Shuji Ogiwara writes:
Patient T's condition is very serious
and he has recently been diagnosed "hypertensive"(170/100mmHg);
he frequently experiences feelings of weakness and mild pain in the neck
and upper chest areas; clinical analyses indicate early atherosclerosis.
He, however, thinks that he is well. So, I think it is very important he
understand his heart condition is very serious.
Lack of exercise and heavy smoking are main factors of heart disease. But, he continues to lack exercise and he smokes heavily. In addition, his mother died after heart by-pass surgery complicated by hardening of the arteries.
I can help him start feeling better in the short term. I will give him an explanation about his condition, because he doesn't care for his body and doesn't know much about his health condition. So, by giving him more information about his health, I can get rid of his anxiety.
The first thing he should do is reduce cholesterol, because cholesterol deposits begin to accumulate along the inner walls of the coronary arteries. As these crusty deposits enlarge, they can cause the arterial openings to narrow, pinching them off completely, causing atherosclerosis. If starved of sufficient blood, the heart muscle begins to die, triggering a myocardial infarction, or heart attack. So, he must exercise, because this reduces levels of "bad" cholesterol and helps open the arteries.
Second, he should stop smoking, because smoking accelerates arterial thickening and raises the risk of heart attack. As people get older, the walls of arteries become gradually thicker. The difference in internal carotid wall thickness between current smokers and non smokers, however, is the difference of ten years.
Third, for the time being, he needs to use aspirins as a treatment against heart attacks. Aspirins which are widely available and cost very little, are as effective as specialized drugs to dissolve the blood clots that cause a heart attack and the other drugs that cost hundreds of dollars per dose.
Fourth, I would like to give patient T the suggestion that he change his diet. Ice cream, eggs and fatty meats have high cholesterol. So, he had better eat foods having as little cholesterol as possible and eat low fatty foods, vegetables, fishes and carbohydrates. So, he can decrease his cholesterol level. And overweight has bad influences on the heart. So, because foods like white bread and cheese have high calorie, he had better eat a diet low in calories and oil.
Finally, in his family there is a history of heart disease. So, he must take care of his health especially. Suffering from heart disease is almost always caused by bad habits. And, in daily life, he should stay relaxed. Stress, also, gives bad influences to the heart.
If he keeps these suggestions, I think, he may live longer.
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