Coronary Artery Disease At A Young Age

In 2012 my 36yr old Husband had a MI. His Cardiologist referred to it as the Widow Maker. He had a single 95% stenosis on his Proximal LAD. They put in one stent. During the angiogram the also discovered his RCA had 100% Chronic total occlusion. The LAD had grew extra vessels to feed the right side of his heart. His EF was 45% after the MI. He discovered he had a total cholesterol level of over 600 at age 27 and an LDL of 400. He began meds at that time but still very hard to control Lipids. At the time of his MI his total was 402 and LDL was 350. Since MI he is on the following Meds. Crestor 60mg, Zetia 10mg, Metoprolol 25 bid, lisinopril 2.5, Plavix 75mg, Fish Oil 4,000mg, Niacin 2,000mg, Garlic, and cholestoff. His numbers are now a total of 226 and and LDL 170. Better than it ever has been. He has done well with no further problems since MI. He did not have any symptoms prior to MI either. His doc thinks he has something called FH  his body cannot get rid of the bad cholesterol. My questions are: How likely is it he will need more stents? How do we keep ontop  this to try and keep that from happening again? How likely is it he will need bypass and would he benefit from it sooner than later? Thanks ~Amanda  

Good questions. Coronary artery disease happens at a young age! 

His cholesterol is much better, but not perfect yet. You haven't discussed diet & exercise, weight, ?smoking, all very important for future control of his heart disease.

Remember, a stent or bypass only improves the blood flow through is coronary arteries, but does nothing to the underlying process of atherosclerosis. Successful control of his cardiac risks, will slow or even stop  that process, but is unlikely to reverse the disease as is sometimes claimed.

Therefore, he will have an ongoing risk of future blockages and stent failure. If that happens, he will be best off with a coronary artery bypass procedure.

Hope this helps,

Dr T


Hi Amanda,

Your husband has a chronic illness, coronary artery disease, caused by a multitude of factors. Like any other disease it needs to be monitored regularly, and that includes all the things I mentioned in my previous answer:

Regular evaluations by his doctors including blood work and cardiac tests such as a stress test. How often depends on his specific situation.

Hope this helps,

Dr T

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