Silent Ischaemia

Ischemia, lack of blood supply, is fatal to tissues. It is also fatal to the soul if we deprive ourselves of the Blood of Christ and His grace. This came to me very strongly this week as I engaged in a battle with physiological ischemia...

Tuesday evening, August 4^th, 2015 I was having pain in my shoulders, but none in my chest or jaw so I put it down to long-standing posture problems which have plagued me since purchasing a computer, and treated it with Anti-inflammatory Cream and Codeine phosphate 30mg. This gave some relief but no real resolution. Next morning (Wednesday) the pain was gone, but that evening it returned. I followed the same procedure as the day before, which provided the same result.

On Thursday the pain appeared quite early in the afternoon, and no relief was obtainable. By midnight it was quite intense so at 3am on the Friday morning I attended the Walk-in Centre at Peterlee. Having told them the family history of early deaths through heart attack they advised that I attend Accident and Emergency (ER) as Peterlee were unable to do ECG or Blood analysis.  I attended A&E at 6am and by 8am, with ECG abnormalities and rising Troponin levels (a heart enzyme released when the heart is damaged), I was being transferred to James Cook Cardiac Centre for care and treatment. That very day they placed three stents in the left coronary artery to the front of my heart with thrombolysis (break-up of clot) and hoped this would fix the problem. I was returned to Durham at 6am the following day (Saturday), with reassurance I would probably be discharged on the Sunday.

I was very eager to be discharged on the Sunday morning, but bitterly disappointed when Sunday came to discover Durham had no cardiology team member on duty to sanction the discharge, so I I had to resign myself to staying another night. This proved to be providential ( a grace from God) as on the Monday morning the Cardiac Registrar came to say that through the night the Telemetry heart tracing had shown ‘nasty ST irregularities’ during sleep(!) An echocardiogram and exercise ECG (treadmill test) were arranged on Wednesday which showed my heart was damaged and really struggling; that I was told not to leave the ward (or even go for a shower without informing nursing staff) in case I suddenly collapsed, so I was to be referred back to James Cook Hospital. At the same time, the telemetry ECG was removed, which left me feeling unsafe and vulnerable as I was now on a ward and not in Coronary Care. I asked to have my feeling of being safety-compromised recorded in my medical records since  it was removed after being I was told not to leave the ward or even go for a shower. Durham did their referral and on Thursday night I was taken back to James Cook, where next day a fourth stent was placed in the artery which circumvents the back of the heart. A post-procedure ECG looked fine so I was allowed to come home, where I am now, with strict inductions to stop smoking, reduce my salt intake and do gentle exercise.

I have had no chest pain at all throughout all of this, a condition described as ‘silent ischemia’ (once known as ‘Silent Myocardial Infarction’ or ‘silent heart attack’). Basically, one has a heart attack and does not know it.  I have been prescribed GTN spray in case I get chest pain -but will I?  I may simply infarct and arrest! A good reason to make sure I am at rights with God at every moment of every day, rather than giving in to sloth and the sharp tongue! A time to build prayer, patience, purity; charity to others and trust in God  -a good way for us all to live! 

Thank you, everyone for your prayers. Keep them up if you want to keep me on my feet!

Troponin –an enzyme released by heart muscle when it is damaged by ischemia (decrease in or loss of blood supply to the heart’s own muscle)

Telementry

A way of gaining a live recoding ECG rhythms at a distance (patient is mobile and not present on the Coronary Care unit

ECG

A tracing of the electrical rhythms of the heart, showing the conduction of the electrical stimuli through the heart’s muscle (it is poor where muscle is damaged).

Angiogram

Use of a contrast medium to show the position and state of the Coronary Arteries

Angioplasty

Placing of a stent in an artery blocked by atheroma (deposits in the artery)

Stent

A metal mesh-like tube placed inside a blocked artery to allow blood to flow to the heart muscle itself resume.

Up-date:

Following a cardiac event such as this one has little energy but a lot of anxiety as to when the next heart attack will occur. There is also some pain as the stents settle into place in the heart, so one is always on edge, added to which there is the possibility of kidney failure following use of the contrast medium for the angiogram (bloods are taken to check for this ten days after the angioplasty). Add to this the stress of having to alter one’s habits (reduce salt intake and quit smoking) and the anxiety only increases. It is said to reduce after some time, as patients learn to live with their condition. Roll on! In three weeks time I am to begin proper rehabilitation exercises led and supervised by health-care professionals in the next door village. Thanks be to God that at present Father Tully is saying the Masses here for me, allowing me to rest (and follow the gentle exercise plan!) and focus on life-style changes. But I must get back to offering Holy Mass soon; like a married man without his spouse the priest without his Mass is a man without his life.