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Todd's Story
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Todd's Story 

 

When we hear about someone having a heart attack in his or her 60s or even 50s, it’s not that unusual. Having a heart attack in your 40s is probably just bad luck, and athletes who suffer a heart attack in their 30s make national news.

My first two heart attacks occurred at age 29, less than six months apart. My third and most damaging heart attack was at age 35.

Yes, I was a smoker, but having a heart attack in your 20s – smoker or not – is highly unusual. After my first two heart attacks, I had blockages cleared and stents placed. I stopped smoking in January 2000, a year prior to my third heart attack. After my third heart attack, I remember telling the cardiologist who put my stents in, “So much for your theory of cigarettes causing my blockages.” He replied, “Had you not given them up when you did, you would probably not have been around to have this conversation with me today.”

The damage from my third heart attack was severe, leaving me with a left ventricular ejection fraction LVEF) of just 15 percent. That means only 15 percent of the heart’s blood is actually pumped out to the rest of the body with every heartbeat. Normally, that number should be closer to 55 percent. I am now 48 years old, on long-term disability and medical retirement, and I am being evaluated for a heart transplant or possible ventricular assist device.

There was definitely something besides cigarettes going on, but the many cardiologists I saw were unable to figure out why I was having so many blockages, so close together, at such a young age. I eventually consulted with cardiologist William Wickemeyer, M.D., at the Iowa Heart Center in Des Moines. He recommended I get a Berkeley HeartLab lipid study, a kind of advanced lipid test (commonly known as a cholesterol test) that looks at more than just the basic lipid numbers.

The test revealed I had a lipoprotein(a) – better known as Lp(a) – level of 66 mg/dL. I was told this is nearly twice the normal level and puts me in the very-high-risk category for developing further heart disease. I also had an increase in both total and small low density lipoprotein (LDL) particles and low HDL-C (high density lipoprotein-cholesterol), which are additional coronary heart disease risk factors. While I admit these numbers meant nothing to me at the time, what’s surprising and tragic is that these numbers meant very little to the many health care professionals I had seen. After reviewing these results, Dr. Wickemeyer started me on a regimen of niacin, which some studies have shown can help lower Lp(a) levels. However, I was unable to tolerate the treatment and had to stop taking it.

My heart disease-related troubles continued in December 2014 when I suffered a TIA (transient ischemic attack), also referred to as a mini-stroke. I believe that also has a great deal to do with my increased LDL particle number and highly elevated Lp(a). At my request, my family physician ordered another Lp(a) test, which continued to show high Lp(a) levels. Although I am hoping I’ll be a candidate for a heart transplant, I fear that my uncontrolled levels of Lp(a) may decide my fate before getting that opportunity.  

Through all my challenges, I have learned a lot about heart disease, lipids (commonly known as cholesterol and triglycerides) and the importance of Lp(a) as well as particle size and number. Much of this has come too late for me and was too late for the doctors who saw me. I have also learned about the emotional and financial strain these health problems have on the entire family. However, by telling my story and increasing awareness of Lp(a), I hope that many others can avoid the disabilities I now live with, and that many lives can be saved through simple awareness and education.

I now know that about one in five Americans has high Lp(a), it is the strongest genetic risk factor for early coronary artery disease and you don’t have to go very far within a family to uncover a pattern of high Lp(a). My two half-brothers and nephew have all had heart disease strike early in their 40's, but to my knowledge, none has been tested for lipoprotein(a). I hope to change that very soon.  

Meanwhile, I’ll continue to work to raise awareness of Lp(a) and make sure that screening is offered to families of patients with high Lp(a). It is my great hope that through the Lp(a) foundation, many will be helped through increased awareness, education and research to find new therapies to treat elevated levels of Lp(a).

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