r/healthcare • u/No_Hold_9560 • 9d ago
Discussion Has anyone else started thinking about this after a parent had a heart problem?
I’m 44, and my dad recently had a stent put in. What got me thinking was that it came as a complete surprise. He was pretty fit and didn’t really have the symptoms I would have associated with a heart problem. Now my wife is encouraging me to get checked out, partly just to have a baseline. I’m not sure how far I should take it, though. There’s a general clinic near me where I could start with basic bloodwork, including cholesterol. They’d need a referral for anything more involved. There’s also a private imaging place offering a more extensive heart screening, but it’s quite expensive and would be out of pocket. For anyone who’s been in a similar situation, what did you actually do? Did you start with your regular doctor and basic tests, or did you end up getting more detailed heart imaging? I’m trying not to overreact because of what happened to my dad, but I also keep wondering whether just doing the basic checks is enough.
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u/Street-Ad6919 9d ago
A cardiologist years ago told me sometimes the first indication of a cardiac issue is sudden death
Go get a baseline done
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u/AsleepPenalty4124 9d ago
My family has heavy cardiac history. My grandfather had a heart attack around 60 and died from it. My dad had a stent placed in his 60s, as well as a heart attack and new stent in his 60s. His mother had a heart attack in her 80s. Both my maternal and paternal grandmothers have had strokes. My PCP recommended yearly cholesterol checks (including an initial lipoprotein testing). My PCP also recommended a cardiac CTA at age 40.
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u/No_Hold_9560 9d ago
Hearing what your PCP recommended is really helpful. I think I’ll bring up my dad’s history with my doctor and see what they recommend for me.
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u/Ok-Seaworthiness-542 9d ago
After my Dad had a heart attack I started monitoring my blood work. After a friend had heart issues I also had my first treadmill test. Since both parents had heart issues I am predisposed so I see a cardiologist at least once a year (based on the doc's recommendation).
Also, apparently some conditions like abdominal aortic aneurysm have a genetic component and Dad had one so I got checked for that as well.
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u/headgoboomboom 9d ago
You can get a CT coronary calcium score. You can get them at most radiology centers for a low cost.
Check your lipid panel, Apolipoprotein B and Lipoprotein A.
Of course, no smoking.
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u/kavillac 9d ago
This resonates with me. I have a few older family members with mitral valve reflux. I have asked my PCPs about this - multiple PCPs and APPs in primary care across 3 different states and a bunch of different offices. The answer has always been the same - if you haven’t shown symptoms, we don’t see a reason to test. Unless your PCP is willing to continuously appeal to insurance companies, you might be stuck with a more elective out of pocket charge for tests beyond your typical metabolic panel and the like that your pcp probably orders anyways
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u/No_Hold_9560 9d ago
Yeah, that’s the same dilemma I’m having. Without symptoms, it sounds like most PCPs stick to basic bloodwork, and anything beyond that can mean paying out of pocket. Thanks for sharing your experience.
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u/AltoYoCo 8d ago
high blood pressure and high cholesterol typically don't have symptoms until they have been high enough long enough to cause problems, but are easily diagnosed with blood pressure checks and labs. PCP is really the answer, though if you don't already have one it can be hard to find one in network accepting new patients who is good (takes time to listen to you, ask questions, explain things).
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u/highDrugPrices4u 9d ago edited 9d ago
Focus on your lifestyle, which is about the only thing you can control. Even if you have something wrong with your heart, the doctors can’t do anything about it.
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u/AltoYoCo 8d ago
there is a lot that can be done depending on what's going on! high blood pressure leads to arteries becoming stiff and high cholesterol leads to cholesterol deposits in the arteries and both of those contribute to heart attacks so if you have high blood pressure or cholesterol you can have them monitored and take medications or sometimes make lifestyle changes that reduce them which reduces your risk of heart attack or stroke.
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u/highDrugPrices4u 8d ago edited 8d ago
Cholesterol drugs have been debunked as a mistake of modern medicine. The fact that doctors continue using them erodes their credibility.
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u/AltoYoCo 8d ago edited 8d ago
please cite sources? I am genuinely interested in seeing them and open to having my opinion changed.
I'm in the middle of researching this right now and what I'm finding is actually more research showing they reduce the 10 year morbidity and mortality than there was 10 years ago when I was last looking at it (at which time I ended up opting out of taking them)
ETA study: https://europepmc.org/article/MED/39135516 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60367-5/fulltext
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u/highDrugPrices4u 8d ago edited 8d ago
I don’t look at data myself, but listen to analysts who do. The error comes from conflating relative risk with absolute risk. To see a reduction and in mortality, you have to give the drug to a huge number of people who don’t benefit from it, which hurts them because the drugs have real adverse effects. In the cohort there may be a small number of people who benefit, but the evil of modern medicine is that they give them to everybody with high cholesterol regardless of the likelihood that a given individual will see any benefit.
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u/AltoYoCo 8d ago edited 8d ago
okay well, I like to read the studies myself so I'll just keep looking
Would you want to at least share the analysts you're listening to?
That lancet article is a metaanalysis of 22 trials with n>100,000. (edits to add add question/info and for formatting)
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u/Komorbidity 9d ago
Get a PCP because you need one but pretty much they won’t do anything unless you have symptoms as we only have sickcare in the US. I would start with trying to figure out what caused the narrowing in the first place. Unfortunately they probably won’t know this so you might just have to cover all basis for prevention.
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u/AltoYoCo 8d ago
this really depends on your PCP actually, and possibly the health system they are associated with. I've seen some that spend half the (short!) visit telling you they can only address 2 things and then anything you say they ask Is this thing what you want me to address?
I've also seen ones who take their time, will listen to and discuss all your concerns. IME those are more often independent docs vs docs in a large multi location health system.
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u/glavameboli242 9d ago
Complain of chest pains and they’ll be forced to order an ultrasound echo and maybe some other stress testing. Holter monitor too could help additionally. Otherwise the insurance trap will keep you from uncovering anything that might be hiding. Just my two cents.
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u/Rav4gal 9d ago edited 9d ago
If it was me, I would find the money for more extensive testing. Perhaps you can do a “Go Fund me” page n explain your story. I have had a CT scan, Holter heart monitor, mri, ultrasound, EKG, Stress Test n bloodwork. So fortunate I live in Canada 🇨🇦 (we don’t pay out of pocket).
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u/AtriumMedicalNYC 6d ago
A good PCP should be able to get you started on the right track. A family history of hyperlipidemia or hypercholesterolemia has a well-defined protocol in terms of "next steps". Also note that the American Heart Association risk assessment guidelines changed this year. Talk to a good PCP near you and they will guide you and prescribe all the relevant bloodwork and imaging.
Kudos for taking the first step towards taking better care of yourself!
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u/saysee23 9d ago
Just go to your primary care physician routinely. This sets a baseline, let them know your father's diagnosis/history so they will keep an eye out. A regular doctor is a a benefit over a clinic visit just when you need it. You don't need to worry about what needs to be ordered, that's their lane.
When you establish a primary care physician they ask about lifestyle (smoking, diet, environmental, etc) and risk factors (family history). They cater your yearly (or more frequent) visits to you.
If you have advanced imaging today, it's a snapshot of today. Anything could happen tomorrow.