When Heart Disease Runs in the Family

I had no idea what was going on,”recalls Jenny Petz, a mother of two. She remembers thinking at the time, Why is my mother sitting on my chest to talk to me? She knew that made no sense, but it was the only explanation she could think of for the extreme chest pressure and heaviness she felt as she lay on the nursery floor in 2008, drifting in and out of consciousness. Later she learnt that her mother was there, but she wasn’t talking to Petz. She was on the phone with a 911 operator, summoning an ambulance. Petz—young, fit, and healthy—had given birth eight days earlier. At age 32, she was having a heart attack.

An EKG at the hospital revealed the severity of Petz’s condition.Her heart attack had been caused by spontaneous coronary artery dissection (SCAD). “It’s as scary as it sounds,” she says. “One of the main arteries to my heart exploded.”Another artery to Petz’s heart was 90 per cent blocked, and when the pregnancy put extra strain on her heart, the clogged artery increased the work for the remaining arteries, and the extra pressure eventually became too much.

Petz was rushed into surgery, where doctors placed a stent in the blocked artery and repaired the one that had ruptured. She was lucky to be alive.Next came the search to figure out why someone who didn’t appear to have risk factors for heart disease had suffered such a potentially cataclysmic event. The culprit: her cholesterol, which measured 317 mg/dl, far into the high-risk category.

“I’d never had my cholesterol tested, because I’d never seen a reason to,” she says. “I had no obvious risk factors.”  A genetic test showed familial hypercholesterolemia, a life-threatening condition that leads to high cholesterol. A mutation means the body can’t remove the LDL (low-density lipoprotein), or ‘bad’ cholesterol, from the blood as it normally would.Heart attacks or strokes often follow.

Familial hypercholesterolemia affects about one in every 250 people, according to the Centers for Disease Control and Prevention (CDC), although many, like Petz, are never diagnosed until serious symptoms arise. Many people are never diagnosed at all, their elevated cholesterol chalked up to bad lifestyle choices.

Familial hypercholesterolemia is only one of many heart conditions that can be passed down from parents to children, including cardiomyopathies (diseases of the heart muscle), arrhythmias (irregular heartbeat) and more.

Of course, lifestyle also plays a powerful role in determining heart health. Inactivity, obesity and smoking contribute. According to the WHO, heart disease led to 16 per cent of all deaths globally in 2019. “The risk for heart disease can increase even more when heredity combines with unhealthy lifestyle choices, such as smoking cigarettes and eating an unhealthy diet,” says Satjit Bhusri,MD, founder of Upper East Side Cardiology in New York City.

Knowing your family history can help you assess your risks and take steps to lower them. The American Heart Association has a free downloadable My Family Health Tree PDF to make this easier to track.

“Make a systematic assessment of the health of your relatives. In addition to your parents, siblings and kids, also remember your grandparents, aunts and uncles, cousins and nephews and nieces,” says Carolyn Yung Ho,MD, the medical director of the Cardiovascular Genetics Center and an associate professor of cardiology at Harvard Medical School in Boston.

“Make note of which side of the family you are talking about, and any important medical illnesses, as well as age and circumstances of how people passed away. Being organized can help you and your doctor identify important patterns,” she says.

Fortunately, even the most problematic genes can lie dormant in most people if they make positive health habits a priority. A 2016 study in the New England Journal of Medicine reported that those with high genetic risk for heart disease had about double the risk for a heart attack or stroke. But they could trim their risk by a whopping 46 per cent with healthy lifestyle choices, including not smoking, exercising regularly, eating a well-balanced diet, and maintaining a body mass index (BMI) of less than 30.

“Try to reduce the risks that you can control,” Dr. Ho says. “Being healthy and active is the best defense and offense.”

Jenny Petz, now 46, has done just that.After her terrifying heart attack, Petz went through cardiac rehabilitation and suffered no lasting heart damage.She began taking a statin to lower her cholesterol, and a drug to lower blood pressure. She does her best to exercise regularly and eat a healthy diet.

“Thanks to these changes, my total cholesterol has stayed around 150 mg/dl—right in the healthy range—for years now,” she says. Petzhad her two children tested for the genetic condition that caused her heart attack, “and, fortunately, they did not inherit it,” she says. 

The Healthy Wellness from THEHEALTHY.COM