44-Year-Old Man Faces High Risk of Heart Failure After 20 Years of Smo.king

A History of Heavy Smo.king Led to Severe Coronary Blockages

 

 

Doctors at Tam Anh General Hospital in Ho Chi Minh City recently treated Mr. Trung, a 44-year-old man suffering from severe coronary artery disease. For the past 20 years, he had been smoking a pack of cigarettes daily.

A month before hospitalization, he began experiencing chest pain during moderate exertion, which subsided with rest. However, as the symptoms became more frequent, he decided to seek medical attention.

Medical history revealed that three years ago, he had already been diagnosed with right coronary artery narrowing and a complete blockage of the left anterior descending (LAD) artery. At the time, doctors performed a stent placement to open the right coronary artery, but the LAD remained completely blocked due to hardened plaque, making intervention impossible.

Severe Coronary Artery Blockage: A Life-Threatening Condition

Recent tests showed that his entire left coronary system (including the circumflex artery and LAD) was now completely blocked. The only blood supply to his heart came from the right coronary artery, putting him at high risk of heart failure. If the right artery were to narrow again, it could completely cut off blood flow to the heart, leading to a heart attack or sudden cardiac arrest.

The challenge for doctors was that the blocked segment in the circumflex artery was too small (1.5 mm in diameter), while the smallest available stent is 2.0 mm, making stent placement impossible. Instead, they decided to reopen the LAD.

Previously, medical teams had attempted angiography-guided intervention, but image overlap and low resolution made it difficult to assess the blockage and properly insert the guiding wire or select the right stent size.

Advanced OCT Imaging Technology Saves the Patient

To overcome these limitations, doctors used Optical Coherence Tomography (OCT), a high-resolution imaging technique that magnifies blood vessels 10 times more than intravascular ultrasound (IVUS). This allowed them to precisely visualize the plaque buildup, select the appropriate guidewire, balloon, and stent, and perform the most effective intervention.

The three-hour procedure involved using a high-rigidity guidewire and balloon catheter to break through the hardened plaque and create a pathway for the stent. After successful stent placement, post-intervention OCT imaging confirmed proper expansion and positioning, with no complications.

As a result, Mr. Trung’s chest pain disappeared, he recovered quickly, and was discharged the following day.

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Why Are More Young People Suffering from Coronary Artery Disease?

Dr. Nguyen Van Duong, a specialist in Interventional Cardiology at Tam Anh General Hospital, explained that coronary artery disease (CAD)—a condition caused by narrowing or blockage of heart arteries—was traditionally seen in people over 50 but is now increasingly affecting younger individuals, with some cases occurring before age 30.

The main reasons behind early-onset CAD include:
✅ Unhealthy habits: Late nights, stress, obesity, physical inactivity, poor diet high in bad cholesterol.
✅ Harmful substance use: Smoking, excessive alcohol consumption, drug use.
✅ Uncontrolled underlying conditions: Diabetes, high blood pressure, and lipid disorders.

For older individuals, CAD develops gradually, leading to progressive artery narrowing until a heart attack occurs. However, in younger patients, sudden arterial blockages due to blood clots are the main cause of heart attacks.

💡 Mr. Trung’s case—triple-vessel disease in his early 40s due to long-term smoking and untreated lipid disorders—is extremely rare, highlighting the dangers of these risk factors.

Preventing Coronary Artery Disease

🔴 Quit smoking – The single biggest risk factor.
🔴 Limit alcohol consumption and avoid drug use.
🔴 Adopt a heart-healthy diet rich in fruits, vegetables, and lean proteins.
🔴 Exercise regularly to maintain a healthy weight.
🔴 Manage underlying conditions such as diabetes and high cholesterol.
🔴 Schedule routine check-ups to detect and address early warning signs.

Early detection and lifestyle changes can significantly reduce the risk of severe heart disease. Don't wait until it's too late!