A stress test for a work physical last October indicated left ventricular hypertrophy and Q wave in inferior lateral leads when I started. A followup echocardiogram shows I had a MI sometime in the last 2 years (date of last stress test, which was normal). My doctor stated that the bottom of my heart is not contracting. My EF is 70%. He has refered me to a cardiologist. He also wants me to start beta blockers and take a daily asprin (325mg).
The shocker to be is that I have never had any symptoms of a heart attack. I am fairly active, light weight training, stationary bike and swimming at gym 2-3 times a week, and I bicycle 30 to 50 miles a week over hilly terrain (fast recreational riding) from April to September. Normal BP for me is 110/60 and resting pulse in the 60's. No family cardiac history and I am not a diabetic.
Anyone ever hear of this happening? This may be a career ender for me, as my job (firefighter) requires good cardiac health. What is the long term prognosis? Just getting my thoughts together and educating myself before I see the cardiologist.
Your heart evidently compensated for the blockage by creating some of its own bypasses. Your EF of 70% is excellent. I believe the last time I had an angiogram mine was 63 and I've had a stent and bypass surgery. I however did not have a heart attack and have no damage. I was 41 when all of this came about.
I would wonder what your cholesterol levels were at the time. Was your HDL low? Did you have high triglycerides? Are you a smoker? My total cholesterol was below 200 but my HDL was a little low and my triglycerides were a little high. I always had great blood pressure readings and I'm not diabetic either. I had been pretty active all my life. Sometimes it's difficult to figure out what went wrong. As for prognosis CAD is a progressive disease but there is alot you can do to slow down the progression of the disease. Diet and exercise are a big part of it. It sounds like you are doing a good bit of exercise so you might look closely at your diet and see if some improvements can be made there. Also you might want to look at your stress levels. I believe stress was a factor in my heart disease.
This is all pretty new for you and it takes a long time to come to grips with it. You will experience alot of different emotions such as anger, fear, sadness, denial and finally acceptance and then you'll go from there and figure out what you need to do to prevent any further problems. My advice is to learn as much as you can about CAD because knowledge really is power.
If you exercise the way you've outlined without having angina, and if your EF is 70%, I wouldn't panic about about cardiac health.
Whether there is damage that might curtail your firefighting career is something I couldn't begin to judge. But I would do a couple of things::
1. Ask your cardiologist for a thallium (nuclear) stress test. This would confirm or disprove the silent heart attack and would show if you have other areas of ischemia which might require further testing (such as cardiac angiography).
2. Get a fasting lipid profile. If your total choloresterol (TC) and low density choloresterol (LDL) are too high, I would ask for a statin for choloresterol reduction. If you bike 30 to 50 miles a week in hilly terrain and do the other exercises you've outlined, my guess is that your high density choloresterol (HDL) will be well above average. It is very desirable for the ratio TC/HDL to be 4.0 or less. And it is also advisable for the LDL to be 100 or lower.
I had a severe MI at age 47, and it wasn't silent, believe me. The bottom part of my heart doesn't work, and I have an aneurism on the heart wall dating from the heart attack. My EF is 35%. I had six bypasses when I was age 55.
But life is good, and I've been able to do what I want in the way of physical work without distress. And I'm now 78 years old and am still perking right along. Had a coronary angiogram a month ago and all my bypasses are still working fine after 24 years.
There is life after CAD if you take advantage of the medical advances and drugs available, and do your part with diet and exercise..
