This article is part of a mini-series, The Faces of Cardiovascular Disease, looking at the different presentations, symptoms, and root causes of a disease that affects millions of men and women around the world. Be sure to read part 1 here. In this installment, we explore the impact of a major CVD event on a person’s life; elements of this story have been inspired by front line doctors whom we have a close connection with.
For anyone who has spent time in a hospital’s intensive care unit (ICU), you know it’s a serious place. If you’re in one, it means you’re in need of close supervision due to a severe injury or a life-threatening illness. You’re not in good shape.
Three days ago, you had a heart attack. Shortly after getting up in the morning, you had a strange feeling in your left shoulder but didn’t think much of it. It wasn’t painful exactly, more of a discomfort. You continued your usual routine before heading to work.
What you didn’t know was that a clot had formed in one of the major arteries supplying blood to your heart. Starved of oxygen, a part of your heart muscle was dying. Hindered by the damage, your heart sped up in an effort to maintain oxygen supply to rest of the body. It wasn’t able to keep up for long.
You collapsed 3 hours later. Thankfully, one of your coworkers acted quickly and called 9-1-1. You realize much later how important his action was in saving your life.
Now that you’ve been stabilized and are in recovery, you meet doctors, specialists and other staff – it feels like you’ve met a handful of new “experts” every day – who will likely have a major influence on your future health-related behaviour. However, after the trauma of the event subsides, you’ll likely come face-to-face with the most important individual at this critical point in time; yourself.
Inevitably, questions arise such as: Did I ignore important symptoms? Could I have done something to prevent this? What can I do in the future so that this doesn’t happen again? Before any answers come, the experts share their news.
The cardiologist explains that a plaque in your coronary artery had ruptured. The clot had almost completely blocked the vessel and was severely restricting blood flow to the heart. You learn that risk of a second event will be highest in the next 30 days.
To make matters worse, the diagnosis of type II diabetes from the endocrinologist is a big surprise, requiring many lifestyle changes moving forward. The next surprise was the list of medications you’ll be on. Nitroglycerin, beta blockers, ACE inhibitors, blood thinners, statins, metformin… Your head spins grappling with why they are all necessary and when they need to be taken. You’ll need to continuously monitor your blood sugar levels – with the help of a glucose monitor – make changes in your diet and possibly use insulin. There are a LOT of lifestyle changes to consider.
All of a sudden, life seems more complicated.
The doctors explained to you this wasn’t a sudden disease, it had been developing for decades. Ok, so you’re not the “healthiest” person in the world but you certainly did not realize how bad it had gotten. While you tried to heed your doctor’s health advice all those years ago, habits are tough to break. Why fix something that doesn’t seem broken?
Before that life-changing day, an insidious process, called atherosclerosis, had been quietly taking place in your arteries for decades.
The high LDL levels in your blood were shuttling lipids that you consumed throughout your blood stream and depositing the fat-rich plaques along the way, like the one slowly building in your left coronary artery. The one that caused your heart attack.
As the lipid deposits continued to grow in the walls of your arteries, adjacent cells became irritated and inflamed. These cells send out signals designed to attract the attention of your immune system.
Immune cells, patrolling your blood stream looking for foreign invaders, were drawn by vascular cell signalling to plaque sites. Once inside the plaques, these immune cells tried to clear the excess lipids, but were overwhelmed by the sheer volume of lipids and died.
The debris left behind contributes to the plaques and stokes inflammation at the plaque site. With more inflammation, more immune cells rush to the site, repeating the process in a vicious circle, over and over again.
A diagnosis is not a prognosis.
While coming to terms with a serious diagnosis can be challenging, the diagnosis itself does not determine health outcomes given all the treatments and preventative measures available for CVD patients today.
The first step is to understand your individual risk factors, and become a champion of your own health through measures such as proper diet and regular exercise. The good news is that altering these two factors alone has been shown to reverse the effects of previous poor cardiovascular health.
There is strength in numbers. Given the impact of CVD on millions of people around the world, it is not difficult to find people who share a common experience. Many support groups exist for those who want to share their knowledge and experiences, and to better inform policy makers and encourage ongoing research.
At Resverlogix, we continue to research the biology underlying CVD and other multi-factorial diseases and publish our findings. Furthermore, we endeavour to explore the human side of the problem associated with these diseases, to ultimately better inform the novel products we develop and to improve the quality of patients’ lives.
Resverlogix’s team has published several articles on our atherosclerosis research program. Stay tuned for future articles in this series which will explore CVD risk factors, additional biological processes that underly CVD, as well as new treatment options.