[Closed] Bugger..I have been diagnosed with heart disease..

30% is not necessarily a big deal, I’m at 70% with no symptoms yet and my consultant told me to keep cycling. I had side effects from the first statin but with the second I tried I’ve had none. I expect to get operated on at some point in the next ten years (either that or have a heart attack!) but you kind of just have to get on with life, especially as it could be shorter than you thought!

My biggest concern right now is how likely is it that a soft plaque would rupture...and what can I do, if anything, to prevent that.

I'm pretty confident that I don't have to alter my life style dramatically to stop it getting worse..my cholestrol use to be through the roof and I smoked. Now I'm fit and healthy, with lowish cholestrol and a good weight.

As i sit here mentally fighting my Angina i sympathise.

Just crack on but be sensible.

Unsure there is any impact on cycling using statins - certainly won't get you first place in the Tour de France, but it might help overall which will give you more benefits.

I'm not medically trained or really aware though, so that might be complete mince.

I've been on Statins for a few years without any perceptible side effects. Still fit, able to do long and hard rides and according to the ludicrous 220 minus age guideline I'm about 25 years younger than my actual age.
Regard yourself lucky. Most heart disease is diagnosed at post mortem.

Statins shouldn't affect cycling at all.

Well there goes the cheese on toast. 🙁

I'd personally be looking for advice from other cardiologists too, such as Aseem Malhotra rather than go the statins route. But that's IMO

Welcome to the club!!

Any level of heart disease is heart disease, so caution always needs to be taken.

I'm 4 years on from diagnosis and treatment of my artery squatter. He's slightly bigger than your guy at 95% blockage, but right up until my angiogram i was regularly riding out on the road bike with lads half my age (i was 46 at the time) and with an average heart rate of !50-160bpm over the course of a 2-3 hour ride. I was told that cycling saved my life as the symptoms only really showed themselves whilst i was exerting myself. The heart surgeon gleefully told be that if i had't self-referred myself to the GP i would very well have not seen Christmas and i didn't self-refer until mid November!!

I ended up with the fella being given a home in the form of a nice titanium stent. Loads of meds for the first year to include beta blockers, statins, asprin, ramipril, omeprazole. Back on the bike after a couple of months (on doctors orders). Told to push on as hard as i could, but to always carry a GTN spray with me. No problems at all with the statins, it was the beta blockers for me - they wouldn't allow my heart rate to pass 120bpm so after a year the doctor took me off them.

4 and a bit years on and still no issues with the statins - it is simply increasing age that is now holding me back.

Speak to your GP about getting a stent inserted, that might allay your fears over the soft plaque.

Oh, and good luck too!

Don't think they look to stent an artery that is only 30% blocked. It doesn't have any impact on blood flow and I don't think stenting would minimise heart attack risk would it. Stenting isn't recommended until it's about 70%?

This is really just beginning to sink in, and is kinda depressing

Yes, its very much a confirmation of your own mortality and I felt the same as you when diagnosed. Better to know and try and manage it than to eventually have a sudden heart attack though.

Think of it this way. Your arteries start furring up as a kid. They’ve reached 30% blockage in 40 years, so in another 40 years you might be up to 60%. In fact, if your lifestyle has improved, maybe that rate of progression is less.

Perhaps that’s being a bit flippant but we wouldn’t really think much of a 30% stenosis and definitely no stent. Like you say it won’t improve blood flow and will be a higher risk of clotting off than the risk in doing nothing. I don’t know the stats off hand but a lot of 45-year olds will have some detectable coronary disease. Most won’t know it, of course.

Take a statin, look after your weight, blood sugar and blood pressure and you’ll be fine.

I’m a doctor, not your doctor. Not medical advice. I’m more sympathetic IRL, honest.

Bad luck mate. Will be following to hear about how it goes.

I agree with the idea that it's handy to know, but i reckon the psychology of this stuff is so hard. Ultimately you've got an opportunity to manage it.

After a few episodes of blacking out a GP told me once when i was in my early 30s that "you might just have to get a pacemaker fitted, that's all." Well, that set the cat amongst my mental pigeons, didn't it? Just like when I was 17 and diagnosed with high BP "You might have a stroke when you're in your 50s, nothing to worry about!" Not for my GP, perhaps, but not ideal.

it was the beta blockers for me – they wouldn’t allow my heart rate to pass 120bpm so after a year the doctor took me off them.

I was on Beta Blockers from 17 until i was 21 and during that time I played 1st team football for my Uni. In the last 1/4 of any game i'd really struggle with cramp and pure exhaustion, and in training exercises i just couldn't get my pulse rate up. Changed to the fancy new ACE inhibitors and things were a bit better. I stopped taking anything in my late 30s as my BP really was only borderline, but in my early 40s now i'm having another look at things.

I've been on statins for nearly 5 years, plus beta blocker, ACE inhibitor and aspirin. This followed a cardiac arrest while I was running in a race. I had some symptoms which GP said were probably acid reflux but turned out to be angina. Anyway, after the resus/defib, trip in air ambulance and stent fitting, it turns out I had a 95% blockage in one artery but the others were clear. I was 41 at the time, doing lots of running and a fair bit of cycling and as you felt as fit as I'd ever been. A steady recovery back to normality, cardiac rehab etc I haven't really noticed the drugs having an impact. I was told that I would never be as fast at running again, however, that's not the case. I have dropped my PB's in every distance I've run up to marathon where I've now managed to do a 2:36, so the upshot is that I've actually improved. Maybe due to the drugs, maybe due to the lifestyle changes, maybe the stent. I don't know which has had the most impact but I do know that it doesn't mean you have to stop doing what you enjoy and it doesn't mean that you can't achieve goals. What I would say though is that you have to be patient and you have to listen to the advice and also listen to what your body is telling you. Don't look at it as a bad thing, look at it as a wake up call and an opportunity to set the past wrongs right and a chance to make things better. You're at an age where you can change things, not an age where you will slowly slide into the downward spiral of decline. Good luck and stay safe.

Sorry to hear that, hope it all works out and you get a good treatment plan.
Completely naive but related question here - does continuing fairly intense exercise into your 40s increase your rate of having a heart attack? I've heard a few stories of local people who've been described as fit as a fiddle, but then collapsed when training for their latest triathlon.

How do you get that far with palpitations and high cholesterol.

I have both and Doctors don't do seem to be interested.

Got diagnosed with angina a few weeks ago following chest pains while on the bike, im 53, doctors put me on aspirin and statins and told to carry the GTN spray all the time, saw cardiologist a week ago and he had a look around using a ultrasound and couldn't see a issue , which is good news.
Waiting for an appointment for a treadmill stress test and then an angiogram to see if I've a blockage anywhere?
Got told to stay off the bike which hurt more than my chest! ... But they know better than I do, so off the bike for now and just playing a waiting game.
All the best OP and hope it works out ok for you

Thanks for the responses. Woke up this morning feeling very sorry for myself but focussed on improving my all ready reasonably healthy lifestyle. And will definitely be going on the statins.

@superficial I know this is your field so can I ask a few questions. The fact that this is a soft plaque is I assume not a good thing. Does that dramatically increase the chances of rupture? Ultimately, the big question fir me is how likely is it going to be that I keel over with a heart attack. The fact that as a cardiologist you say you wouldn't think much of a 30% stenosis is slightly reassuring..

My other concern is would this now make me far more succeptable to covid? I read that it can cause plaque rupture .. I had my first vaccination 3 weeks ago but should I be keeping myself to myself until I have had both shots?

a lot of 45-year olds will have some detectable coronary disease

I've been trying to find out numbers around this to give me some reassurance. This study of young adults who died of non heart related issues seems to suggest 20% of 30-35 year old have a stenosis larger than 40%...That can't be right can it??

@rone..I initially went for a basic echo which was fine, apparently my heart is working perfectly. It's just the stuff round about it that is shit..which I found out by going through private heath provider. No way was nhs going to pay for that.

I see' got you. Cheers.

Try Brazil nuts for cholesterol BTW.

Amazing results for me.

Have PM'd...

How do you get that far with palpitations and high cholesterol.

I have both and Doctors don’t do seem to be interested.

Indeed. There's a definite risk associated with invasive coronary angiography and while I don't think many of my NHS colleagues would avoid doing a necessary test because of cost, a private practitioner may have other incentives. Obviously I/we don't have all the details in this case, I suspect there's at least a bit more to the story. But I do feel the need to defend the standard of care that the NHS gives when this sort of thing comes up.