Cath Lab | Heart attack waiting to happen

I heard about two more Heart Attack Survivors at work recently. Apart from the fact that there seem to be more cardiac emergencies around today than in the past (probably more to do with me than everyone else!), I was struck by the way they had been treated… the two gentlemen had received 8 and 12 stents respectively.

Apparently the guidelines for treatment have changed recently…

When I had my Heart Attack, the approach was to just treat the blockage that was causing the immediate problem. For me that meant fitting two stents in my Left Anterior Descending or LAD artery. During the procedure they identified that another of my arteries (Right Coronary Artery or RCA) was partially blocked, but as it wasn’t causing any distress so it was left untreated.

Apparently now the approach has been revised so that they address any blockages during the initial procedure. As a result, the patient leaves hospital safe in the knowledge that they have no blockages. I guess it maximises the value of the angioplasty procedure, and reduces the chances of having a repeat performance,

There is a point of view that stents aren’t great for you. Yes, they are helpful in an emergency situation like mine, but many people are treated with stents as a preventative measure.

The argument is that the stent treats the symptom rather than the disease, and in the process reduce the chance that any action will be taken to address the root causes themselves. In addition, they leave the patient dependent on a concoction of medication and exposed to the side-effects and potential complications (for example, risks associated with future, non-heart related medical procedures).

Personally I haven’t thought much about whether my situation would be significantly different if my other artery had been treated at the same time. Given the emergency nature of my treatment, I obviously didn’t have an opportunity to think about it in advance. There was certainly no debate or discussion as I got wheeled into the “Cath Lab” (See: The Cath Lab (FD ~02:30)). I didn’t have an opportunity to weigh up the pros and cons.

There was no cosy chat for me when I arrived at the hospital!

To be honest, it doesn’t feel like a huge deal right now, but I recognise that it could turn out to be a big deal at some point in the future. It seems strange to me that if I’d had my Heart Attack today I might have been treated in a very different way than 6 months ago.

I guess I have little option but to carry on taking my medication and stay disciplined, it’s up to me to do the work to address the underlying disease (or at least to prevent it from getting any worse). For me, watching what I eat and drink as well as exercising regularly are the key to my long term health.

I can’t rely on stents to return me to “normal”. Now it’s all about establishing a new, safer, healthier normal.

It turns out that Aberdeen’s road network is very efficient at 02:00 on a Sunday morning (shame about the rest of the time!). We arrived at the Aberdeen Royal Infirmary in next to no time.

Daughter No. 1 was at a sleepover. Fortunately, Daughter No. 2 had slept through the excitement. The in-laws were en-route, thank goodness! Louise was to follow later so Daughter No. 2 could sleep through.

It was clear that the initial tests performed at the house indicated that I was having a heart attack… when we arrived at the hospital the Catheterisation Laboratory (Cath Lab) was already fully prepped and buzzing. I was wheeled in, transferred onto the bed and the team went to work…

There were approx. 8 people in the room… electrodes were applied to my chest together with defibrillator pads (in case of more emergencies!) and my right wrist was prepared for the procedure. (I’m sure there was a lot of other stuff going on too!).

I was awake throughout… a small incision was made in my wrist to gain access to an artery into which guide wires, balloons and stents were eventually inserted. Having had a look around, the cardiologist identified a severe restriction in my Left Anterior Descending (LAD) artery – it wasn’t completely blocked, but was getting there. The balloons were inflated to expand the artery and two stents were inserted to keep it open. While they were there, they checked out my other arteries too… no cause for concern.

The whole thing was quite surreal. It’s obviously not something you can prepare for. I just had to try to relax. I was in the hands of professionals, they knew what they were doing, and I had to let them work. The fact that it was my heart they were working on was almost incidental.

I had the occasional sense of something happening inside me, but I’m not sure how much of that was in my head… it certainly didn’t hurt. The only real sign of action from where I was lying was the camera moving around my chest, a robot whizzing around to look at my heart from different angles.

Within about 40 minutes it was all done. Fixed (at least as much as I could be).

I had had a heart attack and an invasive cardiac procedure (“we don’t call it surgery”). Things were going to be different.

Transferred back to a standard bed, I was taken to the recovery room ready to be moved to the Cardiac Care Unit (CCU). I rolled past Louise and John (Thanks John!) who had recently arrived having successfully navigated the abandoned shell that is ARI at 3 am on a Sunday…

“I told you I was having a heart attack!”

Not the best brag ever. I was right, but nothing to be proud of. What do you say to your loved ones when you’ve just been saved from a heart attack? Hopefully you’ll never need to answer that one!