Widow Maker

A heart attack at 52 should not be a “surprise,” and yet high cholesterol makes that kind of shock far too common. We are two family nurse practitioners, and we are getting very real about why cholesterol is both necessary and dangerous, especially when you have no symptoms to warn you that plaque is building in your arteries.

Nicole shares a personal story about a deputy sheriff who died from a sudden massive heart attack and never knew his cholesterol was high. From there, we break down what cholesterol does in the body, how excess LDL cholesterol can narrow coronary arteries, and why the heart starts to die when oxygen-rich blood cannot get through. We also talk through the “garden hose” way to picture plaque and why “feeling fine” is not the same thing as being low risk.

We go deeper into the widowmaker concept and collateral circulation, and why younger adults may actually be more likely to have a fatal event when a vessel suddenly closes. We also cover genetic hyperlipidemia, including the reality that you can be fit, active, and still have a lipid panel that puts you at serious cardiovascular disease risk. We keep it practical with what to ask your provider, why LDL targets have tightened over time, and how getting a simple cholesterol test can save your life.

If you have not checked your cholesterol lately, make this the nudge to do it now. Subscribe, share this with someone you love, and leave a review so more people hear the message before a silent risk becomes a tragedy.

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Transcript

Kelli 0:12

Hey everybody, welcome back to another episode of Tattoos and Telehealth. I'm Kelly White, Board Certified Family Nurse Practitioner, and this is my good friend and colleague, uh Nicole Baldwin, who's also a board-certified family nurse practitioner. And our attorneys always make us say that listening

Welcome And Medical Disclaimer

Kelli 0:27

to, watching, or participating in this podcast does not constitute a patient-provider relationship. We're just two girls chatting it up. This does not constitute medical advice. We always, always, always ask that you get with your family provider, your person that's taking good care of you before you attempt to institute anything that we discussed today. So, Cole, I wanted to chat for just a little bit about cholesterol. I know that we chatted a little bit about some of the other parts of cholesterol a while back, but you know, I I do a lot of, you know, women's health and functional medicine, and we talk about cholesterol, ad

Why Your Body Needs Cholesterol

Kelli 1:01

nauseum, but guidelines change and et cetera, et cetera. But I want people to understand that you need cholesterol. You have to have it. Your body makes it for a reason. Your body feeds off of it. I lift weights, I lift weights five days a week. I'm strong and my body needs cholesterol to stay strong and healthy. Your organs need it. But there comes a point where it's not okay. Like it's just not okay, especially if you have some underlying genetic predisposition or if you have like maybe some underlying cardiovascular disease that you genetically inherited. So, Nicole, I know that you and I were talking earlier this week, and I'm gonna have you share with everybody an experience that's near and dear to you. You lost someone that you know who was very young because of cholesterol that went unnoticed. So I'm gonna let you kind of take off and tell patients why we still harp on cholesterol, even though it's something that you need.

Nicole 1:56

Yeah, thank you so much. So uh a couple weeks ago, my daughter, her dad is a uh deputy sheriff. And when we were married, he had a colleague

A Sudden Heart Attack At 52

Nicole 2:11

that he was friends with. And when I met him, I was like, Oh, you look like somebody I know. You look like somebody I went to high school with. Like you look just like that person, but the age didn't match. Well, come to find out it was his brother, right? So in a crazy small world. I know. So crazy small world. So, you know, years go by, you know, kids grown, whatever, whatever, all else. Well, I got a call from my daughter's dad that said he said that this this deputy had just died of a sudden massive heart attack. And he was how old? He was 52. 52. So a little bit older than us because I went to high school with his brother, right? A little bit older than us, but not by much. Yeah, not by much. And he did not know that he had high cholesterol. So, what cholesterol does in excess is it blocks our arteries in our heart where blood flows to give our heart oxygen. And nothing

How Plaque Blocks Oxygen To The Heart

Nicole 3:21

lives without oxygen. Plants don't live, nothing lives. If you put a rubber band around your finger tight enough and you cut off the blood supply, which carries oxygen, it will die and fall off. It's the same thing. When you block oxygen to the heart, it starts to die. And that's a heart attack. So you can go on for a while with cholesterol buildup and your little the hole gets smaller of how blood can get through. A lot of times that's angina. We get warning signs that our heart's not oxygenating, not getting a blood supply. But that moment when that vessel that rides along the heart, the cholesterol shuts it off, you're done. That's a heart attack.

Kelli 4:10

I tell people it's like if you have a garden hose, you turn the water on full, it's just like pouring water out. Then the minute you stick your thumb over it to spray really hard, that's cholesterol clamping down on your vessel.

Nicole 4:21

And when it stops, no more, no more pumping through, no more pumping through. So cholesterol is dangerous, and we don't have nerve endings on the inside of our vessels to say, hey, you have high cholesterol, you have high cholesterol, you have high cholesterol, it's getting higher, it's getting higher, it's getting higher. Sometimes we'll get warning signs of chest pain. Now they call it the widowmaker, and the widow maker is not necessarily one vessel. What it has to do with is people that are younger

The Widowmaker And Collateral Circulation

Nicole 4:56

don't have what's called collateral circulation. So for older people, because this happens over time, and that's why older people have it. When one vessel is blocked over the course of time, the body will naturally make another vessel alongside of it in order to keep blood supply, right? So the body will bypass. It will bypass it essentially. The body's smart. It says, look, if I'm not getting through this way, I'm gonna make another way. Just like when you cut yourself, we put it back together, the vessels grow back, right? So it's almost like a snake regrowing, you know, like the tail, or or like you you literally regrow back. But when the body senses you have a cut, it knows that it was cut there. So it grows back scar tissue, which is stronger, saying, I'm not gonna go through that again. So even scar tissue is the body's smart way of saying, I'm not gonna go through this again. I'm I'm I'm gonna grow back stronger, right? So that's the the body is amazing. So the body, if you have mild cholesterol for long enough and you without having a heart attack, which is risky, but if you do and you're older over decades, your body will say, Well, I'm having flow here. I'm gonna go around. I'm gonna go around to get flow. But young people, 60 and younger, or even maybe 65, they don't have time. The body doesn't have time to create that new vessel to go around the semi-blocked area. So when it's blocked for young people, it is usually, it usually makes a widow. It makes a widow because young people don't have collateral. So heart attacks are actually more fatal in younger people than older people. Most older people, I don't know the percentage exactly, but more older people survive heart attacks because of that collateral circulation. Young people do not have collateral circulation. The body hasn't had time to make this alternate route to get oxygen to different parts of the heart. So he had no idea that he had high cholesterol. He wasn't giant, he wasn't obese, he had some genetic cholesterol that he he knew his dad had it, he knew his grandfather had it, but they didn't die from that. So it wasn't like it was a real priority. And because he didn't feel anything going on, he assumed everything was right, everything was good because he didn't feel bad, but all of a sudden one day he killed over and that was it. And EMS was quick, the whole thing, but he did not make it, and so it is super important for you guys to understand that cholesterol can be deadly at any age. I had a patient when I was in internal medicine, I think I've said this before, he was 32, fit as a fiddle, rode his bike to my appointment, and his cholesterol was through the roof. You would have never guessed it. But because he had such a hard family history, he had genetic hyperlipidemia, and he had to be on heavy statin therapy. We had to monitor his carotid arteries to make sure that they weren't going to be blocked because they can get blocked as well as the heart. And just Google cholesterol-filled artery, and pictures will come up and it will show you exactly what it is. It's a vessel where your blood glow goes that is filled with white crap. So think of like a drain that's slow in the kitchen or in the bathroom. It will not drain. That's cholesterol. All that sludge that is in that drain is cholesterol, and the oxygen, the blood that carries the oxygen cannot get through and the heart will die. And a heart dying is a heart attack. That's what that means. When someone is having an MI, a heart attack, the heart is dying. And it is dying because lack of oxygen. So if you need your labs run, if you haven't had your labs run, your cholesterol run, I don't care if you're 25, let us know. We can order them for you. You can go to hamiltontelehealth.com. We will run your

LDL Targets And Getting Labs Ordered

Nicole 9:33

labs. Ask your primary care. Ask any anyone that you go to, your cardiologist, ask anyone, what is my cholesterol? And the LDL is there's there's all kinds of cholesterol. I could go on for hours, but the LDL is the bad cholesterol. It should be low. When I started medicine, the normal was less than 125. Now they want it less than 100 to decrease your cardiovascular risks. So your LDL should be less than 100. If it is not, you need to speak to someone. I don't care if it's me, if it's Kelly. I don't care if it's your person at home, whoever, you need to speak to some healthcare provider who can give you direction on what to do and where to go. So I just wanted to touch on that today because it is definitely someone close to home. It was preventable. It was preventable. So now getting a lab slip for your order, for your for your cholesterol is so easy. You can literally do it from your home, you can do it from your phone, you can do it by chat if that's what's allowed in your state, which most states do. Let us know. We can certainly, certainly order those for you. So if you guys have any questions, please reach out. Contact at myhamiltonhealth.com. We'll get you an email to us or hamiltontelehealth.com and click get started. All those things. So please just get your cholesterol checked. If it's not with us, it's with somebody because it truly

How To Reach Us And Final Reminder

Nicole 11:08

could save your life. Men and women, there are no, there are no exceptions to the rule.

Kelli 11:14

Exactly. Cholesterol does not differentiate, guys. And you may not even have a strong family history. You could be the first. So don't don't ignore it, guys. Don't ignore it.

Nicole 11:23

All right. We hope you guys have a wonderful rest of the week and that you truly listen and take this to heart because it could save your life. Hope you guys have a blessed day. Bye, everybody.