Heart Disease: Surgeries and Medical Advances
One Woman's Story
Susan Goodreds never thought she'd need coronary artery bypass surgery. She had always eaten a healthy diet, never smoked, and had been an athlete all her life. She ran a ski shop in Goshen, New York, for 23 years and had skied all over the world. "I ran 10k races, I played golf, I played tennis, I swam with dolphins," she says. Despite a family history of heart disease -- a problem she assumed was more of a concern to the men in her family -- and a little mild chest pressure from time to time that she attributed to stress, Goodreds, 61, never suspected that she was a heart attack waiting to happen.
Then, several years ago, she learned that her cholesterol was high. But when it didn't respond to several different statin drugs despite her healthy lifestyle, she grew worried. Thanks to information she'd gained from working with the American Heart Association, she went to her doctor and demanded a C-reactive protein test and a heart scan. Her scan showed that she had plaque clogging her coronary arteries, so in January 2003 she underwent cardiac catheterization, in which a scope was inserted into her heart to take a look. The result? Despite having almost no symptoms at all, Goodreds had two coronary arteries that were 90 percent blocked. One of them was the left anterior descending (LAD), the major artery of the heart often called the "widowmaker" in a lingering bit of gender-biased terminology. It likely would have caused her to die if it had closed up completely. Because of the location of the blockages, Goodreds was not a good candidate for an angioplasty, in which a cardiologist threads a catheter into an artery in the leg, up to the aorta, and into the narrowed or blocked artery and inflates a balloon and/or places a stent to keep the artery open. So she would need bypass surgery, also known as coronary artery bypass graft (CABG and, yes, pronounced like the vegetable).
Goodreds was scared, and she didn't want just any heart surgeon to operate on her. Since she now worked as a healthcare marketer, she was a believer in researching doctors and treatments. She sought out Mehmet Oz, MD, for his renown as director of the Cardiovascular Institute at Columbia University-New York Presbyterian Hospital, in New York City, and his state-of-the-art skills. But she was also intrigued by the 43-year-old's reputation for addressing the mind-body connection in healing, especially in women, as founder and medical director of the Integrative Medicine Program at Columbia Presbyterian Medical Center, one of the top medical research institutions in the world.
Dr. Oz often speaks at medical conferences about how different women's hearts are from men's. Goodreds, even with a major blockage that was detectable on a scan, had gone undiagnosed for years due to lack of major symptoms. And some women's arteries may have no detectable plaque at all but may close up from spasm, or a temporary constriction, sometimes even to the point of triggering a heart attack. Although it's not known what causes these spasms, which happen more often in women than men, many doctors believe that fluctuations in estrogen levels contribute, and stress may play a role, too. And it also makes women's heart disease more problematic to treat. "If a man has a blockage," Dr. Oz says, "you can ream it out with angioplasty or put a bypass over it, and it's easy. But in the woman, the problem is more diffuse. How do you bypass a spasm? Technically, it's more difficult."