Heart attacks, anyone?

Factual Questions
1

I’ve wondered this before, but the recent passing of Johnny U prompts the question. Here goes:

Johnny U, for example, had his first heart attack when he was 60ish. OK, so it took 60 years before he had accumulated enough goop in his arteries to cause problems that necessitated surgery.

I’m not familiar with the details of his surgery, (and don’t feel like Googling), I assume that his was probably “multiple bypass.”

Now. . . only 9 years later, he has another heart attack–this one was indeed “the big one.” The question: “Why did it take 60 to clog up the first time, and only 9 years the second?” I’m using Johnny U as an example, but the same thing with varying numbers is not unusual.

2

I’m guessing that it’s related to the body slowing down as it ages and getting less efficient at dealing with problems like arterial clogs.

3

Getting bypassed or having angioplasty with stents (springs to keep an artery open) do not have the effect of making the body new again. Disease processes like hardening of the arteries tend to speed up with time, so the process is still proceeding at full speed despite the intervention.

QtM, MD

4

Short answers:

(a) Vessels other than the ones that were “fixed” earlier may have clogged. If he had goop in some, he would’ve had goop in others.

(b) If he had a bypass, the graft may have clogged. Likewise, if he had angioplasty or a stent, the vessel could have restenosed.

© The above are in contex of, presumably, a heart already weakend by previous heart attack, so less reserve to compensate for further injury. The “big one” may actually have been a small one, but enough of one to do the job.