An experience with arterial plaque

            Mr. Piyawat Kasemsuwan, a 58-year old middle manager in a stock exchange company, underwent a heart by pass surgery in the beginning of 2018. He’s a working man who always took care of his health; he had a balanced diet, loved to eat vegetables, and have been getting 2 health checkups every year. In those checkups, no abnormalities were ever found regarding blood cholesterol and sugar levels, even his blood pressure was normal.

What were the risks?

          He said, “I got married later in life. When I was single, I used to party, drink, and smoke a lot. I was not living a healthy lifestyle. I started drinking at 18, started smoking at 15…I smoked 10 cigarettes a day and on nights I went out, I smoked up to 20 cigarettes. My lifestyle changed when I got married at 50 and I decreased these unhealthy habits.”

          He continued, “in August of 2017, I started to get stabbing pains in the inside part of my left arm. The pain was annoying and continuous, so I rubbed my arm and it would go away. Three to 4 hours later, it would return again. This happened for about 2 months and I started getting muscle fasciculation around my left rib area, to which I tried to solve the issue by rubbing the skin on that area. I began to have suspicions that things are not normal so I consulted a cardiologist at Vibhavadi Hospital. He asked me about me previous symptoms and whether or not I was suffering from chest pains and tightness, if I was suddenly out of breath from doing normal things, like walking up the stairs. I got an electrocardiogram (EKG), the results were normal, but when I went through the Exercise Stress Test (EST) my calves began to experience numbness after walking on the treadmill and I could not finish the designated program. The doctor explained that our arteries resemble a tube, and if plaques like fat or calcium deposited inside the vessels, it would also block off access for blood to travel through. My artery was not completely blocked off, but for some people it could manifest in a sudden way like a heart attack…and could result in death if not helped in time. Because my results were not too bad, I was able to resume normal life and came back again for a 128-Slices CT Scan 2 months later. The results were shocking, 3 of my arteries had calcium plaques inside and I was immediately referred to a cardiologist.

             I was shocked as I was told by the cardiologist that my condition was a ticking time bomb; meaning things could go wrong at any time. I made the decision to go see Dr. Semchai Pohboon, cardiologist at Vibhavadi Hospital. When we saw my CT Scan image, he made an appointment for me to receive a cardiac angiogram and insert a balloon to increase room in the blocked arteries. However, during the procedure we encountered an issue—there was too much calcium deposits inside that it was impossible to insert a catheter. It would not have been an issue if they were fat deposits, but calcium deposits were another story. We could push through it, but it would require 4-5 sessions every 2-3 weeks and a very high risk of kidney failure from the IV contrast dye used…and may result in me having to undergo dialysis for the rest of my life. The doctor told me that there was another option: a coronary bypass surgery. It will help redirect blood through a graft and finally supply the heart with sufficient oxygen. I made my decision, and 4 days later Dr. Semchai Pohboon with Dr. Chaiwut Yottasurodom, the cardiac surgeon, and their team led me into the bypass surgery. The artery from my right leg was used to build the graft. I spent about 4-5 hours in the surgery room, and then I was under observation in the CCU (cardiac care unit) before transferring to a room in the ward, where I spent the rest of my 13 days in the hospital. The doctor told me that my 3 arteries were 75%, 85%, and 95% blocked respectively. He also took the opportunity to change the 4^th artery for me too, to prevent problems down the line. I asked him what were the causes of the blockages, and he told me that there were 2 possible scenarios: 1, being diabetic and receiving insulin regularly causing calcium deposits, and 2, long term regular smoking. I have been smoking since I was 15, 10-20 cigarettes per day. The doctor was sure that my smoking habits were the cause of the calcium deposits blocking my cardiac arteries.

From that day, I decided to quit smoking. It’s been 9 months post surgery now, and my life has returned to normal. I exercise lightly everyday by walking for 5 km around my neighborhood.”

After the near death experience, Mr. Piyawat mentioned that besides risks like smoking, taking one’s health for granted can also be a risk factor. He urges everyone to get yearly health checkups even if they are healthy and feel fine. Do not push your luck, he added, in his case, he was fortunate enough to get the correct treatment for 3 clogged arteries in time…