Even active exercisers should fear the ‘widowmaker’
While stress, obesity are risk factors, heart attack can happen to healthiest
They call it the “widowmaker.” A heart attack caused by a 100 percent blockage in the left anterior descending artery, which carries fresh blood to the heart. When total obstruction occurs here, the heart stops fast, in a move that is often fatal.
Jonathon Coz doesn’t remember this happening to him in February 2016. But his wife does. As a nurse at M.D. Anderson, she’s well trained in CPR, and she performed compressions for about 10 minutes until the ambulance arrived to take Coz to Memorial Hermann.
He woke up the following morning in a cardiac catheterization lab at the hospital, wondering where he was, how he got there and with a new stent in his artery.
Then Coz was told he’d had a heart attack. And immediately, he began asking: “How could this happen to me?”
Yes, he was 58 at the time. But Coz had just run an ultra-marathon less than a month before. He goes to the gym four or five times a week, and spends his Saturday mornings cycling anywhere from 40 to 70 miles with his cycling team each week. Add to that his running, and his healthy diet. It didn’t make sense.
When things became less fuzzy, Coz relayed this surprise to the surgeon who operated on him, Dr. Konstantinos Charitakis, who knew well how disorienting this kind of health issue could be. “When I first started treating patients with coronary artery disease, I thought it was that someone who was overweight or who doesn’t exercise has a high probability for having blockages, and people who are thinner, or go to the gym, I thought the possibility of having obstructive disease was close to, like, minimum,” Charitakis said. “But this is not the case.”
Yes, being overweight, smoking and not getting enough exercise are key risk factors for the “widowmaker.” But so are genetic factors: Things you don’t necessarily see in an otherwise healthy person; things Coz and his doctor didn’t see in his physical, just weeks before the attack.
“People have different sensitivities and genes,” Charitakis said. “So I think that people will say, ‘Oh my goodness. If it happened to this guy, will it happen to me?’ And the answer is, we don’t know.”
Coz’s case was one of those medical idiosyncrasies that forced Charitakis to ruminate on the fact that while humans have come to learn so much about the body, there are an infinite number of mysteries we have yet to crack.
As Charitakis and Coz talked about Coz’s health history immediately following the surgery, the pair learned that they had something in common: They were both avid cyclists. And as follow-up appointments continued for the next few months, including a surgery to insert two more stents into Coz’s artery, their doctor-patient relationship blossomed into friendship.
They began talking gear. Then Coz brought Charitakis a jersey from Coz’s cycling team. About three months after his heart attack, Coz invited his doctor out for a Saturday morning ride.
As is typical of all his rides, Coz spent about an hour getting his gear ready, in preparation for what he thought would be an hours-long affair. then he, Charitakis, a couple other doctors, and one of Coz’s cycling buddies, who had undergone a triple bypass a year earlier, hit the road.
“We started in Memorial, and went to downtown. I thought we
were going to do like 40 miles, but after not even 10 miles, Dr. Charitakis said ‘Let’s go back,’ ” Coz remembers, laughing. It’s funny now, but at he time, he was frustrated with his doctor. All that gear-assembly for what turned out to be a 30-minute cycle.
“I wanted to take it easy,” Charitakis said. With only a few months of time between his patient and a nearly-fatal heart attack, he thought a 40-mile ride could be a bit much.
But over the course of the next several months, the duo began riding together more regularly. Coz brought Charitakis along on his Saturday morning rides with his cycling team. And now, two years later, Charitakis is a steady member. They meet up on weekends, cycle for 50 miles or so, then grab pizza and beer to celebrate their morning adventures.
Charitakis still checks up on Coz, who is more likely to ride near the back of the pack these days (and has also cut down his running, from full and ultramarathons to halves). But while Coz is a little more leisurely in his athletic pursuits, he is still far more active than many 60-yearolds.
“I think it just goes to show you that after a near-death event, you can still have a regular life. Regular exercise. And some pizza and beer with your friends,” Charitakis said one Saturday morning in early December, as he Coz waited for slices of pizza after a long ride through Dickinson. “Does he need a good hospital and good medication? Absolutely. But once he comes out, it doesn’t mean his life is over.”
Moderation is still important, though, Charitakis said. “If this tells you anything, it’s that living a healthy lifestyle doesn’t make you bulletproof.”
“If this tells you anything, it’s that living this lifestyle doesn’t make you bulletproof.”
Dr. Konstaninos Charitakis, cardiovascular disease specialist