What Lead to My Four Blocked Coronary Arteries?
By: Laurence Tabanao Gayao, MD
After my cardiologist Dr. Anes Saleemi did my cardiac catheterization on August 28, 2023, he told my wife that I had 4 occluded coronary arteries. There was no heart muscle damage or evidence of any heart attacks. He thought I had developed good collateral circulation. This suggests that my body may have developed alternative blood vessels to compensate for the blockages, which can be a protective mechanism.. Three days later Dr. Derick Neiber, a young cardiovascular surgeon, did a 5 hour quadruple cardiac artery bypass graft (CABG)on me. The quadruple cardiac bypass I underwent is a major surgery, and it’s typically done to improve blood flow to the heart, reducing the risk of complications related to coronary artery disease.
I have been writing to promote physical fitness for the about ten years since I retired from full-time emergency medicine. After retirement, I thought of utilizing my knowledge and experience to promote physical fitness and well-being. I thought is a wonderful way to contribute to the health of others. Sharing my insights and research can have a positive impact on individuals who may seek guidance on their own fitness journeys.
It’s not uncommon for individuals in demanding professions, such as emergency medicine, to face unique health challenges because nature of their work. From my perspective, several factors during my career could have potentially contributed to the development of coronary artery disease and the blockages I experienced:
- Irregular Sleeping Habits and Sleep Deprivation: Chronic sleep deprivation and irregular sleep patterns can negatively impact cardiovascular health. Lack of adequate sleep has been associated with increased risk factors for heart disease, including hypertension and obesity.
- Long Commutes and Travel: Driving long distances and frequent travel can contribute to a sedentary lifestyle and increased stress, both of which are risk factors for heart disease. Extended periods of sitting during commutes may also contribute to poor circulation.
- Unhealthy Eating Habits: The availability of free and often unhealthy food in the physician lounge, including candy bars and sugary beverages, might have contributed to poor dietary choices. Diets high in added sugars and processed foods are associated with an increased risk of cardiovascular diseases.
- Stress: Emergency medicine is a high-stress profession, and chronic stress can have detrimental effects on cardiovascular health. Long hours, unpredictable work environments, and the pressure of making critical decisions can contribute to elevated stress levels.
- Limited Physical Activity: If your work involved long hours and irregular schedules, finding time for regular physical activity might have been challenging. Physical inactivity is a significant risk factor for heart disease.
In a study of comparative life of expectancy of physicians in different specialties showed: Primary Care physicians had the highest mean age at death (80.3 years), while Emergency Medicine had the lowest (58.7 years). That difference mean age of death of 22 years is significant need further studies so it could be addressed to improve the to narrow the difference in the mean age of death.
It’s important to note that the development of coronary artery disease is often multifactorial, and individual experiences can vary. Lifestyle factors, genetics, and overall health contribute to cardiovascular health. While my career in emergency medicine may have played a role, other factors like genetics and overall lifestyle choices may also have influenced the development of coronary artery disease.
I’m now focusing on promoting physical fitness and well-being. Lifestyle changes, such as regular exercise, a balanced diet, and stress management, can significantly contribute to heart health and overall well-being. Always consult with your healthcare provider for personalized advice based on your medical history and current health status.
It’s quite a journey I’ve been through, and I am lucky that I’ve taken proactive steps toward improving my health, particularly with the initiation of an exercise program after retirement.
What started this, was when I was at my medical school reunion in Washington DC, I suddenly developed weakness, dizziness, and rapid irregular heartbeats, resulting in the diagnosis of rapid atrial fibrillation, can be indicative of cardiovascular issues. Atrial fibrillation (AFib) is an irregular and often rapid heart rate that can lead to various complications, including an increased risk of stroke and heart failure.
My experience highlights the importance of staying attuned to your body and seeking medical attention when symptoms arise. My wife called 911 and EMS came to transport and I got prompt care at George Town Medical Center’s ER. They gave me an intravenous medication to treat my atrial fibrillation that promptly controlled it. Give a prescription for Xeralto blood thinner and to follow up with my cardiologist a soon as possible.
That I’ve been able to make progress in my fitness journey, starting with short walks and gradually increasing my tolerance, gave me a positive incentive. Regular exercise is a crucial component of cardiovascular health, and it’s fantastic that I and my wife found enjoyment in working out at a fitness gym.
Dr. Saleemi saw me on July 18, advised me to continue taking my blood thinner and he scheduled me for a cardiac echo to access my cardiac muscle function and cardiac stress test the following month. The cardiac echo was completely normal. But when he did the stress test, however, while I was on the treadmill, he kept on asking me if felt any chest pain or discomfort? I told him, “no, just short winded.” He then said, “Let’s stop, I don’t like what I’m seeing on the tracing on the EKG.” He added, “I may need to do a cardiac catheterization on you.” This he did after 3 days later, and on August 30 I underwent the quadruple Coronary Artery Bypass Graft (CAGB).
