The story of 55-year-old Aurimas is one example of how preventive health screening can help save a life. The man came to the preventive program feeling completely healthy, but additional tests revealed a complex cardiovascular disease that required urgent bypass surgery.
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Cardiologists and cardiac surgeons at Santaros Clinics say that such stories are not uncommon in their practice. In the article, the patient shares his experience, and the doctors explain which risk factors are most often detected during preventive checks, when stenting is sufficient, and when bypass surgery is needed, and why heart diseases often develop silently, without clear symptoms.
Patient’s story: “One additional test revealed the danger”
55-year-old Aurimas says he had considered himself completely healthy until now. The man regularly participated in preventive health checks: “Every few years I would check my health – doctors performed blood tests, electrocardiograms. My blood pressure was somewhat higher, I took medication, but basically I felt good. There was no pain or any obvious symptoms. It seemed I was a completely healthy person,” Aurimas recounts.
This year, during the preventive program, after the usual tests, the man was recommended an additional cardiologist consultation. After the examination, the doctor suggested a computed tomography scan: “The doctor said that one indicator raised suspicion, so it was worth looking more closely. They did the tomography, and after that, she called and said the situation was serious – one blood vessel was severely narrowed,” the man recalls.
To clarify the situation, a coronary angiography test was scheduled, after which Aurimas expected to return home the same day. However, the doctors’ decision shocked him when he was not discharged: “They told me that urgent heart bypass surgery was necessary. I started asking if there was another option, but the doctors explained that there was no other way,” Aurimas says.
According to Aurimas, the biggest shock was that he did not feel clear signs of the disease before the diagnosis: “You go to the doctor, have nothing serious to complain about, and hear that a major operation is needed because there is a threat to life,” Aurimas recalls his feelings as the diagnosis and treatment became clear. “After everything, when you start thinking about the past, you remember certain moments. For example, a few years ago while vacationing in Egypt, I was swimming in the sea and felt very tired, short of breath – my strength was very depleted. But I recovered quite quickly and at that time I really did not think it could be related to the heart,” Aurimas shares.
The man underwent heart bypass surgery. Today he thanks the medical staff for their professionalism and says that it was precisely the preventive program that may have saved his life.
“Now I understand that prevention is a very necessary thing. If I had ignored the additional tests, the consequences could have been very different. People often do not get checked because they feel nothing, but that is exactly where the danger lies,” he says.
After the surgery, Aurimas is gradually returning to normal life, learning to live at a slower pace and follow the doctors’ recommendations. According to him, the hardest part was not the operation itself, but the psychological moment of learning the diagnosis. “When the doctors said that I could collapse on the street at any time and not get up, it was a huge shock. Such things really change your perspective,” the man confides.
Today he urges his peers not to delay preventive tests: “Getting checked costs nothing, and the benefit can be huge. There is no need to fear tests or treatment. The earlier the problem is detected, the easier it is to solve,” Aurimas is convinced.
Cardiologist: “Preventive screening can prevent a tragedy”
According to Dr. Jolita Badarienė, head of the Preventive Cardiology Department at the Cardiology and Angiology Center of Santaros Clinics, today when talking about cardiovascular diseases, it is important not only to treat but also to detect risk factors as early as possible and prevent disease progression: “Sometimes the first symptom of cardiovascular disease can be a heart attack or even clinical death. Therefore, preventive programs are extremely important – they allow the disease to be detected before dangerous symptoms appear,” says the cardiologist.
According to her, a large part of atherosclerotic cardiovascular diseases can be delayed or even avoided by correcting the main risk factors. “We often talk about the so-called ‘silent killers’ – high blood pressure, cholesterol, and smoking. A person does not feel them, but they quietly increase the risk of heart attack, stroke, or heart failure,” explains cardiologist Prof. J. Badarienė.
She says one of the most important signals is high blood pressure. If the pressure consistently exceeds 140/90 mmHg, it is already a sign to see a doctor. “Even slightly elevated blood pressure gradually damages blood vessels. Controlling hypertension can significantly reduce the risk of heart attack, stroke, and even death,” emphasizes the doctor.
Equally important is elevated cholesterol, which, according to the doctor, also usually causes no symptoms: “A person may feel great, exercise, be active, but atherosclerosis may already be developing in the blood vessels. Therefore, it is very important to know your cholesterol levels and heredity,” she says.
Prof. J. Badarienė points out that other factors increasing cardiovascular risk include smoking, overweight, low physical activity, unbalanced diet, diabetes, lack of sleep, and constant stress.
Commenting on people’s attitudes towards preventive screenings, the doctor admits that part of the public still tends to ignore invitations to get checked: “Sometimes people simply find it convenient not to hear. If nothing hurts, it seems there is no problem. For some, hearing that they have a risk of heart disease, it is hard to accept the idea that they need to change their lifestyle or take medication. But the body is already sending signals that must be heeded,” says Prof. J. Badarienė.
However, the doctor also notices positive changes: “We see an improving trend – people are becoming more conscious, more want to know their risk factors, and come for preventive checks. We also observe a decrease in mortality from cardiovascular diseases, especially in the working-age group. I think this shows that preventive programs provide real benefits,” says the cardiologist who sees positive signs.
According to her, it is very important that people not only undergo tests but also take action: “Knowing alone is not enough – once risk factors are identified, they must be corrected. Prevention is not a punishment or a sign that a person is seriously ill. It is an investment in a longer and better quality life,” emphasizes the cardiologist.
The doctor is pleased that the updated preventive program allows more advanced tests to be performed, helping to detect dangerous changes early: “Stories like Aurimas’s once again show why prevention is necessary. The person did not feel obvious symptoms, but additional tests helped to timely detect a complex heart disease and prevent a possible tragedy,” says cardiologist Prof. J. Badarienė.
Heart surgeon: when stenting is done and when bypass surgery is needed
According to Dr. Remigijus Sipavičius, heart surgeon at the Heart, Vascular and Thoracic Surgery Center of Santaros Clinics, the treatment strategy depends on how many and how severely the heart blood vessels are damaged: “Stenting is usually recommended when one or two coronary arteries are narrowed, the lesions are not very extensive, and the vessels are not heavily calcified. During the procedure, a stent is inserted into the narrowed area to help restore normal blood flow in the heart vessels,” explains the heart surgeon.
During stenting, a special wire mesh tube – a stent – is usually inserted into the heart artery through a blood vessel in the arm. The narrowed area is expanded, and the stent remains in the vessel to prevent it from narrowing again.
However, in some cases, a minimally invasive procedure is not enough. When the lesions are more complex, bypass surgery is required: “This treatment method is chosen when several coronary arteries are damaged, the left main coronary artery is narrowed, the narrowings involve vessel branches, or the vessels are heavily calcified,” says heart surgeon Dr. R. Sipavičius.
According to him, such a condition complicates stenting, so it is necessary to surgically create new blood flow paths bypassing the narrowed areas: “During bypass surgery, the chest is opened, and grafts are sewn beyond the vessel narrowings. Usually, arteries and veins are used for the grafts during the operation: a subcutaneous vein taken from the leg or a small artery running along the sternum from the inner chest wall. Sometimes only arteries are used, sometimes only veins. It is considered that grafts made from arteries ‘last’ longer.
Sometimes it is not possible or rational to use arteries, then veins are used – the surgeon explains the operation technique. – The ‘gold standard’ is considered the method where an arterial graft is sewn to one of the main heart arteries, and venous grafts to the others. In some cases, hybrid treatment is applied – bypass surgery is performed on one main heart artery, and stents are placed in other vessels. Then the operation is done through a smaller incision, and patients recover faster after surgery.”
The doctor points out that coronary artery narrowings can cause symptoms typical of ischemic heart disease – chest pain, shortness of breath, reduced exercise tolerance. However, some people do not feel any symptoms: “Untreated changes increase the risk of myocardial infarction, heart failure, or even sudden death,” warns heart surgeon Dr. R. Sipavičius.
Bypass surgery usually lasts about four hours, but its duration depends on the complexity of the lesions and the number of grafts needed.
After stenting, patients usually return to normal life fairly quickly, but it is necessary to take blood-thinning medications that reduce the risk of stent thrombosis. Recovery after bypass surgery is longer – about 2–3 months it is recommended to avoid heavy physical exertion and wide arm movements until the sternum heals: “After bypass surgery, it is also necessary to take blood-thinning drugs (antiplatelets) that reduce the risk of graft thrombosis,” emphasizes heart surgeon Dr. R. Sipavičius.
Specialists remind that preventive heart tests can help detect dangerous changes before serious symptoms appear. Timely treatment often allows avoiding complex complications and preserving quality of life.
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