My blockage was in the left anterior descending coronary artery

Yesterday marked the 90-day anniversary of my heart attack which occurred on Oct. 15, 2011. I figured this is as good a time as any to give everyone an update on my condition, especially since I went to the cardiologist today. Here’s the latest:

• I feel great. I am back to work full time, attending cardiac rehab twice per week, walking briskly 3-4 additional days per week, eating amazingly well (thanks in no small part to Leslie’s wonderful skills in the kitchen) and doing pretty well emotionally too.
• At the time of my heart attack there were two main concerns — I developed a clot in the lower portion of my heart and there was muscle wall damage there as well. The good news from the cardiologist appointment today was that both of these have improved. The clot has shrunk considerably (the echocardiogram tech couldn’t even see it) and my heart function has improved as well.
• Clots are common with heart attacks. The goal is to eliminate it, and to do that they put me on a series of drugs to thin my blood and lower my heart rate and blood pressure. The doc says another few months on the drugs and the clot should dissipate or be absorbed into the heart wall.
• Heart function is measured by what is called an ejection fraction (EF). Basically it is the percentage of blood that’s pumped out of a filled ventricle with each heartbeat. A normal ejection fraction is anywhere from about 55 to 70. At the time of my heart attack the cardiologist estimated my EF to be around 35 and today it is closer to 45! An EF under 40 can be life threatening and may be a sign of heart failure, so the fact that mine went up so dramatically in just three months is a great sign. This improvement can be attributed to taking my meds, exercising and eating a low fat, low sodium diet.

So, what’s next? In mid-February I will be taking a stress test to see how my heart performs when my heart rate goes up. Since I have no other blockages and my stents have fixed the one I did have, I should be able to exercise vigorously going forward without any trouble and this test will show my doctor how my heart performs under duress. Even though I am exercising now with no trouble, my heart rate has remained low because of the drug therapy. I’d like to start increasing the intensity of my workouts so this will tell the doctor if that is ok. In March I have another appointment with my cardiologist to check my blood work (my cholesterol was around 70 in December…yes, 70, not 170!) and then a few weeks after that I’ll get another echo to see if the clot is gone and if my EF has gone up any more. I can have a very normal life with my EF at 45 but of course the closer to normal the better.

Physically I feel great. Psychologically I am doing good, but I still have bouts of anxiety although these are fewer and further between. The big mental part is wondering what the future holds and whether or not I will be able to do all the things I want to in life. Intellectually I know I will, but the anxiety can still get to me. It’s weird, but it hits at strange times like when I see a commercial on TV where someone is talking about retirement or when someone is working out really strenuously (damn you Gatorade!). I’m sure this will all get better over time, although I am seriously considering starting a local Meetup group for young heart attack victims to have some people to share stories with. It’s hard when all the patients in cardiac rehab are 20-30 years older than me! If you know anyone who might be interested in this kind of meetup group send them my way…

That’s it for now. Take care and thanks for listening!