Pardon the interruption

Tuesday, January 29, 2008

It’s Super Bowl week , but for many people the game doesn’t matter much anymore. They have more important things to worry about, like their heart. I’m a fan of Pardon the Interruption, a talk show on ESPN, only because I enjoy the wit, wisdom and camaraderie of the hosts, Tony Kornheiser and Michael Wilbon. Unfortunately for me and more unfortunately for Mr. Wilbon, instead of being in front of the camera, he was underneath one in a heart cath lab undergoing an angioplasty to open a blocked blood vessel to his heart.

Heart disease remains the number one killer in the United States and each case is a potential failure because risk management wasn’t aggressive enough. There are five major risk factors for heart disease, smoking, high blood pressure, high cholesterol, diabetes and family history. You can’t do anything about the family your inherited, but the other four need life long vigilance to minimize the risk of not only heart attack but also stroke and peripheral vascular disease. All are due to narrowing of the arteries that supply blood to the body and the consequences that occur when organs don’t get enough blood and start to fail.

But back to the heart. It is a muscle like any other and needs blood carrying oxygen and glucose to contract and squeeze and send blood to the rest of the body. When one of the blood vessels to the heart narrows and not enough oxygen gets delivered, that part of the heart gets irritated and starts to ache, no different than arms that gets sore from lifting or legs that hurt from running. Heart pain is called angina and while you can touch an arm or a leg and feel where it hurts, angina can be trickier. It may be chest pressure, indigestion, jaw or arm ache or nothing at all.

Angina is a warning sign that a disaster may be on the horizon. The narrowing of a blood vessel to the heart occurs because of plaque or cholesterol buildup. Should that plaque rupture and completely block the artery, no blood will flow to part of the heart muscle and it starts to die. The clock starts when this occurs and each minute means more heart cells die. When a patient gets to the hospital, the goal is to open the blood vessel with an angioplasty within 90 minutes.

There are a few obstacles. The patient has to get to the hospital, the doctors and nurses need to make the diagnosis, the hospital has to have a cardiologist and team available 24 hours a day and a heart catherization suite to do the procedure. It’s easier to play prevention than disaster manage.

I’m hopeful that Mr. Wilbon recognized that chest pain is not normal and had an angioplasty relatively electively, instead of in the midst of a heart attack. I hope that, like David Letterman and his bypass surgery, it will increase awareness for heart disease and stroke prevention. I hope that when he returns, Mr. Wilbon reminds us about his heart issues and keeps the number one killer in the US in the spotlight.

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