The Future of Your Heart Attack
By Jim Atkinson
ABOUT TWENTY-FIVE YEARS AGO, I listened raptly to a group of young surgeons who were prophesying a time when hearts would be virtually bloodless. The most barbaric and common procedure at the time--open-heart, coronary-artery bypass grafting (CABG)--would become, they said, only slightly more serious than day surgery for an ingrown toenail through the wonders of fiber-optic imaging, microsurgical instrumentation, and lasers that could simply vaporize arterial blockages without a scalpel ever having to touch flesh. Given the pervasiveness of heart disease (our number-one killer, then and now) and the brutal trauma of open-heart surgery, this was big news. A quarter of century later, we're still waiting.
SO IF I BEGIN TO FEEL CHEST PAINS, I STILL HAVE TO GO IN AND BE "OPENED UP' LIKE MY DAD WAS?
Not necessarily. If the bad news about modern heart surgery is that we haven't been able to make it bloodless, the good news is that when the Big One visits, there are a lot more options to run through before being filleted like your dad was. To begin with, while he probably didn't know about his coronary-artery disease until he began to have angina (the chest pains that are an early symptom of it) or the real item, a heart attack, improved screening techniques--high-speed CT scans, MRIs, PET scans, stress echocardiograms--will allow many of us to elope out our problem long before a heart attack arrives. Individually, none of these technologies are anywhere near foolproof, but in aggregate they can fairly accurately separate those of us with an incipient heart-disease problem from those of us who, by virtue of good genes or clean living, don't seem to have a Big One in our future. This gives us a leg up on the problem that our dads didn't have. And though lifestyle adjustments--low-cholesterol and low-sodium diets, exercise, et cetera--haven't proved to be any magic bullet (half of all heart-attack mortalities are among people with normal cholesterol), deaths from heart disease have actually declined 60 percent since 1950, and the reason isn't simply open-heart surgery but cleaner living, particularly a 50 percent reduction in smoking.