Paul's Heart

Life As A Dad, And A Survivor

“LIMA” Attacks

You can relax.  I am not referring to the capital of Peru.

A different world completely, I am referring to the world of cardiology, LIMA, known as “left internal mammary artery”, used in coronary artery bypasses in certain circumstances.  And in my case, my life-saving bypass procedure was done via “LIMA.”

The surgical procedure of redirecting blood flow around a blockage, using a grafted vein, is called a bypass.  A patient may need to have any number from singular to five bypasses to avoid a fatal cardiac event.  Typically, the patient’s own body will supply a vein from their own body to be harvested and used to perform this bypass.  This vein may come from the arm or the leg.  Depending on the circumstance, like my unique health background, upon removing a vein from my leg, realizing it had been compromised due to radiation therapy for my Hodgkin’s Lymphoma decades ago, my surgeon had no other choice than to use a “mammary artery.”  In fact, the mammary artery used, was actually split to bypass a second blockage, not just the major blockage of my left anterior descending artery.

There are pluses and minuses to this option.  A big minus to the LIMA is, there are no other options from my own body for any future bypasses.  The condition of my veins in my body leave them unusable.  So, if I were to need any further bypass procedure, I would guess I would either be looking at cadaver or pig veins.  But I am not going there, at least not yet.

The plus to using the mammary artery, the one end is already attached, meaning only the end on the other side of the blockage needs to be attached.  Plus, being an artery, it can handle a higher pressure than that of a vein.

That is as technical as I am going to get on this post.  Because as the title suggests, something has been getting my attention.

Prior to my bypass, I had symptoms for four months.  I ignored them, but they definitely got my attention.  My father had a major heart attack.  So I understand following my bypass, I need to listen to my body when it gives warnings.

For the first three or four years, my recovery from my bypass was flawless.  Of course I was dealing with my other late developing side effects from my treatment now making themselves known.  But in February of 2013, I developed a pain in my left breast, that left me paralyzed where I stood, afraid to move.  Afraid that one simple step towards help, might trigger a fatal cardiac event.  This pain lasted about a minute, and upon its relief, I went straight to the hospital.  Doctors all agreed that something had happened, but were unable to determine just what, and sent me home.

Fast forward to the end of the summer of 2019, I would have several of these mini episodes of that similar pain.  Knowing that it was nothing of real concern based on the last episode, I was not worried.  And again, these “attacks” subsided.  However, in September, one of these attacks came on, and it did not stop.  I was afraid, this was going to be “the real thing”.  At the half hour point, I made the decision to go to the emergency room.

Treated with nitroglycerin (not enough to explode me to pieces) to open up my circulatory system rapidly (warning… major headache was a side effect), the pain was relieved.  But once again, extensive testing revealed nothing.  Repairs that I had done previously were all in tact.  Doctors did not doubt that something was happening.  They just were not able to pinpoint what.

So, as I qualified for cardiac rehabilitation due to the stent I had placed in another major artery earlier in the year, I complied with the 3-day-a-week regimen for the last several months.  And again, being monitored, my body is acting and behaving the way it is expected to.  And then on Sunday, another one of those attacks came on, but like the older ones, minor and short in duration.

As I am prone to do, and as I have mad respect for them, I find that you can get a lot more information, and time, in talking to a nurse than your actual doctor (I am lucky that I am able to have this luxury with both doctor and nurse).  It was during a recent cardiac rehab session that I mentioned this “attack” to the cardiac nurse.  And that is when she told me about… “LIMA attacks.”

She described them perfectly as “lightning strikes.”  Now, while I have never personally been struck by lighting to explain how that feels, the description of quick and short in duration, and attention getting, fit perfectly to a lightning strike.

It turns out, these attacks are actually common for those who had LIMA bypasses.  Who knew?  She assured me that while they are uncomfortable and alarming, they do not foreshadow any pending cardiac event.  I have an upcoming appointment with my cardiologist, when I will ask and get a much more detailed explanation of this phenomenon.  I want to make sure that I explain it accurately, not just for those reading this, but for my sake as well.

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