Cardiac health: In great shape but close to death

"I was extremely lucky," says Frank – and it's not a visit to the casino that he's referring to. It’s a life-saving check-up.
Andrea Lutz
Published on February 18, 2022

Frank is a businessman, father of two, and passionate endurance athlete. He says, "I feel like I’m 30." However, Frank's date of birth makes doctors sit up and take notice: 1969. Even if a 52-year-old patient seems to be extremely fit, it’s still worth taking a closer look.

Watch the video about Frank telling his story and how grateful he is that his friend pushed him to be screened.
When conducting check-ups, doctors first assess the common risk factors for certain diseases. Age, high blood pressure, high cholesterol, and smoking are typical risk factors for coronary artery disease. These factors together do make up a risk profile, but it’s one that doesn't necessarily exist in every person who suffers a heart attack. If these factors do not exist, high-risk patients may not be reliably detected.
It is thanks to the insistence of a good friend that Frank (name changed) is alive today: "Go for a check-up," his friend warned, who had only recently himself undergone a cardiac catheterization. Frank dithered: “I felt full of energy. As far as I could tell, there was no cause for concern. I don’t smoke, I eat healthily, and I do a lot of sport. There’s no history of heart disease in my family.” Because Frank’s friend kept on at him, he finally made an appointment for a cardio check-up at the Cardiovascular Center Bethanien (CCB) in Frankfurt am Main.
The CCB ordered basic tests including a stress electrocardiogram, an echocardiogram, and laboratory diagnostic tests. Stress ECG revealed nonspecific ST deviations of the <a href="inferior%20leads">inferior leads</a>. Therefore, the physicians also ordered a coronary CT scan, which detected coronary calcium – a sign of coronary atherosclerosis. Additionally, a coronary CT angiogram (CCTA) was performed. The CCTA showed a 90% stenosis of the right coronary artery (RCA). The findings came as a shock to Frank. The clinical CT images showed calcification of the coronary arteries and a stenosis.
The ECG registers 12 leads. Based on these, the electrical excitation in the heart is localized, but also deviations are detected.
A CCTA showing subtotal stenosis of the right coronary artery
A CCTA showing subtotal stenosis of the right coronary artery
“This was a huge shock, and according to the doctors had to act immediately," says Frank. He was transferred to the cath lab and the CT findings were confirmed by invasive coronary angiography. Frank underwent immediate successful coronary intervention with implantation of two <a href="stents">stents</a>. The procedure restored coronary blood flow to the myocardium. After an uneventful course, Frank was discharged just one day later. He wanted to get back to normal life as quickly as possible – and he did manage to return to his printing business 24 hours after the intestentrvention, just as if nothing had happened.
A stent is a wire mesh made of synthetic fiber or metal. These vessel-supports are introduced to expand arteries and keep them open. This keeps blood flowing.
"I really don't understand why I hadn't noticed the coronary arteries narrowing,” says Frank. Today, he suspects that what he thought was merely aching muscles after lifting weights could actually have been the painful signs of blocked coronary arteries. "But I didn't make the connection. When I saw the images of my narrowed arteries, I was speechless," he says. It all ended well, though. Testing for rare risk factors like lipoprotein A showed no pathologies. The patient obviously benefited from the fact that he is very active – but he was nevertheless very lucky. Now Frank is turning this luck to his advantage: "I’m on a follow-up program and have my other organs checked on a regular basis. I have more awareness for the subject and encourage my friends to go for a check-up. I feel lucky that I can now continue my healthy lifestyle and still do sports."
<b>Death rate from heart attack is on the decline</b><br>Coronary artery disease (CAD) is one of the cardiovascular diseases that are the leading cause of death globally, taking an estimated 17.9 million lives each year.<sup>1&nbsp;</sup>Early detection during the symptom-free initial stages of cardiovascular disease, as in Frank's case, could prevent many deaths.<sup>2</sup> There is good news on this front: Although cardiovascular disease is still the main cause of death globally, the death rate from heart attack is on the decline.<sup>3</sup> The main reasons given are advances in diagnosis and therapy. Moreover, the opportunities for innovation in cardiovascular medicine are by no means exhausted yet.

By Andrea Lutz
Andrea Lutz is a journalist and business trainer specialized on medical topics, technology, and healthcare IT. She lives in Nuremberg, Germany.