Fit 38-Year-Old's 100% Blocked Artery Shock: Hidden Genetic Cholesterol Risk
A seemingly healthy 38-year-old marketing professional arrived at the emergency room with severe chest pain. He described it as a squeezing and tightening sensation he had never felt before. Doctors immediately performed an angiography. The results shocked everyone.
Two of his main heart arteries showed dangerous blockages. One artery was completely blocked at 100 per cent. Another key blood vessel had a 90 per cent blockage. Medical professionals consider this sudden angina equivalent to a heart attack. Without prompt treatment, it would have caused a serious cardiac event.
The Patient's Surprising Profile
What made this case remarkable was the patient's apparent health. He looked athletic and sporty. He regularly ran and lifted weights. He didn't smoke and had no history of diabetes. His blood sugar tests always came back clean. He maintained healthy eating habits without excesses.
"Frankly doctor, I had never felt anything was wrong either," he told his cardiologist after receiving stents to open his arteries. "None of my doctors ever suggested a heart health check-up. They all assumed I was a healthy person."
The Hidden Genetic Culprit
The man had one critical problem that timely tests would have revealed. He carried a genetic history of high LDL cholesterol, often called bad cholesterol. His body produced cholesterol faster than normal individuals. This excess cholesterol accumulated as plaque, gradually constricting his heart's arteries.
His Left Anterior Descending artery, a crucial vessel supplying oxygenated blood to the heart, was completely blocked. The Right Coronary Artery showed 90 per cent blockage. Both situations created life-threatening conditions.
Understanding Familial Hypercholesterolemia
What does a family history of cholesterol mean? The most significant factor for rapid, high-volume cholesterol production is familial hypercholesterolemia. This inherited genetic disorder prevents the liver from effectively removing LDL cholesterol from the blood.
In affected individuals, liver receptors that normally clear cholesterol are missing or malfunctioning. Consequently, excess LDL cholesterol circulates in the bloodstream and deposits itself in artery walls. These people develop high cholesterol from early life. They also tend to have unstable plaques, putting them at much higher risk for heart attacks at young ages.
Even partial blockages can become 100 per cent blockages if plaques rupture easily. This rupture causes rapid blood clot formation. A genetic predisposition becomes particularly risky when close relatives developed heart disease early. For men, this means before age 55. For women, it's before age 65.
How Exercise Can Trigger Events
This patient was aggressive with his weight lifting routine. Sudden jolts and movements without adequate rest can trigger heart events in people with pre-existing, often undiagnosed, artery blockages. Heavy, intense lifting induces extreme, temporary blood pressure spikes.
These spikes sometimes exceed 250/170 mmHg. Such pressure surges can cause plaque rupture, tearing and clotting in already narrowed arteries. This leads to sudden heart attacks, including in critical arteries like the LAD.
Other Risk Factors to Monitor
Several other factors contribute to heart disease risk:
- Chronic high blood pressure damages the inner lining of coronary arteries, making them more susceptible to plaque buildup
- High blood sugar damages blood vessels and nerves controlling the heart, accelerating plaque formation
- Long-term kidney issues link to increased coronary artery disease risk
- Autoimmune conditions like rheumatoid arthritis and lupus cause inflammation that damages arteries
- Poor diets high in saturated fats, trans fats, salt and refined sugars promote plaque accumulation
- Sedentary lifestyles, obesity and chronic stress also contribute significantly
In some cases, arteries like the LAD may be naturally too narrow to handle even mild plaques.
The Simple Preventive Solution
There is an easy way to avoid such crises. Everyone should get a lipid profile test starting from age 21. This simple blood test effectively tracks genetic patterns and cholesterol levels. Early detection allows for timely intervention and management.
Regular monitoring becomes especially crucial for individuals with family histories of early heart disease. Don't assume fitness alone guarantees heart health. Underlying genetic factors can create silent dangers that only testing can reveal.
Dr Shetty is lead cardiologist and medical director at Sparsh Hospital in Bengaluru.
