Yet another exercise magic !

How an Active patient and an Astute physician “Abort” a heart attack !

Mr Parker is a 75 year old diabetic. He is always on the go. Wherever possible, whenever possible he avoids a vehicle or an elevator but walks and climbs besides doing his regular half hour walk every morning.

But one evening his long standing diabetes played spoil sport.  He started getting chest pain and hence went to his family physician. The doctor took his ECG, diagnosed a heart attack (technically termed ST elevation myocardial infarction) and packed him off to Nanavati hospital. (Fig 1 from attachment)

But before sending him, he did a wise thing. He gave him a soluble aspirin to chew and 4 tablets of  clopidogrel (another blood thinner like aspirin) to swallow.

By the time Mr Parker reached the hospital, his pain had subsided completely and the ECG reverted to normal (in medical terms- the elevated ST segments regressed to baseline). (Fig 2 from attachment)

This was because of the dissolution of the clot or thrombus which was occluding a coronary artery.  Usually it requires the intravenous injection of a clot buster (fibrinolytic drug) or emergency balloon angioplasty to dissolve or remove the clot and open the artery. In Mr Parker’s case it happened without any of these these remedies. It is very likely it came about due to the physical activity habit of the patient as well as the timely diagnosis with an ECG and administration of the blood thinners in correct dosage by the family doctor.

An angiogram that I did the next day confirmed our premise, and Mr Parker was referred for bypass surgery due to presence of multiple serious blocks in other arteries too.

Regular, moderate intensity  physical activity is known to stimulate body’s own “fibrinolytic” system- that is, the body’s ability to spontaneously dissolve unwanted clots.

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Although due to diabetes, Mr Parker had fat deposits and a threatened heart attack due to clot formation, the latter “melted”  due to a combination of his own vigorous fibrinolytic potential because of regular exercise and the blood thinners promptly given by the doctor after a quick diagnosis of ST elevation MI. Hence he did not suffer from much damage to his heart muscle. The bomb was diffused before it could explode !