Daisuke Yoshikawa writes:
Patient T's heart condition is very
serious. He is "hypertensive" and it is indicated that he has
early atherosclerosis. But, he thinks that he is well. So, I think that
it is very important for him to understand his heart condition is very
serious.
Lack of exercise and heavy smoking are main factors of heart disease. Patient
T conforms to these conditions. Also, his mother died after heart by-pass
surgery complicated by hardening of the arteries. So, I think his heart
problem is related to poor heredity.
Now, I would say to T: "The most important issue for you to understand
is that your heart condition is very serious. You are hypertensive and
have atherosclerosis according to clinical analysis. Cholesterol deposits
begin to accumulate along the inner walls of the coronary arteries. As
these crusty deposits enlarge, they can cause the arterial openings to
narrow, pinching off completely. Like these, atherosclerosis happens. If
starved of sufficient blood, heart muscle begins to die, triggering a myocardial
infarction, or heart attack. To reduce cholesterol, you have to exercise.
But, this exercise should not impose a burden on the heart, because prolonged
endurance training may substantially affect coronary artery anatomy and
physiology. For example, you do jogging for only 30 to 60 minutes, at least
three times a week. And you had better play golf with co-workers, two times
a month.
"You are a heavy smoker. Smoking
accelerates arterial thickening. If you continue to smoking, you increase
your risk of heart attack and stroke. As people age, the walls of their
arteries gradually thicken. But, the difference in internal carotid wall
thickness between current smokers and non smokers is greater than the difference
associated with 10 years of age. You were a former marathon racer. A study
shows that long-distance runners have a greater capacity to "dilate"
their coronary arteries and thus markedly increase blood flow to their
heart muscle.
"For the time being, you need to use aspirins to treat against heart
attacks. Aspirins which are widely available and cost very little, are
as effective as specialized drugs to dissolve the blood clots that cause
a heart attack and the other drugs that cost hundreds of dollars per dose.
"In the long term, you have to stop smoking and lose weight. If you
can't have a time to do exercises, you should limit your diet. About smoking,
I hope that you stop smoking instantly. But if you can't do this, you may
stop smoking gradually.
"Anyway, your heart condition is very serious. you have many factors
to be heart attack. So, you must understand what I said, you should live
your life carefully."
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