Heart Study Tries to Give Me a Heart Attack

By Susan Esther Barnes

For 25 years or so I’ve been a participant in a study about heart disease called Cardia. I wrote about my most recent exam here.

I was picked for this study randomly – not because there was any reason to believe there is anything wrong with my heart. The idea is to get a bunch of folks in their early 20’s and follow them through their life, taking various measurements over time. Then, as we age and start having heart issues, they can compare their data on us over our life span, and look for correlations between the various measurements and who has heart trouble, to see if they can identify predicting factors and/or identify habits people can change to minimize their risk.

Being in the study has made me feel pretty confident about my cardiovascular system, because test results in the past have shown that I have no calcium built up in my heart, no signs of plaque buildup in the main arteries in my neck, decent cholesterol levels, etc.

I was looking forward to seeing this cycle’s test results in particular because this time they gave us a diabetes test. My father, alav hashalom, struggled with diabetes, so it’s something I think about, and want to avoid. But if I have it, or am heading in that direction, I want to know so I can start taking care of it right away.

The first page of the results, which I just received, showed my echocardiogram results. I assumed this page would just be a quick glance for me. After all, I know already that my heart is in good shape.

Imagine my surprise, then, when I read, “The purpose of this letter is to let you know that one or more reported values of your echocardiogram fall in a range that requires clinical follow up for your age group or gender.” (Emphasis in bold in the original). That doesn’t sound good. I was starting to worry.

So I looked down at the chart which shows the various measurements for my heart, compared to the values Cardia considers to be worthy of a person seeking medical advice. Dimensions are fine. Septal thickness is fine. Amount of blood being pumped is fine, etc. So, what’s wrong? Add frustration to my concern. I could feel my blood pressure rising. This can’t be good for my (apparently ailing) heart.

I read the offending sentence aloud to my husband, “The purpose of this letter…” to which he replied, “So, they’re saying one or more of the values is bad but they don’t say which one?” Finally, I noticed one sentence at the bottom of the chart, in small print. It said, “Other: Mitral valve prolapse with mild mitral regurgitation.”

Oh, for goodness sake! I was diagnosed with mitral valve prolapse when I was in college, before I ever entered the Cardia study. As I was told at the time, and as confirmed on the Mayo Clinic website, “In most people, mitral valve prolapse isn’t life-threatening and doesn’t require treatment or changes in lifestyle.” I am one of those people. The only symptom I ever have is an occasional irregular heartbeat, but that doesn’t happen often, and it doesn’t hurt. In fact, it kind of tickles.

In other words, there is no reason to worry about these results, or to see my doctor.

So I finally got to turn the page and see that all my other results were normal, including the glucose test. I don’t have diabetes, or pre-diabetes, and my cholesterol levels are good, too. Baruch hashem.

Of course, my CT scan results aren’t in yet, so there’s still an opportunity for Cardia to try to give me another heart attack.

My Heart Live! On Screen!

By Susan Esther Barnes

When I was in college, I received a letter saying I had been randomly selected to participate in a medical study called Cardia which was being conducted in four cities in the US. The purpose of the study was to learn about how heart disease develops in young adults.

What they didn't tell us at the time, or perhaps I wasn't paying attention, was that if they could get ongoing funding, their intention was to keep track of us throughout our lives, testing us every few years, and seeing who among us was developing heart disease so they could compare their test results with those of us whose hearts are still going strong.

This explains why, recently, I found myself in the room pictured above, with the cool lions should lie down with lambs poster, getting an echocardiogram. Rather than just the boring test we've all seen that produces nothing more than a wavy line on a piece of paper, this test included the use of sound waves to show the structure and functioning of my heart on a computer screen.

So I got to lie there, looking at the different chambers in my heart pumping, and my heart valves opening and closing, in real time. They also do some cool color coding so I could see the speed and direction of the blood flow (just with sound waves, without pumping any yucky stuff into me), so I could actually see the blood flowing from my lungs into one chamber, the valve closing, and another valve opening while the chamber contracted and pushed the blood out into my body. Too cool.

Of course I started by describing the most fun part, and skipped over some other parts, like the four multi-page consent forms I had to sign, the multiple vials of blood they took, and the glucose tolerance test that includes drinking a bottle of sickly sweet orange drink which probably had about 8 million calories and left my stomach feeling angry for hours.

On the upside, though, the lab staff was great, and kept me well distracted while they were taking my blood. Which is a good thing, because if they let me brood on what they're doing, my blood pressure drops, and in past years they've had to stroke my arm to try to squeeze enough blood out into the tubes. And we won't talk about the one year when they assaulted me with smelling salts.

This year they didn't do anything like they had in the past to try to raise our blood pressure to see how high it would go. The most effective method they have of doing this is the treadmill test, which keeps raising the angle and speed until you cry "Uncle!"

One year they tried to make us play the (not so old at the time) "Breakout" video game (basically using a "paddle" to make a bouncing "ball" break a "wall"), but so many of us were so bad at the game we lost before they had time to take our blood pressure. Another time, they had us hold our arm in a bucket of icewater for 60 seconds. It may not sound like a big deal, but you try it some time. It was so painful a bunch of the study participants threatened to never come back, and they had to promise us they would never do it again.

As they like to remind us from time to time, the longer the study goes on, the more precious and irreplaceable we are. There is no other group they can draw from that has this same pool of data from the last 25 years.



Yes, at the risk of dating myself, as the T-shirt says, this study has been going on for 25 years now. But they're not always testing the same things. For instance, the heart function test I mentioned above tested for some factors that are now known to be indicators of heart disease, but included some new measurements they think might be predictive, and are gathering data on now.

This year, for the first time (that I recall), they did a congnitive test, which included asking me to listen to a long list of random words and then repeat back as many of them as I could remember. They did this a few times with the same list of words, and then did it once with a second list of words. Then they got all tricky on me asked me to go back and say as many words as I could from the first list without me saying any of the words on the second list.

Lucky me, it turns out that I qualify for a brain MRI test they also want to do, so I get to go do that and a CTI scan of my heart next month.

It's all a bit inconvenient, but it's a mitzvah, I do get to see some cool test results, and I feel good about contributing to medical knowledge that could help future generations live longer (and has already resulted in a bunch of publications). Plus, I can't say enough about how professional, helpful and friendly all the Cardia staff are.

So stay healthy, and the next time you read about a study that shows a new way to predict or prevent heart disease, think of me!