating oatmeal for breakfast 5 days a week and was successful in lowering his cholesterol to the same numbers I have but I have to take 60 mg. Pravachol. Also eating fish a few times per week helps - my mom's HDL is over 100 but she eats fish 4 to 5 times per week..usually steamed or broiled rather than fried. I was able to increase my HDL from 30 to 46 by just adding a 20 minute walk 5 days a week. This is in addition to a 3 time a week one hour aerobic class that includes weight training. I also take Toprol XL 25 mg. & yes I have to work harder to get my heartrate up to target but it can be done. Good luck to you !!
Do NOT let your PVC's intimidate you in any way from exercising and achieving your fitness goals. I have sinus arrhythmia, a wandering supraventricular pacemaker, a hyperdynamic pulse and low resting heart rate, but all of them are natually occuring adaptations to rigorous exercise and are in no way harmful to a healthy, strong heart. Go see your cardio to get the green light, then set your plan in motion.
I am a 33 year old male with constantly low HDL. It has been as low as 24. My LDL and TC has always been normal. I have stomach probelms and cannot tolerate the Niacin side-effects. I had my doctor start me on Zocor 20mg so I would at least have something making my ratio better. My lipids are as follows:
Do you think I have done the right thing considering my options?
1. The one test that could have reliable predictive value would be the heart scan. This test is being marketed heavily now, but I think is generally NOT covered by insurance.
2. To improve lipid profile be sure to eliminate the all fats that are solid at room temperature - i.e. butter, margerine, lard, etc. Use olive oil when you must have oil, and eat the fresh water fish that provide the omega fatty acids. Salmon from the sea is good, and NOT the same as the salmon raised on farms - which is now so widely available at lower prices.
3. For weight loss and general health a diet based primarily on vegetables, fruits (though these are high in sugar) and whole grains (eliminate refined flour - breads, pastas) will work. Steamed veggies are delicious - really!
All this is assuming you have the green light from your cardio doc. The most important aspect of exerise is intensity level. Not distance or time spent doing the activity. The more intense the aerobic activity, the higher the heart rate and the more you sweat, and the harder and faster you breath. There are studies that conclude how exercise tolerance is the most powerful indicator of heart health...more so than HDL level, body type, blood pressure, smoking, diet. All these other indicators are important also, but the ability to exercise intensely is the most powerful. Like I said in my other post, you can't exercise at 90% VO2 Max all the time, and for long periods of time. (This is quite an intense level)...perhaps once a week to start, then twice a week when you get really fit. In between the hard workouts, do your light biking and yard work...this will help your body recover from the hard training sessions by circulating enriched, oxygenated blood to your muscles. It will take time, but really not too much time if you are serious about it and stick to your plan. The leaner and more fit you become, the higher your hdl will get. Your heart muscle itself will also become stronger, get slightly bigger and beat slower when resting. Set a goal for 4 months, 6 months and 1 year. Then create a training plan and stick with it and document your results religously. Also, learn everything you can about fitness. Get a heart rate monitor...it's very motivational and an excellent training tool.
Check out this site:
Thanks so much to all of you for helping me! I haven't been to a cardiologist for about 6 years - when I had all the testing done. I have had EKG's since for the PVC's and all came out fine - I do believe that my hormones play a HUGE part in the pvcs as I can mow the grass front and back without stopping the first week after my cycle ends, but at ovulation and a week before - watch out - I cant even seem to get out of bed the wrong way and wham! I hate them. I notice exercise does help. I worry a little abou the intense workouts as I seem to be real out of shape - my heart will throw a pvc if I push it too hard - thats why Im worried - I asked the cardio and he said Im out of shape - so I hope I will be able to make it intense after Im in better shape?? Anyone have any suggestions on eating vegetables and fruits ?? I know thats how I should eat - but have never been a vegetable eater - I have been able to partially enjoy steamed veggies - I just cant eat raw - unless its salad and I know there isnt much nutritional value there. What else do you steam other than brocolli and cauliflower? I am way new at eating like this - I was a go out to eat girl most fo the week! I try subway more now if I want to go out - its hard. No Bypass - I do go back to the doc in another month to recheck the levels - she thot they were way out of whack too and I will ask her about the HDL raising niacin one / I think with diet alone I can lower the tri's and the LDL since the LDL was close to the 130 that it should be / but the tris were way high and I think thats attributed to my weight. Can you believe my other GP told me that I shouldnt pay attn to the triglycerides as they are directly related to weight and not really a cardiac factor? Thanks so much for your support and making me feel better about doing something about it now - I have been waking up everyday thinking that Ive already blown it - that its too late and IM going to have a heart attack in the next few years - my aunt did at 39 (course she was 450 pounds too) - I figured my arteries were already clogging up - but it seems maybe I still have a chance to turn this around - does anyone know if you can actually reverse some of the clogging that has already occurred by eating and exercising right? Does some of that actually diminish in your arteries? WOW it seems a lot of people who have already had a cardiac event in their life really have turned it around and are living healthy lives - much more so than a healthy person! I commend those who work so hard - it always made me mad that my stepdads family could just live til they were 98 and never even so much as lift a weight - smoke - whatever, and never have that heart problem. ARG! LOL! I guess we all have to have something - I had skin cancer a few years ago - I just thank the Lord I am healthy still and have a chance to change my outlook now.
OH! Also - I take toprol @ 25ml which isnt much - but its enough to lower my heart rate a bit - how do I get it really high when working out? Will it go to where I need it to when I really get into the exercise? My husband says no way - he doesnt believe in drugs but the toprol has really helped w/my pvcs and I would like to stay on it a bit until I lose the weight I need and get into shape - then Ill wean off it - by then I hope to have my lipids better too with the drugs - I really doubt my HDL is gonna raise all that much by itself / wow those drugs really can raise it ! No bypass - will you let me know what yours turns out to be when you have your blood tests? I hope I can have your attitude! Im such a wuss.
Thanks everyone again! Nice chatting with ya all!
Oh my email is ***@****.
There are no prerequisites to improving your health. Every day is a new day and you can start from where you are at. That feeling that everything is lost because you didn't do the right things earlier is false and very defeating.
That sense of failure can permeate a life in all areas:
Grades in school.
Many millionaires were broke several times in their lives. World champion athletes have had cancer and other health challenges. People who have dropped out of high school have become rich, famous, or world leaders. People who have tried and have failed spectacularly have made comebacks.
You can restart every day from where you are at and build from there. The past is is not important and the future is not here yet - today is here for you to do your best and enjoy life without fear or worry.
I have learned this the hard way and don't always follow it, but I try to. I try to go to the park in the morning and listen to the birds - to enjoy at least a few moments free from fear, worry, and the so called problems of the day. Hopefully one day I will have the ability to do this all day long.
I am 34 years old, 6'6" tall and weigh 250lbs. I play basketball 2-3 times a week and am fairly active. There is absolutely no heart conditons in my family.
I have recently been going through several tests to rule out Marfan's Syndrome. The tests included: ECG and a CT Heart Scan.
The tests were done at a small hospital with a "supposedly" good cardiology department. The summary of the results for the ECG said I had narrowing of the LV, mild mitral valve regurgitation and possible diostolic dysfunction. The ejection factor was 60%.
The CT Scan summary said I had prominent dilation of left and right coronary sinuses.
I decided to get a second opinion from a very well known cardiologist in New York. He did his own ECG and Stress ECG and totally disagreed with the measurements taken across the LV, the diostolic dysfunction and the mild regurgitation. The LV was measured three tmes and could not seem to come up with the same number from the previous ECG. The LV was not narrowed at all. He told me the mitral valve was considered to have "slight regurgitation" and considered it to be normal. He did not repeat the CT Heart Scan but mentioned that for somebody my height and weight the coronary sinuses should be slightly dilated from the "average" person. The Stress ECG showed everything to be normal but the blood pressure seemed to hit 230 while the heart rate peaked out at 160 BPM. He also had me squeeze a grip-o-meter immediately getting off the tread mill while the ECG was being performed.
My questions are:
1)Should the coronary sinuses be larger on a person my height and weight and what would be the concern if they are in fact dilated?
2)Should I be concerned about with blood pressure at 160 BPM if my blood pressure is always normal at rest?
3)Should there be any regurgitation through the mitral valve?
4)What is the purpose of the grip-o-meter during the Stress ECG?
This whole Daryl Kile thing really is a tragedy and has gotten me concerned.
You might try to repost your question as a new thread. The doctors only answer new threads. Because the board only accepts 1 or 2 questions per day. You have to hit it at just the right time. I don't know what time that is - perhaps just after 12:01 AM eastern, but I haven't tried it or a long time.
I do not believe you can calculate Triglycrides. They must be a direct measure from a 12-hour fast. LDL is most often calcuated from lipid measurements; however, a direct LDL measurement is much more accurate, especially if the tri's are in the 200 or more level. Hope this helped.
OH MY! To have an HDL of 100!!!!!!!!!!!!! I would honestly cut off my right arm for that!! You know - I have been studying the Omega 3/6's and WOW! How interesting - I hate fish for the most part - but I have began taking DHA/EPA fish pills instead - I got the best Twin labs one that they recommend all over the web - I have noticed after taking these for a month that my pvc's are slightly better too - who knows? I know omega 3's also act as a blood thinner - so that would help as well.
Thanks so much for your thoughts too bypass - you are so right - I always have had a positive attitude, but I let panic and anxiety take over where I shouldn't. It helps to hear people like you who have overcome really huge obstacles. Thanks to all who gave me examples of HDL's and how to raise them etc - I like to hear examples of #'s and how exercise and eating etc really CAN raise it more than my dr is telling me. She tells me a max of 10, maybe. I need more than that at 30 / I would like to see it above 50 minimum. Bypass - did you get your results back yet? Just curious -
Santiken - you are right! I just need to do it - I think the toprol works - but I would like to get off of it someday - if I have a healthy heart - then I shouldnt worry - I am working at it but Im still afraid to PUSH it - I get a pvc when I do - but I think its because Im out of shape - Ill keep working on it - Slye thanks for the #'s! That proves that you can do it! If I coudl get to 46 that would be nice / a LOT nicer than 29 or 30! GEEZ _ WHO GAVE ME THESE CRAPPY GENES???????????? LOL!
Have a great week ALL!
On June 27, 07 I had a Liberte stent placed in RCA due to a 99.5% blockage. After the insertion I had terrible burning feeling on left side of chest, they treated it with Darvocet. It helped the burning but then squeezing pain started. Discharged the next day. Still have 2-3 episoded a week of this squeezing pain mainly on my left side which is lasting longer and longer. These squeezing pains last from 45 min to hours. Had another EKG and stress test done on Fri., do you think this is just spasms or another blockage? Cardiologist states that I should be feeling better after the stent work and I am getting worse. If blocked again, is it reasonably safe to go back and have the second stent in so soon? How really bad is a totally blocked RCA? Some tell me it isn't near as fatal as a Left sided one. I am contemplating not doing the stent again if needed as this one sure hasn't made me feel any better.
Thanks for this wonderful web site, I am learning a lot!
Copyright 1994-2017MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.