A heart attack at 40: When genetics works against you
One-third of Canadians haven’t talked with doctor about known family heart disease history, poll finds
Huffing and puffing in a spin class last February, Elana Trainoff began wondering about the strange sensations she’d been experiencing for several days.
The Toronto resident was short of breath and felt like she had heartburn. She joked to a friend about having one of those “female” heart attacks you read about in women’s magazines — the ones that last for days, as oppose to the Hollywood-style scene of a man falling to the floor, clutching his chest. But who has a heart attack at 40?
Trainoff brushed it off and went about her business. The next day — a Saturday — she went snowboarding and then headed to a party. She woke up at 4 a.m. with crushing chest pain.
The pain ebbed and flowed for an hour, but Trainoff soon realized something was seriously wrong.
Her partner at the time drove her to the nearest emergency department. Trainoff was hooked up for an electrocardiogram — a test that checks for problems with the electrical activity of your heart — and within minutes, doctors were rushing to save her life.
Trainoff was experiencing a STEMI, or ST-elevation myocardial infarction, a type of heart attack caused by a protracted blockage of blood supply in the heart.
In Trainoff’s case, that meant a 100-percent blockage in a small artery and a 40-per-cent blockage in a main one. In other words, a full-blown, potentially deadly heart attack.
“Your life flashes before your eyes in a heartbeat when you think you have heartburn — and then suddenly you’re not sure if you’re dying,” said the now 41-year-old film and television producer.
While Trainoff was caught off guard by her heart attack, she knew she had a de- gree of risk because she knew her family history of heart disease.
Her mother has had an angioplasty, three of her four grandparents suffered from heart disease, two of her cousins have undergone quadruple bypasses and most members of her extended family have diabetes and take medication for high cholesterol and blood pressure.
“I knew that my genetics were working against me, but when you’re younger you don’t think it’ll impact you for awhile,” she says.
But Trainoff is not alone in underestimating the risks hidden in her genetic makeup.
A recent survey by the Heart and Stroke Foundation found 51 per cent of Canadians are aware they have a family history of heart disease or stroke — but a third haven’t visited their doctor to talk about the risks.
It’s a staggering number since more than 1.4 million Canadians have heart disease, which is also one of the leading causes of death in Canada, claiming more than 33,000 lives every year.
Dr. Jacob Udell, a cardiologist at Women’s College Hospital and the Peter Munk Cardiac Centre at Toronto General Hospital, says physicians generally don’t consider younger patients at high enough risk to routinely screen for high blood pressure.
But, he says, “If those people had a family history we’d be taking that much more seriously.”
Cardiologists are particularly interested in first-degree relatives — parents and siblings — and any premature coronary artery disease in male relatives younger than 55 and female relatives under 65. If any of those family members had a heart attack, stroke, bypass surgery or angioplasty at an early age, that would be a major warning sign, Udell says.
The key is finding out what, if any, your genetic risk factors are, and discussing them with your family doctor.
The holidays, when family mem- bers gather, are a good time to ask about relatives’ heart health, Udell says. “Did anyone in your family die of a heart condition, or pass away at a young age and you didn’t know why?”
He also recommended using the Heart and Stroke Foundation’s Risk Assessment, an online tool that, through a series of confidential questions, helps determine your risk for heart disease and stroke.
If you have a family history, your physician can recommend lifestyle changes and medications, Udell says.
Trainoff underwent two angioplasties, which unblock blood vessels, although the first one was unsuccessful. In the past nine months, she has also radically changed her lifestyle.
She quit smoking and started exercising regularly, is eating a healthy, balanced diet and practising meditation. She is also taking five different medications.
Major lifestyle changes aren’t always easy, Trainoff admits, but she says the experience changed her life for the better. “I’m finding a Zen space to live in that I didn’t really know existed and I’m a lot happier than I’ve ever been,” she says.
Her advice to others, regardless of their age, is to take genetic risk factors seriously and make changes early. “It doesn’t matter how old you are,” Trainoff says. “I think there’s a misconception that heart attacks only happen to old people — but they don’t.”