All of a sudden, Jack Blatherwick couldn’t take 50 steps into his four-mile daily walk without extreme chest pain. With a Ph.D. in physiology and a career overseeing the conditioning of professional and Olympic ice hockey players, Jack, 65, recognized his symptoms as angina – the chest pain that occurs when arteries to the heart are blocked and the heart is starved for oxygen.
But he had trouble grasping how suddenly the angina had come on. Just three months before, he had played “super hard” on the ice with members of the Washington Capitals professional hockey team, and he had felt no symptoms.
On top of that, he had always been active: as the physiologist for five professional hockey teams and for U.S. Olympic Hockey Teams from 1980 through 1994, as well as a jogger for 40 years, running six to seven miles five times a week. A fall from a ladder three years earlier had ended his running, but he had taken up walking four to five miles a day, often near his “permanent” home in St. Paul, Minnesota.
“I always ate pretty healthy,” he says. “And I had low cholesterol, high HDL (good cholesterol), and my blood pressure was low. About the only thing I didn’t do was go to the doctor regularly to get checked,” he says.
However, there was one risk factor for heart disease that Jack couldn’t control: His genetic heritage. Both his father and uncle had died from heart attack in their 50s.
When he arrived at Abbott Northwestern Hospital in Minneapolis with angina, doctors performed an angiogram, a diagnostic test that enables them to “see” blockages in the arteries. The results showed multiple vessels with blockages of 90 percent or more, some of which were located where blood vessels branch (bifurcate) to deliver blood to different parts of the body.
The cardiologists who reviewed Jack’s angiogram told him he should prepare for coronary bypass surgery. They told Jack they were uncomfortable with the idea of opening blockages with angioplasty and inserting stents near bifurcating arteries. In angioplasty, an interventional cardiologist threads a catheter, or small tube, with a tiny uninflated balloon on its tip, to the blockage. The physician then inflates the balloon to push the plaque, or fatty deposits, to the artery wall. A stent, a small metal mesh tube, is then typically inserted at the point at which the blockage was cleared to prop open the artery.
Jack’s open heart surgery was scheduled for a week later, giving him time to take care of some team business in Washington and make preparations for the three-month recovery he expected after bypass surgery. Jack even found time to build a small door to let his dog in and out of the house during his recovery.
While he was in Washington, Jack received a phone call from Abbott Northwestern interventional cardiologist Dr. Timothy Henry. The news was good: After further review of his angiogram, the cardiology team had decided it would be OK to go with angioplasty and stents. Jack would not have to undergo the trauma of open heart surgery – and a long recovery.
A few days later, Jack underwent angioplasty and stenting. When the procedure was finished, Dr. Henry had inserted six stents, all at different locations in Jack’s coronary arteries. According to Jack, at least one of them was implanted at a vessel bifurcation.
“I spent one night in the hospital,” says Jack. “And I felt totally recovered as soon as I walked out of the hospital. I’m just floored at how far medicine has advanced.”
“Skill, experience, and knowledge are critically important for all physicians, of course,” says Jack. “But angioplasty might require another factor. Dr. Henry saw solutions where there were unique problems. It is apparent that creativity will play an important role as this procedure advances.”
Jack’s back at work, he takes walks in the morning and afternoon, and he’s building an addition on his house (so he’s allowed himself to temporarily stop lifting weights). If there’s one bit of advice he’d offer about preventing coronary blockages, it’s this: “No matter how heart-healthy your lifestyle, you need to see a cardiologist. I wished I had seen a cardiologist, had a blood test every six months and had the protection that medications may have provided,” he says.Chest pain can be an important signal that blood flow to the heart has become, or is becoming, restricted or blocked. SecondsCount features information about different forms of angina – stable and unstable – as well as diagnosis and treatment.