24 yr old heart attack.... NO WAY

--The Questions:

Just how serious is this? - Do I need to get my ducks in a row.

Do you get over a heart attack?- Eventually does my life resume as normal. Again im 24yrs old. I play softball on Sundays. I run, jump, play etc....

Is this something I will have to weigh before doing certain things?
Cant ride this roller coaster etc....

How common is this?
Am I alone? Doc says in his 22yrs he has only had six patients with this and none out of his six have every had a second heart attack.

What causes spasms?
Is this caused by stress, over extending etc...

What do I tell everyone?
Is this a disorder, disease, condition. Because it was originally diagnosed as a viral miacard thing-a-ma-bob everyone's first question is have I gotten over the virus.

He did mention the detection of the enzymes in the blood. My understanding is, there are heart muscle specific enzymes detected in the blood when heart muscle cells die. Then, some enzymes, some permanent damage.

It seems to me that tracking enzyme concentrations in time might be a good way to get a measure of the amount of cardiac muscle damage.

Are there any other drugs which cause spasm?
You seem to be so knowledgeable.

I recently read a book written about 1950. In it, the man has a heart attack and his wife is informed that the hospital will perform a
"cardiograph" and that it will determine whether it was a thrombus caused attack, or the less dangerous spasm caused attack. I have the exact quote written down, but not here. So, my question is, "Can an electrocardiogram distinguish, with accuracy, the difference in the two conditions?"

I would tell Bryan, who is no longer monitoring this group, that my MI, with odd symptoms and clear coronary arteries which occurred at age 52, 40 months ago has produced no measurable disabilities to me.
Mine was probably due to spasm.

He's right, but he does not know that the
"intact male bovine excrement" being posted here is a rather recent phenomenon.

The title is ci.med.cardiology.
sciENCE:medICINE:cardiology. Personally, I do not open messages which do not fit into that general category. That includes diet discussions. If you need to lose weight, go to a diet group.

This Bryan Martin is on an interesting track... that of cardiac vasospasm.
Discussion is lost due to the insincerity of

in the last few months.

One more thing: people who post messages with a moniker that cannot possibly be a real name carry no weight. Others should refrain from replying to them. Might reduce some of the nonsense.

Can one get rhabdomylosis without statin drug ingestion?

We don't have "gas station weight loss meds" in the Great White North!

Was hoping you could forward information on the blood pressure drugs. If an ACE inhibitor or a beta blocker were to cause a heart attack (As their package inserts say they might.), would it not be more likely to be via spasm than thrombosis?

The direct quote is:

"The cardiograph would reveal whether or no the attack was a simple muscular spasm, which would not be so serious, or a coronary thrombosis, which would be very serious indeed."

In the late 40's a "cardiograph" was a much more complicated procedure mainly because electronic amplifiers were no where near as effective as they are today. The
"cardiograph" in the book was to be carried out the following day, and, probably only one time.

Perhaps you can ask one of your older colleagues whether or not "cardiographs," back then, were effective in distinguishing between spasm and thrombosis type heart attacks. I think it is important for the patient to know because, certainly, different therapies would apply.

Thanks, A.L.

P.S. In my own case, a young Med Student was first to offer the results of my angiogram.
She did so in the presence of my wife. She said, "The angiogram showed blockages of 25 to 35%. This would not be unexpected in a person of my age [~25YO]. So, you have likely had a coronary artery spasm." (Approximate quote.) If there is a possibility that the
EKG (ECG) taken at the time contains that information, I would certainly pursue that route.

(I was also immediately thrown out the the cushy CCU into the general hospital population.)

Also, my symptoms were unusual... no one
"sitting on my chest" no pain radiating. I had a sharp, localized annoying pain just behind the lower portion of the breast bone with both biceps feeling like they had been worked to exhaustion. When I explained this sharp pain symptom to another doctor about 6 months ago, she said, "Pains we tell you to ignore." I replied, I did ignore it the first time, but since it awakened me the second time, I had to get it checked out.

You poor dear!

Do you need to get your ducks in a row? I wouldn't.

Spasms are serious but are easily controllable. They are also terrifying to the patient. The norvasc will help the smooth artery relax. Both spasms and traditional heart attacks cause blood to stop flowing down a coronary artery depriving it of needed oxygen. With a spasm, the blood flow is usually returned to normal before any damage is done. With a traditional
Myocardial Infarction, a clot occludes the artery and permanent damage is a strong possibility. It doesn't sound you fall into the latter category.

Do everyone a favor and do not adjust your meds by yourself.

Can certain things precipitate spasms? Sure but they are not the same for everyone. I would talk to your doc. He should have been more forthcoming.
For what it is worth, I would avoid certain meds like over the counter decongestants which cause vasoconstriction but your doc might not think it is a problem for you. Please ask. Anxiety is often a factor as is stress.

or her. Typically what happens is that a patient so scared they are gonna die or so relieved to find out that they aren't going to die that they forget to ask the questions. A good doc will typically anticipate some of them but you never know if he had an emergency cath awaiting him in the cath lab or if his wife was crabby in the morning or whatever. Still, you or your insurance paid dearly for sound medical care and teaching patients is a very large part of it.

Be careful with the Nitro. It doesn't like heat or light. Do not keep it in your pants pocked. If it doesn't tingle, it is dead. Buy new stuff frequently and keep it with you. It will relieve spasms. Also, sit down while you take it if possible because it can cause your blood pressure to drop and make you fall. It isn't serious until you break something on the concrete or split your lip. Very messy.

I seriously doubt that you would have been dismissed as quickly as you were if you had active viral myocarditis. However, I am hardly in a position to know. Ask the doc.

You are exactly right but I am not sure about the severity of permanent damage when the blood flow is immediately restored. This is the rationale of either giving thrombolytics (clot busters) or rushing MI patients to the heart lab so that blood flow can be restored before actual tissue death occurs. The enzymes referred to are probably CPK. A very small percentage of that directly reflects heart muscle and is referred to as the MB band.
In the old days, (and to a degree even now), heart patients were not given injections into their muscles because any damage to muscle cells will cause the total CK to rise. However, most people heal nicely after receiving an injection unless I am really, really mad at them. I have also had rare patients with a disease called rhabdomylosis which is a very bad muscle wasting disease sent to the heart unit because their CK was so very high.

There are certainly others. The thing is that people respond differently to medications and other substances. 'All Natural' diet pills available at every gas station and drug store come to mind immediately. Very sensitive people might also respond the same way to caffiene. Alcohol normally relaxes the arteries but it is conceivable that an artery might spasm in response to the sudden relaxation as a counter measure. As long as the spasms are well controlled with medications, it is mostly a matter of avoiding obvious dangers (like gas station weight loss meds) and doing every thing else in moderation until one's personal response is known. Some asthma medications and inhalers also have these effects.

I have never had the burden of caring for patients without access to immediate cath films! However, I imagine it would be possible to infer that a cardiac problem is related to spasm to some degree by taking serial EKG's or leaving them on a continuous monitor. When an artery is completely occluded, there is a characteristic elevation of one part of the rhythm strip. If you know what you are looking at, you can diagnose an MI from across the room with one eye closed. As the heart attack resolves, the rhythm follows a predictable pattern.

However, if you see a completely occluded artery on an EKG alternated with a normal strip it would be reasonable to assume that spasms are involved. The question would be was the spasm severe enough to cut off circulation or was it a minor spasm and the artery was occluded because of a near total blockage? Anyone have the answer to that?

Plavix is an anticoagulant. I believe it makes the platelets slippery so that they might slide all over each other and not form untoward blood clots in areas of arterial walls that are damaged and tend to collect platelets and form clots.

Whenever anyone is given an anticoagulant (even aspirin) bleeding may occur anywhere there is a problem which might lead to bleeding. In the OP's case, the doc was probably suspicious of hemorrhoids that would maintain on their own but with the addition of Plavix, they sort of bled out of control. You also see patients with ulcers start to bleed or other areas where vascular tissue is compromised.

-----BEGIN PGP SIGNED MESSAGE-----
Hash: SHA1

FWIW, I don't understand the bleeding part. What is Plavix, and why would Plavix cause bleeding from the rectum? Sounds like quite a serious side effect!

Nevermind. Please ignore this post. I failed to read previous post and

This post will no longer be monitored and has been taken to other more

Bryan