Risk of myocardial infarction after many years of smoking

Heart attacks can come suddenly, but are completely preventable if you take care of your health early, proactively screen and listen to your body every day.

While playing pickleball, about 15 minutes after the start of the match, Mr. Binh suddenly experienced severe chest pain, pain spreading to his neck, accompanied by difficulty breathing and profuse sweating.

He was immediately taken from the sports field to Tam Anh General Hospital in Hanoi in an emergency. Master, Doctor Nguyen Hoai Vu, Department of Cardiology of the hospital, said that the patient was admitted with typical symptoms of angina. The electrocardiogram results showed acute ST-elevation myocardial infarction. This is one of the most dangerous types of infarction. Percutaneous coronary angiography (DSA) showed that the patient's coronary artery was completely blocked by a blood clot.

The patient is being treated at the medical facility.

Taking his medical history, the doctors discovered that Mr. Binh had been smoking for many years. This is identified as one of the leading risk factors leading to atherosclerosis.

This process progressed silently without the patient knowing, and was not treated properly. In his coronary artery, an unstable atherosclerotic plaque, a “fragile” type of plaque containing a lot of cholesterol, with a thin shell and poor stability, formed. During strenuous exercise, specifically when playing pickleball, a sport that requires speed and endurance, the atherosclerotic plaque ruptured, forming a blood clot that completely blocked the coronary artery, leading to an acute myocardial infarction.

Immediately after being diagnosed, Mr. Binh was immediately transferred to the intervention room. The medical team placed a stent into the right coronary artery branch under the guidance of intravascular ultrasound (IVUS).

From the time the patient entered the emergency room until the balloon was inflated to restore blood flow (door-to-balloon) took less than 30 minutes. This achievement far exceeded the American Heart Association (AHA/ACC) recommendation of less than 90 minutes. Timely myocardial reperfusion helped reduce the risk of complications and preserve heart function.

After the intervention, the patient quickly escaped the critical condition, chest pain was gone, heart function was stable with ejection fraction (EF) reaching 55%.

After a week of monitoring, with his health stable, Mr. Binh was discharged with instructions to take regular medication, do light exercise and gradually increase the intensity under medical supervision. However, he should not return to high-intensity competitive sports such as pickleball until his cardiovascular system is completely stable.

Dr. Nguyen Hoai Vu said that Mr. Binh’s case is a wake-up call, showing that myocardial infarction can happen even in young people. Mr. Binh is only 42 years old, in the “early onset” group of myocardial infarction, which is defined as men under 55 years old and women under 65 years old.

In recent years, medicine has been particularly interested in the concept of “plaque vulnerability”. About 60-70% of acute myocardial infarctions are caused by unstable lipid plaques, even if the degree of narrowing of the lumen is only mild or moderate. People with cardiovascular risk factors such as smoking, dyslipidemia, high LDL-C, diabetes, obesity, lack of exercise… are highly likely to form this dangerous type of plaque.

It is worth mentioning that currently, it is impossible to accurately detect unstable lipid plaques without using modern imaging techniques such as new generation coronary CT, intravascular ultrasound (IVUS) or intravascular optical coherence tomography (OCT). Therefore, Dr. Vu emphasized that not only the degree of narrowing of the lumen determines the risk of myocardial infarction, but the nature of the atherosclerotic plaque is the key factor.

For people with cardiovascular risk factors, doctors recommend proactive screening through regular health check-ups, blood lipid tests, electrocardiograms, echocardiograms and coronary CT scans if indicated. At the same time, it is necessary to maintain a healthy lifestyle such as a balanced diet, limiting saturated fat and refined sugar; regular exercise at an appropriate intensity; weight control and absolutely no smoking.

Pickleball, a high-speed sport that requires quick reflexes and continuous movement in multiple directions, is a form of strenuous exercise. Sudden acceleration and changes in direction can cause the heart to work at high intensity in a short period of time, easily leading to arrhythmia or myocardial ischemia in middle-aged or elderly people with underlying diseases.

Therefore, with high-intensity sports such as pickleball, soccer, tennis, etc., people with underlying cardiovascular disease or cardiovascular risk factors need to be carefully assessed before participating.

It is necessary to check heart function, perform an exercise test or consult a cardiologist to determine the appropriate level of exercise and prevent sudden cardiovascular events during exercise.

Mr. Binh’s case is a living proof that the heart does not “age” with age, but “gets tired” with the way we treat it. Myocardial infarction can come suddenly, but it is completely preventable if we know how to take care of our health early, proactively screen and listen to our body every day.

Source: https://baodautu.vn/nguy-co-mac-nhoi-mau-co-tim-sau-nhieu-nam-hut-thuoc-la-d413646.html