In the period 1994 to 1996 my family and I stayed in Asia Pacific living in Singapore. On October first 1994 I was sustained an acute myocardial infarction. The infarction was complicated by hypotension, ventricular ectopy and left ventricular failure. I was given 1.5 mill units of streptokinase and survived. The coronary angiogram showed severe disease of left anterior descending artery as well as lesions in right coronary artery and right posterior descending artery The left ventriculogram showed an anterior akinetic segment with a reduced ejection fraction (EF) of about 40%.
A Coronary angioplasty (PTCA) was done two weeks later (see map above), and after successful ballooning, I was advised to have adequate convalescence for a bout one - 1 - month post infarction.
The working conditions in Singapore was a little different than in Norway, and my doctor did not want his recommendation to my employer should make problems for my career.
18 months later I suffered another acute infero-posterior and right ventricular myocardial infarction. Although I had received streptokinase under the first infarct, the doctor decided to give me another infusion. I then experienced complete atrioventricular block with transient hypotension, but responded promptly to intravenous atropine and isoprenaline, and I subsequently made an uneventful recovery. Although the doctor said to my wife "We almost lost him", I survived for the second time.
Once again I went through successful PTCA to RCA proximal from 100% to 25% residual stenosis, and a successful (although balloon ruptured) PTCA to RPL from 90% to 25% stenosis.
My doctor in Singapore: Dato Dr Arthur T H Tan , (with an extremely high competence and position list on his CV), recommended me to contact Norwegian Cardiologists during my summer holiday back home.
I talked to Dr Arne Westheim at Ullevål Hospital who did not recommend bypass operation at that time, and I then met with my later good friend Dr Lars Aaberge at "Senteret for Hjertemedisin" who gave the following conclusion: Arne has a severely impaired systolic function with an ejection fraction of about 25%. There was no evidence of stress-induced ischemia, but clinically I had a heart failure. No bypass recommended but study for heart transplantation should be applied for.
In 1998 I went through a Simultaneous TX Cor and TX Renis due to End-stage Heart and Renal Failure. But that is another story.
You can never fully prepare yourself for the "pong" as Singapore´s Senior Minister Lee Kuan Yew called it when he suffered a heart attack in January 1996.
"..........., absolutely nothing, then - PONG - Monday 15th I felt it. Tuesday it became worse, Wednesday it became worse." he told the Straits Times after leaving SGH and had been taken under treatment of my own doctor - Arthur Tan -.
I understand how to translate his word "worse". He meant pain, very, very strong pain in chest and back.We are both still alive, thanks to among others our Dr Arthur Tan, who I had the pleasure to visit in his office during our return-visit to Singapore in May 2007.
"Your Gods must love you" was his greetings to me. Life is great.
If you are afraid of meeting some of the challenges I and many others have been through due to heart problems, take a look at the Stress test above and see if you are in the dangerous category. (from dr Chandra Patel´s book Fighting Heart Disease)