How could this happen?

I am a 44 yr. old white female.  Last year on May 16, 1998 at the age of 42 I suffered a minor heart attack.  There were no warning signs, I had no health related risk factors and there is no history of heart disease in my family.  When the paramedics arrived they thought I was simply having a panic attack as my vital signs were normal.  At the ER however, the EKG showed a dip and my blood enzyme count was 350.  After an angiogram, it was discovered that a piece of soft plaque ruptured and tore a hole in my left anterior descending artery.  I had to have a single by-pass using my mammory artery.  I was in surgery only 2.5 hours and the cardiac surgeon found my heart to be disease free and all other arteries smooth with no signs of plaque building any where else.  My recovery went very well and now I feel better physically than I did before all this happened.

But my question is how could something like this happen and could it happen again?  My doctors cannot give me an explanation other than to tell me that it is a very rare occurance and can happen from time to time!  That is not enough to ease my mind.  Is my cholesterol containing properties that make it more volitile? Or are my blood vessels at some kind of risk for aneurysms?  I feel I need  more information or some kind of explanation as to why and how this happend.  Please advise.

[Cleveland Clinic, MD]

Heart disease is due to a combination of genetic and environment.  You can't change your genes but you can change your environment.  If you smoke, stop today.  Maintain a strict low-fat diet and check your cholesterol regularly.  Your LDL should be less than 100.  If it is greater than 130 you need to take cholesterol medications.  In addition begin an exercise program with your doctors approval.  If you are overweight work on reducing.  With these changes you can decrease your risks of having another heart attack in the future.  Best wishes.

[sheryl]

Thank you for your response.

I should have been more specific with my descriptors.  At the time of the heart attack, I:

- was at my ideal weight (130 lbs., ht 5'4")

- did not smoke, drink, or use drugs

- ate a relatively low-fat diet

-

[sheryl]

Sorry - I submitted my response before I finished typing!

- exercised often but not regularly

- my blood pressure was 130/80

- my total blood cholesterol was 164

- LDL, HDL and blood sugar were in normal ranges, however, my doctor did tell me that my tryglicerides were slightly elevated

The only contributing factor I can think of is that my grandfather (on mom's side) died at age 65 of a ruptured stomach aneurysm and my mom had a brain aneurysm in 1992 which was caught in time.  There does seem to be a history of hypertension on my mother's side and because of this my doctor has put me on 50 mg of Lopressor and 10 mg of Lotension.  My blood pressure now is around 120/80, however my bottom number seems to be on the high side fluctuating between 80 and 100 from time to time.

I did read a news article several months ago that soft plaque was found to be more dangerous now than hard plaque and that it seems to be the cause for unexpected heart attacks in relatively healthy people ( which seems to be what happened to me).  Could you please explain soft plaque, the relationship between hypertension and soft plaque and how soft plaque can rupture?

Thank you.

[Wendy]

Sheryl,
   I had a heart attack at 44, no risk factors either. Mine was apparently from a spasm of the coronary arteries. I, like you, have been having a tough time understanding what happened and my future risks. If you'd like to talk more with someone, write me at ***@****.

[Teresa]

I had a heart attack at age 27. I had some risk factors, including strong family history, smoking, and usin oral birth control.  I had single bypass surgery and that was 12 years ago. I have since had a baby who is now almost 5. I am on coreg to help with some symptoms of congestive heart failure, but stay active and live life as full as I can. I'm counting on living til I'm about 80. I'm 40 now. I hate heart attacks and all that goes with it, but I know I am blessed to be alive and don't take that for granted one minute. Event hough I had some risk factors, I still questions why, why, why and still once in a while do. But no matter what the circumstances, the truth is noone wants to go through this.   Unfortunately, it happens and it teaches us life's most valuable lesson - to be thankful for every heartbeat, every breath.  Take care.

[Cleveland Clinic, MD]

Thanks Wendy and Theresa for your comments.  There are many things which we don't fully understand yet.  Soft plaque is "more dnagerous" than hard plaque because it is more likely to "break" and cause heart attacks.  High blood pressure results in a build-up of these soft-plaques.

[sheryl]

Thank you all for your comments.  I was so happy to hear from other people my age who have had similar experiences, fears, questions and concerns.  Since this happened I have not been able to find anyone who understands what I have been going through.  Like you, Theresa, I have a 4 year old son who I want to be around for so I'm just trying to do the best I can so this doesn't happen again.  Your words were very encouraging - thanks so much.  And Wendy, I will contact you through your e-mail address so we can "talk" and give each other support.  If there are any other young people out there with similar experiences who need support, you can e-mail me at ***@****.  And to this Heart Forum, thanks so much for this service - it is so helpful and good to be able to voice our concerns!  Keep up the good work!

[Cleveland Clinic, MD]

Please let us know if there is anything else we can do for you.