homocysteine level as a risk factor

Posted by chris on May 19, 1999 at 10:31:42
Hi!  I went to the lecture last night on homocysteine levels as a factor in heart attacks given by a local cardiologist. He stated that homocysteine levels in adults can rise because of a decrease in the enzyme that breaks down the amino acid homocysteine in the stomach. This decrease is due to either a genetic defect or vitamin deficiency. Increased homocysteine level does not replace the top 5 risk factors (which if I remember correctly were high blood pressure, elevated cholesterol, diabetes, family history, smoking) but should be considered when someone without any of these risk factors has a heart attack. The treatment is Vitamin B supplements (B6, B12, and folate.) He mentioned that heart disease is on the decline in the U.S. and wondered if our consumption of enriched bread products/cereals/etc might be in part responsible for this trend. Very interesting!

Posted by CCF CARDIO MD - DLB on May 20, 1999 at 13:54:34
Dear Chris
It sounds like your friend had a blockage in a small branch of the right coronary artery that was too small to perform an angioplasty. Bypassing this blockage would not be worth the risk of surgery, most likely. Treatment with medications sounds reasonable. If he is still having symptoms, he may need more or different medications. If symptoms persist even then, the pain may not be due to the heart after all.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.