It’s a Heartache

I recently found an article that challenged everything that we thought we knew about the cause of heart disease and heart attacks.  Since one out of every two Americans will die of heart disease, this caught my attention.  Traditionally, we are taught to believe that heart attacks occur due to problems in the coronary (heart) arteries.  But new research is suggesting that the problems likely happen as a result of event happening in the muscle of the heart known as the myocardium.

So, heart disease is caused by a lack of oxygen to the heart muscle from a buildup of plaque in the arteries as a result of excessive cholesterol, right? And preventing heart disease comes from opening those arteries by reducing cholesterol and various emergency procedures such as coronary bypass, stents, or angioplasty?  Well, that’s what most of the free world believes.  However, doctors and researchers alike are starting to question this conventional thinking due to the results of a couple recent studies.  First, angiogram studies, where radiographic dye is injected into the coronary arteries and observed, shows that blood gets to the heart even where the major coronary arteries are completely blocked off.  Another 2003 study conducted at the Mayo clinic concluded that bypass surgeries, stents, and angioplasty can indeed relieve symptoms of heart disease such as chest pain, but that they do not prevent further heart attacks.  The explanation for this is that shortly after birth, a normal heart develops an extensive network of what are called collateral blood vessels that will provide numerous alternate routes for blood flow.  Think of this as taking the scenic route when the highway is blocked.  In fact, the body is so smart that even when a blockage does develop in a coronary artery, these collateral arteries can grow new, at any age, to bypass and reroute the blockage.  Nobody is trying to say that high cholesterol, especially the inflammatory LDL’s is a good thing; they’re just saying that this is not the end of the story with heart disease.  If this were true, don’t you think that, with all the cholesterol drugs that have been given out along with all the emergency and preventive procedures performed, there would have been a dent in heart disease over the last 30-40 years?

So what is really going on?  The researchers performing these newer studies believe it comes back to the effect the nervous system is having on the heart and particularly the rate of your heart.  Your nervous system is broken into a fight/flight or sympathetic side as well as a parasympathetic side that is considered to be active when we sleep, heal, and digest (or relax).  The major parasympathetic nerve (the Vagus) comes off the brainstem and serves to slow and relax the heart.  Multiple studies have shown that a decrease of parasympathetic nerve flow results in ischemic heart disease where the oxygen is being cut off.  Next week, I would like to discuss how this happens and what the real-life factors are contributing to this #1 killer in America.