An Unexpected Event

Posted On January 6, 2018

Leading a healthy lifestyle might not be enough to thwart a heart attack. Sometimes we overlook hazards to our heart health.

By Linda H. Lamb

If Greg Gerald could have a heart attack, you probably could, too.

The week before it happened, Gerald was golfing, swimming and snorkeling during a vacation in Aruba. A licensed pharmacist, he wasn't overweight, and he and his wife enjoyed a healthful Mediterranean diet. In fact, they own two stores in the Midlands that sell an array of heart-healthy olive oils.

And yet, about a week after returning home to Chapin from his Caribbean vacation in July, Gerald woke up at 4 a.m. having severe chest pains.

He'd eaten some spicy wasabi tuna the night before – "I thought it was just really bad heartburn," said Gerald, 62.

As his sharp, radiating pain turned into a dull ache, he decided to scale back his Saturday activities. But his wife, Kaye, insisted on a trip to the hospital first, to rule out the possibility that his "heartburn" really was heart trouble.

Within minutes of their arrival at Lexington Medical Center, Gerald said, he had a "very ugly" EKG test and was whisked into the catheterization lab. Dye was flushed into his heart through a thin tube that ran through the radial artery from his wrist. It revealed that his left descending coronary artery, which supplies the heart muscle with blood, was 100 percent blocked.

"They told me the kind of heart attack I had was known as the widowmaker," Gerald said. There also was 80 percent blockage in an artery on the right side. Dr. Brandon Drafts, of Lexington Cardiology, worked to clear the completely blocked artery and place a stent in it – a tiny wire-mesh tube that props the blood vessel open.

Gerald said that because of his Christian faith, he didn't feel fearful, and "the whole experience couldn't have gone any better." Still, why did he, of all people, suffer a heart attack?

Family history matters

One clue might lie in Gerald's family history. His mother had high blood pressure for years and was only in her 50s when she died following a stroke. His father died of congestive heart failure at age 67. And while the Geralds adopted their healthy diet several years ago, his upbringing in Horry County included a typical Southern diet.

"He was doing most everything right ... active, not overweight, not a smoker," said Mark Stout, an exercise physiologist who worked with Gerald in Lexington Medical Center's cardiac rehabilitation program.

But a family history of heart disease “can increase people’s risk tremendously," Stout said.

The American Heart Association warns that many lifestyle factors can increase the risk for hardened or blocked arteries. These include smoking, high cholesterol, high blood pressure, stress, obesity and a sedentary lifestyle. Then there are the risks beyond one’s control, such as aging, being male and being African-American.

Looking back, Gerald says he could have exercised more regularly, and he also had a fairly stressful job in pharmaceutical sales. However, he also thinks he could have paid more attention to his family history.

"Everyone who knows me says I was the last person they would've thought would have a heart attack," he said. "But even if you're eating healthy, if you have that family history, you're still at risk."

Sneaky symptoms

Drafts said people should be more alert for signs of heart trouble – which can sneak up on them.

"It's important to listen to your body and be aware of possible symptoms,” he said.

The American Heart Association urges vigilance for symptoms such as:

Pressure, squeezing, fullness or pain in the center of the chest
Pain or discomfort in one or both arms, the back, neck, jaw or stomach
Shortness of breath
Nausea, lightheadedness or cold sweats

As people age, Stout said, they might downplay feelings of fatigue, thinking they're just part of getting older. But fatigue can be a subtle symptom of heart trouble as well.

Road to recovery

Gerald started on anti-platelet medication to prevent blood clots, as well as medications to control blood pressure and cholesterol. He also required a second procedure to place a stent in blood vessel that was 80 percent blocked.

Some lifestyle changes came next. "We're managing the medications, but a lot of this is on the patient to follow a heart-healthy diet and make a commitment to cardiac rehabilitation," Drafts said.

Gerald – a father of two and grandfather of six – has taken that commitment seriously.

About two weeks after his heart attack, he entered Lexington Medical Center's Cardiac Rehabilitation program. Connected to a heart monitor as a precaution, he progressed from treadmill to stationary bike to stairsteps. He also learned about stents, diet, exercise and grocery shopping.

"We want to make sure people understand what they've been through," Stout said. "We’re trying to get people to be more active, make better nutrition choices, take their medications and manage their stress."

The 12-week program also helps restore patients' confidence.

"For a lot of people, that's the question mark," said Stout, who has worked at Lexington Medical Center for 25 years. "Are they going to be able to get back to what they've done in the past – cutting the grass, golfing, working, traveling?"

Gerald decided to take early retirement, but plans to stay as active as possible. His heart surgeon sees a bright future for him.

"Knowing he is motivated, I believe he'll have a great shot at not having further problems," Drafts said.

"Before you knew his story, you would have thought he personified good health. I think the message is that anybody can be affected by heart disease."

What’s New in Heart Health?

Innovations affecting cardiac care range from new surgical techniques to personal fitness devices that help with rehab. Dr. Brandon Drafts, of Lexington Cardiology, mentioned two developments cardiologists are excited about:

TAVR – Transcatheter aortic valve replacement offers a new option for certain patients with severe damage to the vital aortic valve. Replacing this valve used to require open-heart surgery, making it a poor option for higher-risk patients. With TAVR, a collapsible replacement valve is pushed into place through a catheter – in a minimally invasive procedure done through the femoral artery.

Micra – It's the world's smallest pacemaker, only about the size of a large vitamin capsule. Because it's implanted directly in the heart, it eliminates the need for a chest incision and for wires that run from the device to the heart. (It may be an option for patients who need a single chamber, or ventricular, pacemaker.)