Having a Heart Attack Saved My Mother's Life

[DeStrider]

As some of you may know, my mother had a heart attack around Easter. It was her fault as she felt healthy and stopped taking her BP meds. 2 weeks later she had a heart attack. Luckily she was in the hospital when it happened (she was experiencing stomach pain due to the impending attack). She is a very stubborn woman who didn’t want to take meds. The heart attack changed her mind.

The good news is after the attack (and 2 stents) she now takes her health seriously. Before the attack she had an HBA1C of 8.5-9.5 (8.5 on a good day). Now she has an HBA1C of 6.4 due to Empagliflozin and diet changes. She refused to take it before the heart attack!

Before the heart attack her LDL was 110. Now it’s 31 and her HDL is 34. Thanks Atorvastatin and diet changes! She refused lipid meds before the heart attack.

Before the heart attack, a SBP of 165 was good for her. Now she’s in the 80-120 range (we’re still adjusting the meds). Thanks Telmisartan! She was taking Lisinopril before… Until she stopped and had the heart attack!

Before the attack she regularly ate sugary cereals and pastries for breakfast. She’d eat fast food like McDonald’s. She’d eat crappy milk chocolate bars daily. No wonder she was diabetic! After the heart attack, she is eating healthy.

Unfortunately she developed AFIB from the heart attack. We’re working on fixing that, but her heart rate is too low due to the AFib meds (42. We want 60). Any advice here? The doctors want to ablate her heart and install a pacemaker. Is that the best option? @rivasp12 @DrFraser

All in all, without the heart attack, her diabetes, high BP, diet and cholesterol would have continued to get worse until it was too late. IMHO this heart attack was needed to get her to clean up her act.

Thank you for any advice that can help my 75 yo mother. And please, whatever you do, don’t stop your BP meds if you have high blood pressure!

[DrFraser]

I’m sad she came to harm to get some good - but it is a frequently travelled path.

So I appreciate the Cardiologist and Electrophysiology folks being keen to just do one sedation and do both procedures. However, in the event the ablation is successful and she is back in a normal sinus rhythm, then they should be able to cease medications causing her to be bradycardic.

I also am unclear on why they’d be running the doses of the medications so high as to cause this currently?

They may thing she has sick sinus syndrome underlying and be convinced that even with a successful ablation and no medications she will have too slow of a heart rate.

There will likely be a lot of important details that are highly relevant that aren’t in the details above.

Irrespective, I’d at least ask about those items, as they may be game for doing the ablation and if successful, weaning the meds.

The EP guys are pretty smart, and I bet there is a good reason why they think both done together is the correct move. A pacemaker, if she needs it (as in her heart rate might go too low) is not a bad thing, as the consequences often include fainting, which leads to fractures, head bleeds, etc … which often starts the spiral of death in older individuals. Pacemakers rarely cause any complications.

So I’d ask the EP doctors on a risk benefit … what if she did just get the ablation? What would be the risk/benefit. Getting both … risk/benefit.

I suspect it’ll become pretty clear as to the right decision with a couple of sensibly framed questions.