Doctor’s Heart Attack | Hacker News Reader

Doctor’s Heart Attack

spyderdoc.substack.com

26 pointssumanmd14 comments

There must be major genetic component to heart attacks. They run in some families, and, as the article says, being South Asian is in itself higher risk.

Then there are the counterexamples. My grandma ate like pig (as a kid, I couldn't even tolerate the smell of some foods she enjoyed), was fat for most of her life, her blood lipids were all over the place, she never exercised and died of cancer aged 90 with negligible levels of atherosclerosis. Something in her genetic(?) makeup protected her from the consequences.

There are definitely genetic factors in the risk that cholesterol poses to the body. We are finding more and more genes that impact either how we digest and process food, what we do with excesses, and how our bodies react to all this. Then there is all the work going into the microbiome and its impact on these factors.

We like to think that everyone is the same, but the more that people research this stuff the more complex it seems to be.

What did she eat? There's a massive difference between gorging in meat and vegetables or donuts and fries. Not all food is the same.

She didn't eat donuts and fries, true. She was born in 1926 in rural eastern Slovakia, so her staples were meat (including cheap, highly processed meat), local variant of pasta (halušky), plus a lot of animal fat.

Her cholesterol was something like 9,5, often exceeding 10. She also smoked for 30 years, but stopped around 65 years of age.

Theoretically, her arteries should have been clogged like crazy. They weren't.

I have had two people 40's and 50's die recently from heart attacks. I wonder if these days can you get like a secondary artificial heart on purpose. I imagine there is a space problem, maybe it could be placed elsewhere like in the guts but idk... My side of the family all died out from heart problems and I'm in line/too stupid to stop eating salt.

Heart attacks aren't caused by the heart itself failing but rather by arterial occlusion. Even if it were possible to build such a secondary artificial heart (it isn't) the risks of implantation surgery would far outweigh any possible benefits.

Salt is an essential nutrient. Hypertension does increase the risk of cardiovascular disease, but eating salt doesn't necessarily cause hypertension. The issue is with osmolality rather than quantity. (And genetics area huge factor.)

https://peterattiamd.com/rickjohnson2/

The disease is more common than we think.

For those interested in a deeper dive into heart disease, the Peter Attia Drive podcast from last week has a great summary of root causes, tests, and prevention.

https://peterattiamd.com/ama34/

Dr Ronesh Sinha wrote an excellent book “The South Asian Health solution” which has some very good recommendations for diets. I highly recommend that book.

Great write up. In your case, sounds like risk factors were relatively minor, but your blockage was severe - do you know of any efforts to increase proactive use of cardiac PET or other scans? I understand the typical stress test isn't indicated before other symptoms manifest.

Thanks. I have implemented more detailed lab testing and coronary calcium scoring based on the risk level and metabolic disease. Unfortunately unless we look deep and harder we can miss it especially in south Asians which tend to die very young due to coronary disease.

Running is actually bad for you. Health is not the same as Fitness. The more you run, the more you risk long term damage. I know a lot of people reading this will disagree. In response I say: read "Body by Science".

Bullshit. There is no evidence that running with proper form harms your health.

Of course for optimal health people shouldn't just run as their only form of exercise. Ideally it should be combined with frequent weight training and other forms of cross training in order to gain muscle and avoid overuse injuries.

Unique perspective from the lens of the Physician as a patient

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