heart attack at 24. How bad was it ?

[happybuddha]

I did some skipping & pushups, I lied down to relax, and then there was shooting pain all over my chest. I had pain starting from my underarms going up to my middle finger ( pain as if one nerve is being pulled, kind of ). since I had just exercised  I just lied down. Later went for a checkup and found a BP of 140/100. Was advised to take a stamlo Beta and to have a Lipid profile and an ECG taken, as per the docs advise. The lipid was normal (values in next post)
the next day evening after the pain I went to a Cardiologist and he again took a ECG and an echo and said I had a Myocardial infarction and my right ventricle was affected. I was admitted into a hospital for observation and medication. I am now on medication of :
Clopigrel 75 mg(twice), Ecosprin 150 mg(once), Pantodac 40mg(once), Storvas 40mg(once), Covance 25 mg(once), Metoprolol 12.5 mg(twice), Angispan TR 25 mg(twice).
My question is : How bad was this attack(if it was an attack at all) ?
Can i not exercise, smoke, have physical activity any longer ?
I am due for an Angiogram very shortly.
Please let me know.

Thank you in advance.

[happybuddha]

Dear all,

Thanks for being patient. I actually went in for a 3D Cardiovascular Cartography. The reports are out.
The problem is I do not know which values I should post :-( its a good 5+ page report. While undergoing the imagery, the doc said my heart is pretty normal and there are no clots as such (clots lesser than 20 % cant be detected, she said).and that the heart was normal.
the EF is 60 %
The abnormal values which are pointed out in the observation of the report are:
TFF Alpha :2.64 (optimal is <2)
Evidence of high thrombogenicity
Reduced arterial compliance - indicative of atherosclerosis
Demand-supply ratio shows mild decompensation - suggestion of ischemia
Pressure volume shows signs of LVdysfunction
Left Ventricular ejection fraction is 60%

I would love to know your kind opinion on this. Also please let me know if you are looking for a specific value, I can post here.


Love,

[Forum-M.D.-MJM]

btw, the typical angiogram after an MI is a young smoke like  yourself will show either one lesion or blockage or no lesion at all.  the body sometimes resorbs the clot and there is no evidence of CAD.

PLEASE STOP SMOKING.

[Forum-M.D.-MJM]

by timing I mean how soon after the chest were the enzymes checked.

It would be very strange to have an electrical persistent electrical problem after an MI with preserved ejection fraction would be very rare.

PLEASE STOP SMOKING AND CONVINCE YOUR FRIENDS TO STOP SMOKING.  IT WILL BE EASIER FOR YOU STOP IF THEY DON'T SMOKE AROUND.

[LukeL]

I would like to hear what your angiogram results are. I am wondering if you have some coronary artery defects which have been present since birth.

[happybuddha]

Dear Forum-M.D.-MJM,

>>elevated but does not appear to be very high -- it all depends on timing.

What depends on the timing ? Is the timing you are talking about, about when the test was conducted ? or .. ?


>>the good news is that your heart function is very well preserved.
ok. I presume, whenyou say this that the electric system of the heart is still good. Isnt it ?

Thanks for your patience

[happybuddha]

Sure, I will post them here as soon as I get them.
Coronary problem since birth ??? .. I dont think so.
May be. If I had any, I would have been warned by family or atleast should have experienced some kind of unusual experiences, which never happened. I have thrown myself at a lot of things. I had been doing Weightlifting when I was around 21. Then I tore a ligament in my knee and quit. All in all, done a lot of things where there could have been a lot of stress, without any problems.

I guess I will just wait till I get the angio report. Will post the results here.

thank you so much for reading.

[happybuddha]

Hello,

thanks for your quick response.
I have not done drugs ever. i only smoke cigarettes.
I have no family history of any type of heart diseases.
I know the attack at this age is rare ( coming to terms with living a life so changed is going to be a very demanding battle in itself ).

I am still obscured about how bad the attack was (and how bright are my propects of more heart diseases) ?


Thank you for answering.

[happybuddha]

(total cholestrol was 160 mg/dl). exceptions were with triglyceride at 190 mg/dl (test within 24 hours of pain) and Triglycleride/HDL C.Ratio 4.75. The other out of range values were :
(test >24 but <48 hours of pain)
pus cells 6-8/hpf (Urine examination) (test >24 but <48 hours of pain)
TLC Count : 15400/cuul
Neutrophil : 78%
Lymphocyte : 16%
CPK MB : 101 U/L
Troponin T : 1.3 ng/ml

Echo examination : (test >24 but <48 hours of pain)
Mitral, Aortic, Tricuspid, Pulmonary valve : Normal
Left atrium : 3.0 cms
Left ventrical : EDD-4.6cm;ESD-3.3cm;EF:56%PW-
Right Atrium : Mild dilation
Right Ventricle : Mild dilation
IVS: intact
IAS: intact
Aorta : 3.0 cms
Pulmonary Artery : Normal
Pericardium : Normal
Doppler/Colour : No MR No AR
-TR Jet vel-PPG:mmHg Est RVSP:mmHg
MVG:PPG-mmHg MPG:mmHg MVA:Sq.cms
Conclusions: CAD
RWMA+(Hypokensia of inferior & posterior wall)
good LV Systolic Function

Echo examination (> 48 hours of pain(test conducted at a different lab))
Mitral, Aortic, Tricuspid, Pulmonary valve : Normal
Left atrium : 3.8 cms
Left ventrical : EDD-5.1cm;ESD-3.1cm;EF:60%PW:1.0 cms
Right Atrium : Normal
Right Ventricle : Normal
IVS: 1.0 cm, intact
IAS: intact
Aorta : 3.0 cms
Pulmonary Artery : Normal
Pericardium : Normal
Doppler/Colour : No MR No AR
No TR Jet vel-PPG:mmHg Est RVSP:mmHg
MVF:E-1.0m/sec, A- 0.9 m/sec, ABF: 1.2 m/sec, PBF: 1.1 m/sec
other findings : Mild, mid & basal inferior hypokinesia. No LV clot

Conclusions: CAD with RWMA
good LV Systolic Function

[Forum-M.D.-MJM]

Hello,
I can't make recommmendations about when it is ok to exercise over the internet.  That is a clinical decision and would require some face to face time and seeing all your test results. In almost all cases, returning to excercise is not a problem but you may need to exercise less intensely.  Having a heart attack at your age is a very rare event -- very rare event.  We only see people your age having heart attacks a few times per year and we are busy major referral center.  It is more commone when people have used cocaine or some other stimulant.  It is also more common in people with out of control lipids (LDL very high like 300 or higher) or strong family history.

If your doctor said you had a heart attack based on cardiac enzymes, Troponin and CKMB, then you have to believe him until proven otherwise.  The troponin value is elevated but does not appear to be very high -- it all depends on timing.  the good news is that your heart function is very well preserved.

In the mean time, only do as much as your doctor recommends and consider cardiac rehab after your doctor says it is ok.

I hope this helps -- good luck.