Left main: A killer

Heart attack is a vicious killer, responsible for one death every 34 seconds in the United States alone. Among Americans, more than 2,500 succumb to heart disease every day, and one person develops a heart attack every twenty seconds.

While the fact that heart attack kills is a common knowledge, most people do not know that the stenosis (blockage) of one particular coronary artery is the subtle and treacherous killer that usually victimize and claim the lives of younger and younger people today, many times suddenly, without warning. This culprit is the left main coronary artery that supplies the left ventricular muscle of the heart. Medically, this entity is known as the Widow Maker, since it has killed many a husband. 

Today, more and more women also suffer heart attacks. When this main artery is blocked more than 50 percent, the flow to the recipient heart muscle is compromised and that part of the heart muscle is deprived of enough blood (which carries essential oxygen and nutrients, etc., to the heart muscle). This is basically the course of events that leads to a heart attack.

The left main coronary artery branches into two, the left anterior descending (LAD) coronary artery (supplying blood to the front segment of the left ventricle) and the circumflex coronary artery (supplying the back of the heart). The other main branch is the right coronary artery supplying the right ventricle, which is less dominant than the left main (the artery that supplies the left ventricle, the main pumping chamber of the heart).

When we hear of sudden death from a heart attack, especially among the younger patients, this is usually caused by left main disease. And many times, without the classical symptoms of chest pains, or any indication at all that there is a blockage in the coronary artery.

Here are some important data observed about heart disease:

(1) Male pattern baldness, hair in the ear canals, and creased earlobes are apparently linked to a higher risk of coronary heart disease among white men. (2) Elevated level of an amino acid (homocysteine) is associated with an increased risk of heart attack and stroke.

(3) African-American women have the highest death rate from heart disease. (4) People who are sedentary, who do not exercise regularly, have almost twice the risk of developing a heart attack than those who do.

(5) Males who are clinically depressed have a higher risk for heart disease and heart attack than those who are not depressed.

(6) Genetics are involved in the development of arteriosclerosis (hardening of the artery, which causes arterial blockages in the arteries all over the body). (7) Red meat and egg eaters are more prone to develop high blood cholesterol and heart attacks.

(8) Those who eat beans at least 4 times a week have a reduced level of heart disease (19 percent lower) than those who eat beans less than once a week. (9) Those who abstain from red meat and eggs and eat a lot of vegetables, fruits, grains, nuts, and other high fiber foods are less prone to develop heart attack.

The positive side of all these is that medical science has proven that the development of hardening of the artery could be slowed down simply by eating the right food and regular physical exercise on a daily basis. We cannot do anything about our genetics (heredity), but environmental factors, of which lifestyle is most important, have been shown to have the ability to effectively “buffer” the negative traits in a person’s genetics. In simple terms, even if your parents have high blood pressure, heart disease, or even diabetes mellitus; it does not necessarily mean that, as their child, you will have these medical problems also. 

If their diet was high in cholesterol (red meats, eggs, dairy products) and carbohydrate (rice, cakes, sweets, pop beverages, etc.), and they smoke, are sedentary and not medically compliant with their health care, and, on the other hand, you are eating mostly fish, vegetables, fruits, nuts and grains, doing daily exercises, you don’t smoke, and are carefully monitoring your health; then your chances of NOT developing the hypertension, heart attack, stroke or diabetes you parents have, is fairly high compared to the sedentary meat eaters who smoke.

As we have stated in a previous column, the impact of diet is most significant. Here is one report from almost two decades ago: “1999 meta-analysis of five studies comparing vegetarian and non-vegetarian  mortality rates in Western countries found that in comparison with regular meat-eaters, mortality from  ischemic heart  disease was 34 percent lower in pescetarians, 34 percent lower in  ovo-lacto vegetarians, 26 percent lower in  vegans.”

Individuals on pescatarian diet could achieve excellent health and minimize heart attacks, stroke, and other diseases as long as they live a healthy lifestyle. Fish, eggs and other dairies, legumes, and nuts, are enough as sources of protein for one to have good nutrition on pescatarian diet. The opposite is true among meat eaters as the data above and below show. Abstinence from red meat, especially processed meats (and processed food items in general) is healthier.

So, when it comes to health, we are not what are parents are. We are more what lifestyle we have chosen for ourselves. Most of these diseases we face today are mostly self-inflicted and literally preventable. Making the right choice and the sacrifices may not be easy, but maintaining good health and longevity to the fullest is worth all our effort. My mother, who still watches her diet carefully, who used to exercise daily up to the age of 88, and who, today, still remembers the birthdays of her children, grandchildren, and great-grandchildren, said to me on her 100th birthday last November, “Healthy lifestyle is the best antidote to diseases and premature death…Trust me on this one.”

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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