I'm lying on the cold bed getting attacked from both sides. A large man who I've only just met is holding a razor and tells me he's about to shave my groins just in case things don't go to plan. The nurses are struggling to get a drip in either of my arms and are starting to get desperate. I show them where to aim but really wish I could take it out of their hands and do it myself... it's their 4th attempt and the painful novelty is wearing off. My veins do disappear when I'm nervous and cold and I'm sure it’s not helping that my cardiologist is looking over their shoulder. I'm in the Cardiac Unit at Monash Hospital about to have an angiogram and a stent placed in my heart's main artery....the very situation I have been trying to avoid for the past few years.
A couple of weeks ago prior to this we learned of the tragic news that Shane Warne died at 52 from a suspected heart attack. A larger than life figure with the world at his feet and family who he adored - now all gone. Shane and I both had heart disease, the difference is, he probably didn't know it, whereas I discovered it early. I'd read that he had some chest pains during the week leading up to his death, maybe some warning signs but we don't know whether he looked into it or not. I was 48 when Warnie passed away. I’d never had any chest pain until one month before my angiogram and right up till then I was doing sprint training in the park keeping up with a younger friend in heavy circuit training and felt on top of the world. Never leaner, never stronger and never fitter.
I knew I had some early atherosclerotic changes (damage or minor blockages) in my heart vessels that was picked up on a Coronary Artery Calcification (CAC) score 2 years prior. I had arranged this for myself after learning about this simple test in a presentation on heart disease prevention. I'm an Emergency Physician and I was unaware of this test and was surprised it wasn't used more frequently to screen for heart disease. A CAC score is a quick and low dose CT scan of the heart that shows any calcium in the arteries of the heart which indicates the presence of plaque or damage in these arteries. It's not a perfect test but in the right age and risk group its's very reassuring if it comes back negative. Mine was positive. It was still a low score but concerning enough that I changed my diet. I cut out any remaining processed foods and more carbs and as a result my blood pressure and most of my blood tests improved significantly. I'd never smoked, was always active, had carried a few excess kilograms in the past but that had all gone. At 48, I was fitter than most of my mates and colleagues and looking pretty good, so I thought.
And then it all fell apart. In October 2021 I had a repeat CAC score which showed progression of disease, I was gutted.
I thought I had done everything I could and it had gotten worse. My cardiologist told me to get a CT coronary angiogram which confirmed the worst - I had a severe blockage in the LAD, the main blood vessel on the front of the heart, the one that if it blocks off, kills you. I still have plenty to do in this life so I did the right thing and stopped sprinting, stopped training hard and entered self- preservation mode.
My cardiologist sent me off for an exercise stress test because my situation didn’t make sense. Severe blockage but I was still exercising at a high level and had no symptoms? I nervously jumped on the treadmill rigged up to umpteen wires and monitoring machines and started to run. And run I did! Faster and faster up more and more of an incline till my heart rate was at 175 and I was running in a pool of sweat. The cardiologist stood up and asked if I was feeling OK. I said yes and asked her why and she said that there were some bad changes on the ECG tracing and that I should stop now and get on the table. They quickly checked my heart with an ultrasound and it showed that part of it wasn't beating properly because it was being starved of blood. Still no chest pain. Short of breath sure but I had just been jogging up an incline in a tiny hot room with a bloody mask on!
So here’s the scary part! I was a sitting duck for a heart attack and although I was aware of my previous tests, I wasn't aware that things had gotten worse. And then it dawned on me. The last couple of times in the park working out I did feel a bit funny, a little nauseous and feeling like I had less energy. There was that time after sprint training when I had to lie down for 10 minutes because I thought I was going to vomit and pass out and another time when I was in the garage working out with Mrs Fritz when she noticed I was taking more frequent breaks between my sets. It was kind of subtle or maybe it was the power of denial but either which way, I wasn't quite right.
So they finally got a drip in. My groins and wrists were shaved and next thing I knew I was on the Cath Lab operating table where they usually open the arteries of people having a heart attack. They gave me some light sedation and inserted the catheter in through the artery in my wrist and then up into the heart, squirted in some dye and took some measurements. They ballooned up the blockage and placed a stent to stop it collapsing, all the while the ED doc inside me was keeping a keen eye on my heart rhythm hoping it would continue on normally. Thankfully I survived the procedure. I had to stay overnight for observation and after a night with no sleep in a busy Cardiology ward I overheard that there was a heart attack patient coming in but there were no beds. I really wanted to get out of there. I told the nurses at 6:30am that I was fine and my cardiologist was happy for me to go first thing in the morning and Mrs Fritz was on her way to pick me up. Some poor guy needed the bed more than me, I was out of there before sunrise.
So if you're over 40 and think you couldn't possibly have a heart attack at your age, think again.
If you have a heart there is a chance you have heart disease and until you've had it checked out you'll never know. Blood tests and risk factors assessments are poor substitutes for actually seeing what the anatomy shows. And although I look and feel pretty fit there was a serious issue going on inside that I managed to catch just in time.
I can’t help but wonder if maybe Warnie would have had a CAC score or a CT angiogram early enough he could've done something about it and lived to tell the tale in his Aussie larrikin way. Don't leave it too late because heart disease doesn't discriminate. Get your doctor onto it so you don't have to go through what I did, or possibly worse.
