It can strike at any time, at any place, and, most importantly, in anyone, even if you’re seemingly healthy. It’s known as the mother of all heart attacks–the widowmaker. While any heart attack can be fatal, what makes the widowmaker feared is the area where it occurs: in the left anterior descending artery. The LAD provides blood and oxygen to the entire front of the heart–a larger area than other coronary arteries. A clot in the LAD can cut off about 40 percent of the heart’s blood.
“It’s a larger heart attack with a higher risk of resulting complications,” said Steven Bailey, M.D., professor of cardiology at the University of Texas Health Science Center at San Antonio. Complications can include irregular heartbeat, heart failure, and less often, sudden death.
The term “sudden” when applied to a heart attack can translate into minutes of life once complications such as arrhythmia begin, or a heart attack cal last for hours. However, there is a window of opportunity to stop the heart attack before it kills. But “a third of sudden cardiac deaths in the U.S. are widowmakers,” added Dr. Bailey.
Aside from being lethal, the widowmaker is fast and sneaky. Half of men who die due to sudden coronary heart disease have no prior symptoms. A majority of them are actually healthy and fit. Men between the ages of 30 and 60 account for almost four times as many coronary heart disease deaths when compared to women. Some research suggests that estrogen may offer some protection.
Fortunately, there is one consolation. Clogged arteries can now be quickly cleared with timely care. Chances are that you are within 30 minutes range of a heart center with a catheterization lab. Even if you are farther away, EMTs can keep your heart going with drugs until you get there. Once you arrive, a cath lab’s interventional cardiologist can perform an angioplasty– threading a thin tube (catheter) into the blocked coronary artery and expanding it by inflating a small balloon. Most of the people who undergo an angioplasty will also have a stent installed in order to help keep the blood vessel open.
Your chances of living depend entirely on the severity and complications, as well as a little bit of luck. “If you’re seen within the first two hours, survival can be as high as 96 percent specifically as a result of what the interventional cardiologist does,” said Dr. Bailey.
Although there are advanced and available treatments, they still won’t save the lives of approximately 421,000 men dying of cardiovascular disease every year. The answer is assessing your risk now, and taking the proper action to protect yourself, even if it means changing your lifestyle. Here are seven steps to take in order to avoid a widowmaker.
7. Understand Your Archenemy
To understand the severity of the situation, you must first understand what causes a heart attack. A heart attack is caused by a blockage in an artery due to atherosclerosis, the process by which fatty deposits called plaque build up inside your arteries. But having plaque in your arteries doesn’t mean you’re at imminent risk of a sudden, fatal heart attack. “The heart can tolerate a 40 or 50 percent blockage,” said Helene Glassberg, M.D., associate professor of clinical cardiovascular medicine at the University of Pennsylvania’s Perelman School of Medicine. “It’s like a pipe in your sink; if it’s half-clogged, you can still brush your teeth.”
You can begin to feel symptoms such as chest pain with an artery blockage of about 70 percent or more. But blockages between 40 and 90 percent are capable of causing deadly heart attacks. Plaque buildup is akin to a zit popping, said Dr. Bailey. Plaque forms as a soft, unpredictable deposit rather than a hard, stable one. A thin cap of the plaque can rupture at any time, and fatty material then rushes into the bloodstream. The body interprets this as an injury and resorts to the release of clotting factors and platelets to seal the “wound”. As a result, a clot can form within minutes.
The cells inside both types of plaque (soft and hard) are inflammatory, meaning they attract ongoing immune system attention. “Risk factors like smoking, eating processed foods, being overweight, and having high cholesterol make these cells angrier and more prone to rupture,” said Dr. Glassberg. This is where opportunity strikes. By addressing these factors, you can reduce the risk of plaque buildup and help stabilize the amount you already have.
6. Calculate Your Own Heart Attack Risk
Search “ASCVD” in your web browser and click on the American College of Cardiology’s ASCVD Risk Estimator Plus. Enter the information for age, cholesterol (HDL and LDL), and blood pressure, and answer several yes or no questions. In moments, you will have a percentage that estimates your risk of developing atherosclerosis within the next 10 years. If you happen to score 7.5 percent or higher, speak with your doctor about how you can lower your risk. “I’d rather talk about overall risk,” said Martha Gulati, M.D., cardiology chief at the University of Arizona College of Medicine-Phoenix. “It’s not just about one component.”