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   A few general questions about my friend. (Heart Disorders board)

18th September 2007
I have a friend who had a heart attack while at work about 5 weeks ago and am concerned about him and I have some questions that if anyone could shed some light on for me would be appreciated. I am not gonna pass any of this information along. It is just for my head and I don't want to bother him by asking him too many questions.

Here is as much information that I can think of. He is a non-smoking 51 year old white male. Non-smoker and non-drinker with a some family history of cardiovascular disease. This person is not overweight. They DID have numerous previous warning signs that were ignored.

His attack... which they say affected the BOTTOM of his heart, which supposedly "they" say is a more favorable location. He had a 100% blockage in one vessel and 85% in the other.

He was hospitalized for about 10 days in which time a couple of stents were put in and the vessel with the 85% blockage needs addressing in the very near future. A permanent pacemake was implanted.

His recovery is going quite smoothly. He is on the following medications.....

COREG -- 10mg once a day.
PRAVIX -- 75mg once a day.
LIPITOR -- 20mg once a day.

Also... he was prescribed 500mg. of NIACIN (Nia-Span) for which he has apprehension because of the flushing factor.

He has no discomfort and tries to walk daily and is taking his medications and following the docs orders to a tee.

Now.... the thing that frustrates him is the fact that not only is he missing work, but he cannot drive and they told him not to raise his arms above his head. Also... is has been 5 weeks since his attack and his first cardio-rehab appointment is within a few days.

In your guys opinion, is there anything that stands out here? I am just curious about all of this.

Is 5 weeks a long time to begin cardio-rehab? Do you think he will be able to drive and work again, and how soon?

I know that you cannot diagnose and give any kind of medical advice but I am just curious as to whether or not you think this line of treatment is the standard procedure, or does anything seem a little bit unusual?

Thanks for reading my long post.

DAVID
19th September 2007
As mentioned by the other posters, everyone's case is different. The fact that your friend had to undergo a pacemaker implant (could be an ICD=internal cardiac defibrillator?) indicates that the heart attack might have left him with a low ejection fraction. The fact that he is on Coreg might also back up that theory. He might also be on other medications such as an Ace inhibitor. You did not list aspirin as one of his medications. Dual anti-coagulant therapy (plavix and aspirin) after stent implantation is almost mandatory unless he is allergic to aspirin or for some reason he cannot tolerate it or he might have been placed on Coumadin? With the implantation of a pacemaker/ICD?, his recovery period is a little longer than someone just undergoing a stent implant because he has to be careful with the surgical site to allow it to heal properly and to avoid dislodging the leads (wires) of the implanted device. This is why he was asked not to raise his arms and not to drive until everything is healed, and that also explains the delay in starting the rehab program. Based the above, it seems that five weeks of recovery is reasonable and that he is undergoing the proper treatment. I hope he feels better soon.
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