Late one night Mike McCullough, of Timonium, couldn't sleep. He thought heartburn was keeping him awake. "Took some Tums, because every once in a while I do get that. Waited about a half hour, and it didn't go away."
He waited another hour, "I wasn't really that uncomfortable except for when I laid down." It wasn't getting any better, so Mike drove himself to GBMC. "After a while it was pretty evident to me that something else was going on. Whether it was an actual heart attack or something major, I didn't know, but it definitely wasn't heartburn."
Doctors realized what was happening and called an ambulance to take him to nearby University of Maryland St. Joseph Medical Center. At just 44 years old, Mike was having a heart attack.
"These are patients in the 40 to 60 year old range that scare me the most because they don't know that they have heart disease, and heart disease is silent and one third of the time your first symptom is your last," Dr. Jeremy Pollock, Cardiologist, University of Maryland St. Joseph Medical Center explains.
Mike lived because he got cared for so quickly. Doctors inserted a stent into the blocked artery, allowing blood to flow once again to the heart tissue. Dr. Pollack says his case was severe, "He had a complete blockage of one of the major arteries to his heart."
Mike didn't know it, but before that sudden blockage he did have heart disease. He had a partial blockage of a coronary artery. Cardiologist Dr. Jeremy Pollock says even in younger men, with no risk factors, plaque can build up along the inside wall of the artery, and the plaque can rupture.
The body tries to do what it always does, fit itself, but in cases like this, the results can be catastrophic. "What the blood and body does is it clots off the artery. When you clot off the artery than every muscle tissue below and beyond doesn't get blood flow any more and starts to die, and that is a heart attack."
So the real question for people like Mike is how to know whether there is even a small amount of plaque clogging a coronary artery. Mike, a completely healthy 44-year-old man, did have one risk factor, his father had a heart attack at a young age. Many men get EKG's or stress tests during regular check-ups with their primary care physician but, those tests do not uncover plaque buildup.
"Heart disease is the number one killer but we don't have a standard screening program for it," Dr. Pollack explains.
There is something. It's a test called the "coronary calcium score". Men with a risk factor, like Mike, can request a CT scan of the arteries of the heart. "It can identify plaque, because in plaque you get little pieces of calcium that light up on a CT scan and it can give me a number"
That number should be zero, no plaque in the coronary arteries."If you have any number that's above zero, you, by definition, have heart disease."
Had he been tested, Mike would have had a score above zero. If you do, doctors would likely prescribe a daily regimen of aspirin or a cholesterol medication, to lower your risk of a full blockage. Dr. Pollack himself has a risk, so he gets a CT scan of his own coronary arteries every five years.
Now, just two months after coming within minutes of death, Mike has made some changes to his diet. He's exercising more and he's been talking to his 12-year-old son about his family's hidden risk. "That is the ultimate goal for me. I mean for me, you know, I want to be there for him. But I need him to live long also once I'm gone."