A doctor colleague surgeon by profession who was having no symptoms of heart disease & leading a very active life with no diabetes or high BP,jogging for 5-10 km daily comes to casualty of Metro Hospital, Faridabad with chest pain which started during morning jogging. He was diagnosed with major heart attack. He was given some injection and tablets immediately and taken to Cath Lab where his angiography was done which showed complete blockage of major artery LAD which was then opened by angioplasty & stenting. His heart problem got resolved quickly after that.
20% of the heart attack occurs in peoples who do not have any risk factors & this doctor colleague of ours was in that 20% bracket. 80% of heart attack occurs in patients who have one or more risk factors like tobacco use, unhealthy diet, physical inactivity, diabetes, high BP, and high cholesterol.
The big question here is how should we know who all can have heart attack, so that we can prevent and control it with wonderful medicines statins in order to prevent heart attack, sudden death, heart failure etc. Unfortunately heart diseases remain silent till the blockage in the artery becomes critical. ECG and even ECHO can be normal even when all three arteries of heart have 90% blockage. Stress test or TMT can give false positive or false negative results. Moreover it can’t detect less than 70% of blockage in the artery.
Person can get sudden heart attack even with 50% blockage especially during strenuous activity like playing a game of lawn tennis or participating in marathon or any other race. This is due to rupture of silently present cholesterol plaque exposing it to platelets flowing in the lumen of the artery. These platelets get activated & aggregate to make a big clot causing sudden complete occlusion of artery of heart leading to major heart attack or sudden death or heart failure. So it is very important to know who is at risk of heart attack. As less than 70% block can’t be detected by ECG, ECHO, TMT, Thallium etc, the only way to detect a coronary angiography by CT scan which is a non-invasive test and can be done on OPD basis at the earliest possible stage. If you detect them at an early stage, you can take all preventive steps like statins to control further cholesterol deposition and sometime even regression of block has been seen with the use of statin medicine.
Moreover you can be more vigilant about your BP, cholesterol & sugar levels. You can become more conscious about your regular exercise & diet. Best motivator to adopt a healthy lifestyle is early detection of silent disease & best way is CT angiography.