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Dyslipedmia Erases Estrogen Protection

   –   One Woman's Story

It was at a Dean Ornish Seminar that I first met Ann Marie (last name withheld) of Marlton, New Jersey. As we crunched on our low-fat vegetarian lunch, Ann Marie confided why she came to the day's seminar.

“I’m interested in a holistic approach to prevent heart disease because heart disease runs in my family”. (Dr. Dean Ornish is president and director of the Preventive Medicine Research Institute in Sausalito, California and author of Dr. Dean Ornish's Program for Reversing Heart Disease).

Ann Marie went on to tell me of her family history. “My mother died from a heart attack at the age of 47, her sister at 46 and her brother at 28. Their mother (my grandmother) also died of a heart attack at 32. My sisters Peg and Mary are here today and both have heart disease. Peg had a heart attack at age 41. may, who just turned 42, is a to have a cardiac catheterization as her thallium stress test was positive. They work as nurses, one in a hospital, the other in public health. All my maternal cousins have heart disease and many have already died prematurely from heat attacks.

“Here I am at the age of 34 and I’ve been having chest pain for over 3 years, but no one believes me. I have been to three different cardiologists at three different institutions and, since my stress thalliums always come up negative, they tell me my heart is fine and there is nothing wrong with me. For my third and last doctor visit, I selected a woman cardiologist because I thought she might be different. Perhaps she’d believe me. What she told me, however, was that I was having sympathy pain for my sister who had just suffered a heart attack.

“My cholesterol is 500. I don't smoke. I weight 130 lbs. and I’m 5’7” tall. I am very active as my husband and I have two children and I work full time as a nurse recruiter, though I, myself, am not a nurse. I keep very busy, so, you see, I really don’t have the time to find yet another doctor who may or may not believe me. I know I’m going to have to do something about this soon as my family keeps urging me to, but I’m just not ready to go back for more of the same. It’s very humiliating to be told I am a nervous person and that this is all caused by anxiety, so I’ve managed to stay away from doctors for the past three years”.

Ann Marie’s sisters were both there to show their support. Each contributed to the conversation, stating that Ann Marie must find another doctor. I found myself joining in. “Ann marie, you must not give up. There must be a doctor out there who will investigate further, who believes you and who takes your complaints seriously. Please call this week and make an appointment with someone, then let me know how you made out”. Ann Marie replied that she would think about it.

On July 19, I returned from my vacation and heard from Ann Marie. She called to tell me that she had undergone coronary artery bypass surgery July 7 and that she was at home recovering. She finally did see another doctor, but only due to the continual daily prodding by a coworker, nurse Judith. “If it weren’t for Judith asking me every single day if I had made an appointment, I don't think that I would have done it. I was getting progressively worse with more shortness of breath and the cardiac care nurses began to get on my case. A friend gave me the name of Dr. Gary Burke. I eventually called him to schedule an appointment, but before my first visit, I decided to write him a long letter explaining my entire family history. I also told him that I didn't like wasting my time going to see doctors who didn’t believe me.

“When I met Dr. Burke, the first thing he said to me was that he believed me. With my family history, he said, he was quite sure that I had blockages and that he wanted to do another test called a stress cardiolyte. This time, I did have chest pain during the test and I had depressed S-T segments on my EKG. I asked the cardiac team if I could delay having the cardiac catheterization until after I enjoyed the July 4th holiday with my family and they reluctantly agreed.

“The cardiac catheterization was done July 6 and showed a 95% blockage of the left anterior descending artery with two lesser blockages. I consented to the surgery July 7. I am so glad to be alive. I am convinced that if I had delayed another couple of months, I may not have been around”.

The surgery took place in 1994, and, at the age of 34, Ann Marie held the dubious distinction of being the youngest female patient to have ever had coronary artery bypass surgery at that particular institution. As Ann Marie and her sisters can attest, family history of heart disease with abnormal levels of LDL blood fats (dyslipidemia) erases a woman's estrogen protection. Young women, even women as young as 30, can and do get heart disease.

Ann Marie has a parting message for any woman experiencing chest pain:  Insist on testing to rule out heart disease. It can save your life.

    - bha

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