Heart Attack

On Friday, July 3, 1998 I experienced chest pains which demanded attention. The pains begin at 5:45 am and my wife, Dianne, transported me to the hospital by 6:30 am. A blood sample was obtained and the results indicated higher than normal levels of the enzymes creatine kinase and glutamic-oxaloacetic transaminase. It was a heart attack.

I was immediately given a dose of TPA (tissue plasminogen activator), a clot-dissolving enzyme used to rescue heart attack victims if administered soon after the heart attack occurs. I owe a lot to Dianne, the world's most cautious driver, for getting me to the emergency room rapidly. (We even went through a few red lights!)

It was determined that the extent of damage was small. However, a heart catheterization would reveal any blockages. The idea is frightening. A wire is inserted into your groin and then into your heart where an iodide based contrast agent will be administered and X-Rays taken of your coronary arteries. However, after a dose of Valium, one does not fear anything.

The following figure illustrates the 95% blockage in my right coronary artery. (Photo courtesy of Dr. Erich Schneider.)

In research on cholesterol and it's role in heart disease, the most attention recently has centered on HDLs (High Density Lipoproteins) and LDLs (Low Density Lipoproteins.) The more cholesterol a person has bound to HDLs the lower the risk of coronary heart disease. LDLs are believed to promote coronary heart disease by first penetrating the coronary artery wall, where they are broken down enzymatically to cholesterol, cholesterol esters and protein. The cholesterol and cholesterol esters are then oxidized in the artery wall, becoming major parts of atherosclerosic plaque. Atherosclerosis is essentially a chronic form of inflamation. Platelet-derived growth factor (PDGF) is one of the secretions that bind to a receptor on the surface of some cells in arterial plaque. If the receptor is then activated, by a process known as phosphorylation, it can transmit a message into the cell. That message might stoke inflamation, for example.

It was determined that the best course of action would be to place a stent in the blocked coronary artery. The stent would force the blockage open and ensure that the artery would remain open. The following figure illustrates the same artery without a blockage. (Photo courtesy of Dr. Paul Traverse.)

I owe a lot to Dr. Richard A. Ryder, who administered the TPA, and Drs. Schneider and Traverse who performed the angiogram and angioplasty respectively. During my one week "visit" to the hospital I met about a dozen nurses (my former students) who either stopped by to chat or perform necessary procedures on me. My deepest thanks to all of you!

Special thanks also to Mr. John Micha of the BCC Chemistry Department for scanning these pictures.