Heart attack, Car accident, and triple bypass surgery bro's

[Mr. dB]

Then if you think you had a one-sided weakness. I would go ahead with a neuro workup and get your imaged to make sure there are no brain infarcts (old strokes/cvas)

Some people with high blood pressure can get lacunar infarcts (they look like lakes of dead tissue hence the term lacunar to describe them)

Well, it resolved itself within a month, and that was five years ago.

 

[redsamurai]

The articles I've recently read at least seemed to refute the genetics argument. They couldn't find anything genetically different with asians as it pertained to heart disease, yet they have virtually no heart disease. This was in an article from a researcher at Johns Hopkins. His conclusion was that the asian diet, which was very low not just in meat...but in every other type of refined or processed food.....was the key to them not having heart disease. And when they do eat meat they do something different in the cooking AND they just cook it rarer......I can't remember the specifics of the article. But I remember the guy was on a PBS special on heart disease.

From what I've read, it seems that alot of people are blaming the western diet for "Bringing out" the genetic propensities for heart disease and other maladies as well. They mentioned the japanese who have virtually no rate of stomach cancer while living outside the U.S, yet japanese living in japan who partake in the sodium rich seafood diets have the largest rate of stomach cancer in the world. It seems there's still alot left to be learned on this. I'm going to enroll in a program my cardiologist is starting that includes genetic testing.

Well Red, there is no "exact" answer to what causes the genetic link. There are genetic links with premature atherosclerosis. Thats beyond a doubt. But, its not guaranteed, that is without a doubt as well and genetics is a funny thing. Its combinations of combinations of these genes and I am not going to explain it here.
But if there are four children. Have can have blue eyes the other half can have brown eyes. One of the blue eyed people might get the genes for heart disease and one brown eyed person. And the other set of blue eyd and brown eyed siblings just dont have it.

Genetics is a roll of the dice. You can beat genetics of course, but its still a risk factor nonetheless. It is a reliable indicator of the chance of them having heart disease based on family history. Its just a fact.
If a person has no family history, well its unlikely they will have premature atherosclerotic disease.

THere are some with real bad genetics that if they just ate grasshoppers and plants, theyd still have heart disease b/c they picked their wrong parents. Same exact family history, the person smokes, has diabetes, high blood pressure. THen we do an angiogram and they have clean arteries.
THere is no exactness to the disease. thats the main problem and why all the testing is done.

Now, I know exactly the disease process how it works, what it looks like under a microscope, what an angiogram looks like

The treatments and meds are what I know.

And I can tell you this, without a reason of doubt in my mind is that only meds prevent heart attacks. Stents do not, they treat symptoms, CABG and I believe in evidence medicine do increase length of life,antithetical to stents which CABG is major surgyer and the grafts fail.

But according to the science that currently is accepted. Intervention does not prevent heart attack. The drugs prevent heart attack. The 4 drugs I metioned and you can fiddle with some other stuff as well.

And as far as the philosophy of once you start them, then you dont stop them.

Thats the philosophy of physicians. If a patient is on them, dont take them off.

I talked to several endricrinologists about menopausal HRT and the one speaker at the conference summed it up.
"Dont put them on it and dont take them off of it"

Thats a bit different than the cardiac guidelines but its pervasive to not change drugs proven to lower risk in people if they tolerate the side effects.

There is no "one size fits all exact answer" to this

Each patient should be assessed and treated to the appropriate guidelines based on an evidence-based medical algorhythm.
If yes or no, then proceed here to this appropriate therapy. Often its just a game of running several tests to get the root cause.

You cant say genetics is right or wrong all the time. A genetically prone person who gets diabetes from obesity, does not exercise and smokes. Is MUCH higher to get coronary artery disease, than say a obese diabetic who smokes and doesnt exercise but DOES NOT have a family history.
;
As my old professor used to say in medicine when asked a question "Always, Sometimes, Never Maybe!" in response. I cant help but say that now