Tell HN: I knew I was headed for a heart attack | Hacker News Reader

Tell HN: I knew I was headed for a heart attack

48 pointsAnimalMuppet13 comments

I'm not overweight (OK, I should lose 10 pounds). I'm in decent shape. And yet, I just had two stents put in my heart, because one coronary artery was 90% blocked and one was 80% blocked. How did I know to start looking for that kind of problem?

It's pretty simple. A doctor told me "Your physical performance falls off slowly, over decades. That's not what you're looking for. When it drops off quickly, over a week or two, that's what you're looking for." And that's what happened. I play ultimate frisbee. One day I realized, "Hey, I'm more winded than I was two weeks ago. And it's taking me longer to recover from being winded."

So I got a stress echo test on my heart[1]. That showed "abnormal motion of the heart muscles under stress". Translation: the arteries couldn't feed enough oxygen to part of my heart when it was having to beat really hard.

Note well: This is not the only way to tell. Pay attention to other things, too (especially to crushing pain in your chest). But if you see this kind of drop-off in your physical performance, don't ignore it.

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[1] This is an interesting test. They take some ultrasounds of your heart, then run you on a treadmill until your heart rate reaches 90% of your theoretical maximum, then take some more ultrasounds.

One part that hackers might appreciate: During the ultrasounds, they told me to take a deep breath, then let it out, then stop. Eventually I asked why. Turns out they're trying to shoot an ultrasound beam between my ribs to the heart, and they have to get the spacing between the ribs to line up with the part of the heart that they're trying to see. So they use my lung volume to change the spacing. I thought that was very clever.

I wish there were some kind of master list of things to look out for with regards to health. I know generally "if you suddenly feel consistently worse than before, that's bad", but more specific advice - like what your doctor said about suddenly worsening stamina - would be nice.

It feels like all too often we hear of people getting diagnosed with a few months to live out of the blue... perhaps it's just my inner hypochondriac, but I can't help but worry about my own health every time I read one of those headlines, and wonder if there were really no warning signs or if they were simply ignored out of innocent ignorance/negligence. A mild headache, a dull numbness, suddenly getting winded, how often are serious warning signs ignored until it's too late because of their deceptive mildness making people think "it'll probably go away"? Anyways, congratulations to you on catching something before it happened!

I've been involved with endurance athletics the last few years. Triathlons but also the things that go into it separately (running, swimming, biking, etc.)

There's kind of a genre of posts that show up on triathlon forums that roughly fall into the category of "I'm a dedicated triathlete who does X impressive triathlons every year with good times and I just had a heart attack." Sometimes there's a variant of this along the lines of the OP: "I suddenly started feeling winded and didn't feel right so I got checked and they rolled me into the OR immediately."

Inevitably everyone on the forum is terrified, wondering how such a thing could happen that someone could be at the pinnacle of aerobic health, and then suddenly collapse with a serious cardiovascular problem. Then everyone realizes this is a recurring theme, there's a discussion of whether triathletes are at greater or lesser risk for cardiovascular problems, and people usually end up with some rough consensus that exercise is actually good. Then finally everyone starts talking about how to identify problems before they get too bad.

The conclusion is usually that it's impossible to just tell without preventative screening. That is, the best thing to do is to go get checkups. Get stress tests etc. proactively. Get physicals and so forth and so on. Not that you should be a hypochondriac, but you need medical testing and screening, not monitoring of symptoms.

I'm probably as guilty of not doing regular screenings as anyone, but maybe that should change.

But then, aren't symptomless screenings also discouraged? Because many screenings have risks of false positives, and you end up having to do more (possibly dangerous/invasive) screenings as well as stress out about it needlessly?

In particular, this is often brought up when preventative cancer screening is discussed.

This happened to my personal trainer recently.

He ignored it for way too long, and it damaged his lungs and his heart badly enough that he now needs a heart transplant, and his lungs will never even remotely perform at a decent level anymore.

Dude is like 45. Had to retire on unemployment. Will probably not live to see 47. Really tragic.

I am glad you caught this!

lot of people have lot of heart disease, in america and most western countries, and now even (or especially) in the global south.

my first reco, based on a couple years of reading, is go 'whole food plant-based' diet -- i.e. vegan and also subtracting oil (along with too much fat, generally) - and of course drastically reducing sugar. in theory that reverses the athleroslcosorosisisiisis (artery hardening), blockages, etc.

big or 'extreme' change, but not necessarily more extreme than getting stents.

the 'whole food plant based' label seems to be most healthy based on what i've read/seen.

dr. greger's books are about as mainstream as you can get, and his website has tons of bite-sized videos (and plenty of youtubes):

https://nutritionfacts.org/

the story of his grandma is trippy, and hacker-ish -- she was helped by self-researcher and non-medical doctor, Nathan Pritikin.

Great website, and it seems completely non-commercial.

Glad you got good care and are doing well. This is a good example of the good and bad sides of "functional reserve," the concept that many organ systems are able to maintain good to acceptable performance even while deteriorating until a sudden step-down in function occurs (80-90% occlusion of coronary arteries is a common point at which people become symptomatic when exerting themselves).

Do you feel comfortable sharing your age, gender, family history to other readers to help them incorporate how your experience compares to their risk factors?

59, male, two grandparents had heart attacks.

Appreciate you taking the time to post this. I tend to worry about my own health (and mortality) a lot, and find this bit of information to be quite useful. As someone who has health anxiety, it can be tough to ascertain what is a legitimate concern and what is overblown.

I havnt been to the doctor in fifteen years, since I was a teenager. Planning on taking care of that this year though.

Thank you for sharing. Lately I have had short pulses of chest pain, like a faint ache that comes and goes. Pretty small area, like a finger pushed on it.

I'll have to watch out for this sign.

There is strong evidence seed oils are the problem causing heart disease, dyor.

This is deeply disconcerting, as I have also had an acute physical drop off recently, that I may have erroneously attributed to a bad covid vaccine reaction.

A couple questions:

It appears your arteries became blocked over a short time period, I don't understand the dynamics of heart blockages, but I'd figure this would be a gradual build up, leading to a gradual loss of athletic ability, if so, why did your symptoms present suddenly?

Another question: I thought heart stents were shown to be ineffective?

https://www.google.com/url?q=https://www.nytimes.com/2018/02...

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