Thursday, April 15, 2010

The Asymptomatic Condition

Whereby Indian-style prevention reveals that I am traveling with an impending massive heart attack, and its not my heart.

My extraordinary business partner and I were making our fourth business trip to India. Thanks to the British Airways strike, we were afforded a very comfortable 'four adjacent seats across' seating, and slept from Raleigh to London. The London to Bangalore flight was more typical, and we were greeted in the new Bangalore terminal. Quite the change from the old terminal, and representative of the welcoming progress throughout India.

Our first visit was at the Fortis (previously Wockhardt) Hospital, where we not only met with our friends and colleagues, but took advantage of the exhaustive Executive Healthcheck. In addition to a complete panel of blood work and imaging, we also completed cardiac stress tests. Although I must admit I do not get my heart rate up to the 158 target as often as I should, this old mule passed with flying colors.

We were quite surprised that my partner's test exhibited some unexpected and disturbing results. These were immediately reviewed by a cardiologist, who urged my colleague to schedule a cardiac cath while in Bangalore. This took us both by surprise, as he watches his weight, diet and gets exercise...and had never had any symptoms. He took the offer for a cardiac cath as typical Indian hospitality, and decided it best to discuss the operation with his wife upon his return to the US...with the intention of having the cath during his return trip to India in a few months.

Grateful to have this new bit of personal health information, we continued our journey on to Mumbai and Delhi over the next two weeks.

Upon his return to Raleigh, he casually asked a cardiologist friend to take a look at the stress test results. Upon reviewing them, he scheduled my colleague for a cath at Wake Med the next day.

The cath revealed one artery with a 90% blockage and another with a 99% blockage.

He was taken off to surgery for two new stents.

Later, we find out that diabeties commonly masks heart pain, and my colleague was no doubt having 'mini' heart attacks without even knowing. This story typically ends badly...the unsuspecting patient drops dead of a massive heart attack...to the surprise of the US physician and the patient's family and friends.

My colleague was scheduled for a cath at age 50...it is unlikely he would have made it.

Next, we will take a look at the cost of fixing this undiagnosed condition, and how it compares with the same procedure in India. The irony of this averted tragedy is sadly quite instructive.