The Georges in Peru

“If the fire is hot enough, anything will burn.”

27 Jan 2021

No, that isn't some theological quote!  That is a quote from a marathoner, who bragged he could eat anything he wanted because he ran so much it would keep any atherosclerotic lesions from building up on his coronaries.  It always seemed a bit misguided, since Jim Fixx, a runner credited with making distance running mainstream after writing his book, The Complete Book of Running died of a heart attack at age 52 (Yikes!  That's a year younger than I!).  But nonetheless, we runners tend to think we are bullet-proof as we go back for another bowl of ice cream after a platter of fries.  

My family is lucky to have low cholesterol.  Since my parents were the only surviving children from their respective families, our family history doesn't have enough numbers to give good statistics, though none of us six kids have had any coronary problems.   So I didn't worry about heart issues.  If anything, I bragged that I was extremely low risk.  So when I started getting sudden attacks of chest tightness while running just over a year ago, I was surprised and concerned.  Pulmonary and cardiac workups didn't reveal anything.  My cardiologist here inflated my ego by telling me he doesn't get many people my age that can do his complete treadmill protocol.  My symptoms became concerning enough (hard runs interrupted by light-headedness and having to stop) that Dr. Porter (thanks again!) recommended that I try to see if I could get a CT coronary angiogram here in Peru.  As it happens, two years ago, a local radiology clinic started offering that study.  So last week, I had it performed.  

You maybe can see here that my coronaries look good, with good flow.  

The arrow points to the problem.  Coronary arteries are supposed to run on the surface of the heart, but one of my coronaries burrows under the heart muscle for about 9 mm.  When my heart squeezes, it blocks the artery.  When it relaxes, the blood flows again.  Actually, when anyone's heart squeezes, it temporarily stops the blood flow into it, but when the heart relaxes the flow resumes.  If the coronary goes under the muscle and the heart is beating really fast, then it can't relax quickly enough to resume blood flow and then it starts telling its owner to 'slow down!'

So now what?  I'm not at any immediate risk as long as I don't race, so I won't do anything drastic at this time.  When we go to North American in July, we will probably have Dr. Porter do a few more tests.  Meanwhile, I'm going to cut back on the ice cream and butter.