A couple of months ago I went through an angiography, followed by an angioplasty to open up a blocked coronary artery. Stented and ready for the next 100,000 miles, I am back with a vengeance - working, playing golf, exercising and even climbing hills. I am also wiser due to a few surprising lessons I learnt in the process. Some of these lessons might be handy for others.
Staying physically fit does not keep heart disease away
I have been physically fit all my life. As a kid I played several sports, and have continued playing at least one sport ever since. Although I did not get into a regular fitness regime until a few years ago, my daily routine has generally included walking and going up and down stairs. I have been playing golf for many years, and I walk very briskly on the golf course - an average of 6-10 kilometres a week.
I have never been overweight, and have always been classified as "physically fit", and that is how I have felt. Until two months before my surgery. So what went wrong?
Coronary heart disease is caused by the gradual blocking of the coronary arteries - arteries that supply oxygen-rich blood to the heart muscles. The supply of blood keeps the heart muscles pumping, but when this blood supply is interrupted, the heart muscle(s) can stop working leading to angina or a heart attack.
The blockage of the coronary arteries is caused by the deposit of fat tissue on the arterial walls. Two major factors determine the tendency of our body to deposit these fats.
- The amount of fat and cholesterol in our blood, which depends upon our diet and metabolism
- The propensity of our body to deposit the fats on the artery walls. This factor varies among people, and is not very well understood. It appears to be genetically inherited.
Regular exercise has a limited influence on (1) above, but in general the gradual blocking of our coronary arteries continues in spite of regular exercise. Symptoms do not start showing up even during vigorous exercise until the blockage exceeds 70%. I have been doing regular vigorous exercise for several years now, and my symptoms did not show up until my main coronary artery (LAD) was blocked almost 100%!
So remember this: you may be physically fit and exercising regularly but your coronary arteries may be getting blocked anyway and angina or a heart attack may be on its way.
The biggest predictor of such a situation is your family history of heart disease. Additional risk factors are high blood cholesterol and stress. If you are at risk, talk to a cardiologist and undergo the required tests regularly. Even if you are not at risk, it is best to be aware that your coronary arteries are getting gradually clogged.
Regular exercise may save your life - but not the way you think
I just said that exercise does not prevent heart disease, and now I am saying that exercise may save your life! Contradiction? No.
Regular exercise, especially vigorous cardiovascular exercise, results in a greater demand for blood from our heart. If our coronary arteries are not able to supply enough blood to the heart to increase the pumping action, some of the smaller blood vessels (capillaries) around the coronary arteries gradually take up this load. Over time, with regular vigorous exercise, the capillary network can become quite large. This network of smaller coronary blood vessels is called the collateral network.
Strong collaterals act as a safety net and can prevent heart attacks even if the main coronary arteries are blocked. In my case a set of strong collaterals probably saved my life because my main coronary artery was almost 100% blocked. The strong collaterals were a result of years of vigorous exercise and were clearly visible during the angiography.
Of course before undertaking a vigorous exercise program, it is important to consult a doctor. Any exercise program, particularly later in life, must be built up gradually to avoid a sudden strain on the heart.
Symptoms of heart disease can be quite unusual
Like most people, I had always associated heart disease with chest pain, shortness of breath, or a pain in the left arm. While these are common symptoms, they are by no means the only ones.
The only symptom I ever had was a sort of choking sensation in my throat whenever I exercised. Because I did not know better, I ignored this symptom for almost 6 weeks. This ignorance could have killed me.
Finally when I spoke to my doctor, he recognized the symptom for what it was. I discovered later that there are other lesser known symptoms of heart disease like a feeling of suffocation, burning sensation in the chest, a pain in the left shoulder or a pain in the jaw.
This is what I think one should do: if you encounter any sort of discomfort that shows up as a result of increased physical activity, particularly in the upper body, report it to your doctor and get help.
In my case, even if I had reported my symptom to a doctor over the phone, I would have been treated 6 weeks sooner. I was very fortunate to get away with the delay.
Heart disease can be reversed!
Yes this sounds too good to be true, and honestly I don't know if it is true.
After my surgery, a good neighbour gave me a book to read - "Reversal of Heart Disease in 5 Easy Steps" by Dr. Bimal Chhajer.
Dr. Chhajer is a cardiologist who has pioneered a program called SAAOL (Science And Art Of Living). Believe me, I am a sceptic, and am not convinced easily when I hear something that sounds too good to be true. However a lot of what Chhajer says makes sense. The program prescribed by the good doctor is not easy to follow, but I am experimenting with it.
One interesting consequence of the program is that with the zero oil cooking at our home, my wife had unexpectedly dropped a few kilograms of weight. Whether I reverse my heart disease or not, we are staying with the program!
Happy living!
