Posted on 06/17/2008 6:03:22 PM PDT by neverdem
Given the great strides that have been made in preventing and treating heart disease, what explains Tim Russert’s sudden death last week at 58 from a heart attack?
The answer, at least in part, is that although doctors knew that Mr. Russert, the longtime moderator of “Meet the Press” on NBC, had coronary artery disease and were treating him for it, they did not realize how severe the disease was because he did not have chest pain or other telltale symptoms that would have justified the kind of invasive tests needed to make a definitive diagnosis. In that sense, his case was sadly typical: more than 50 percent of all men who die of coronary heart disease have no previous symptoms, the American Heart Association says.
It is not clear whether Mr. Russert’s death could have been prevented. He was doing nearly all he could to lower his risk. He took blood pressure pills and a statin drug to control his cholesterol, he worked out every day on an exercise bike, and he was trying to lose weight, his doctors said on Monday. And still it was not enough.
If there is any lesson in his death, his doctors said, it is a reminder that heart disease can be silent, and that people, especially...
--snip--
Even so, Dr. Newman said, “the autopsy findings were a surprise.”
In an interview, Dr. Newman and Mr. Russert’s cardiologist, Dr. George Bren, said the autopsy found significant blockages in several coronary arteries, which feed blood to the heart muscle.
Blockages start out as cholesterol deposits in the artery walls that turn into lesions or plaques, narrowing the vessels. Heart attacks occur when a plaque ruptures, causing a blood clot that quickly closes the artery and pinches off the blood supply to part of the heart...
(Excerpt) Read more at nytimes.com ...
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Thanks for the interesting link.
I wish that they had one in N California.
you can at least get a 64-slice CT scan of your heart... the images it produces are amazing...
Neverdem, what is the age of the oldest patients they generally do bypasses on? Looks like my mother is starting down the road, beginning with a thallium stress test due to pain.
The technical term is “Arkancide”....remember, he put the first crack in the HIllary invincibility myth with the question on NY and illegal drivers....
The bottom line is you never know when your time is up.
http://www.nypost.com/seven/06112008/tv/wallace_days_on_tv_over_114953.htm
Mike Wallace, 90, had “triple bypass surgery” in late January. If it’s only one or two bad arteries usually stents are used by cardiologists. It depends.
Because the test --- Cardiac catheterization -- can be dangerous. When they do them, they have a surgeon and operation room on hold because it can cause a major heart attack, stroke or even rupture of cardiac vessels. You don't do it just because you are curious. You only do it after some other symptom indicates that it is worth the risk to take a close look inside for blockages.
Marking for later review.
Thanks!
I’m one who had the non-invasive and elective EBCT calcium scan of the heart. Had to pay cash.
I had a surprising ZERO calcium score which means no hard plaque. My HDL was quite high but total chol. was also high so I am now, after resisting my primary doc’s suggestion, taking just 10 mg. generic Zocor. Trigs have always been super low.
Doc at Cedars-Sinai who did EBCT test said that my “score” was unusual at mid-fifties age range and wants to redo in a couple of years. He actually said I did not need a statin though total chol was high and naturally LDL too.
I asked my primary doc if it isn’t true that the soft plaque could still be roaming around inside, waiting to harden despite lack of obvious hard plaque. (I’m not very trusting of any tests.) She said anything’s possible but what she hears is that when a person has a zero to very low hard calcium score, odds are nothing is accumulating in the arteries.
Don’t know, and won’t know unless I keel over. A cardiologist is the one who said “have EBCT test” because he wasn’t sure if I should be on a statin or not with my high (good) HDL and low trigs.
But I am female and females exhibit different symptoms than men when it comes to the heart. So I will just have to wait and see what happens. Lots of heart issues with my deceased senior female relatives but it seemed to be mostly valve related.
It’s true that no matter how careful one is or how many precautions/tests are taken, we can never truly predict our future health.
A zero calcium score is good news. However, soft plaque takes a number of years before it calcifies and becomes detectable on a calcium score ct test. That’s why coronary cta is so mush better.
With coronary ct angiography, dye is injected into your vein like any other ct scan. Your heart is monitored with and EKG to synchronize the beat with the ct data. The data is acquired when the heart is between beats and the artereis aren’t moving rapidly. It requires a special ct scanner (64 channel) that is fast enough to scan the heart in one or two beats. Coronay CT angiography allows us to visualize the arteries directly and detect soft plaque and get a good idea how tight or open the arteries are.
Coronary CT angiography is not as good at looking at small arteries as a coronary catherization. However, it is much simpler and safer and detects soft plaque that a coronary cath can’t see. As I said on an earlier post, many cardiologists aren’t embracing coronary CT angiography because that don’t perform the test, they aren’t directly familar with the technology, and they like their current paradigm.
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