Surviving heart attacks: The Magic of Cardiac Collateralization 

You end the video with a thank you to us all ! It’s actually us who must thank you for your selfless giving in this way which helps and blesses everyone🙏🥰

The same situation happened with me. I had a 100% blocked LAD. And it was found by accident. I went to my doctor to get medicine for my allergies and he did an EKG because I had not had one in a long time. My EKG was abnormal. He was concerned so sent me to a cardiologist. The cardiologist put me through a battery of different exams and tests to include a cardiac Cath and a stress test. That’s when they found the blockage, but because my body created collateral arteries around the blockage to feed the area of the heart that needed it I had no symptoms, and no damage to my heart muscle. I definitely got lucky. I’m now on the proper medication, controlling my cholesterol I had a stent placed two years later my cholesterol is looking great and I am healthy. My doctor told me one of the things that saved my life was my level of fitness, I run 4 to 5 days a week and I work out with weights five days a week he said my body created a need for more blood flow to my heart and a creative these other accessory arteries

Genius how you explain the complexity of the Heart in ways we can relate with an analogy. Gives understanding. And allays Fears. Thank you 😊 for your humble kindness.

If only all cardiologists took the time to explain to patients what is happening it would not only educate patients but also relieve stress and provide HOPE

Dear Dr Gupta, I would love for you to do a podcast with Dr Aseem Malhotra, or at the very least make a video addressing your opinons on his concerns and statements. I am living in constant fear of having a heart attack after having a medical procedure a couple of years ago that was previously not being used. I don't know if im imagining this but it seems to be more common place that were seeing more SADs than in previous years. What is the best test to check there are no blockages and that the heart is in good health. Many thanks

Understood better/more than my college 3hr lecture! You are an excellent teacher Dr Gupta, thank you for your service🙏🏻

Woooow….. looking real good with that beard. 😉

Similar to others' stories, I began hiking on a regular basis 10 years ago and have never had any angina. In 2020 I had an ultrasound which showed an aortic aneurysm so I was referred for a catscan, which showed that I have 3-vessel coronary artery disease with an Agatston.score of 352 in the proximal LAD alone and an overall calcium score of 754. Given my ability to pass a stress echo test and go on difficult hikes with no chest pain or shortness of breath, my cardiologist and two interventional cardiologists agreed that I didn't need CABG or PCI and didn't even need an angiogram. Keep moving!

Could you please do a video of a leaking heart valve ? I lost a friend a few years ago completely misdiagnosed ! Symptoms persistent dry cough ! I have a constant dry cough not breathless on exercise but fatigue for sure recently ! Many thanks 💗💗

Thanks Dr Sanjay . What’s your opinion on tiny arteries being blocked and that’s causing chest pain and breathlessness? What’s the solution for that? A friend of mine , two years ago was told that two of his main arteries were 30% blocked ( Each one was 30% blocked) . He was told nothing could be done until they were 80% blocked. He was given yet another anti - cholesterol tablet. He then got a second opinion at another hospital. There he was told to give him a better quality of life they’d put in 2 stents! He now feels much better and no longer suffers from angina and feels very well . What’s your opinion on that Dr Sanjay?

Your sir an awful lot to reassure anxious cardiophobia patients like me.

Thank God, I've never had a heart attack (I'm 67, never smoked, nondrinker) but I do have a question: the heart, as you stated, is a muscle. But when you bruise a muscle (which a heart attack has been described as) it eventually heals and becomes good as new. But why doesn't the heart heal? Is it a different type of muscle that prevents it from healing like any other muscle in the body? Thanks ❤

Dear Doc your post are very informative and I am thankful to you from the core of my heart. You are doing a great service to the humanity 🙏

This is very reassuring and proof of God’s wondrous design of the human body. May God bless & keep you Dr. Gupta 🙏🏻 I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. ~ Psalm 139:14

Anyone had a bubbling feeling in their heart? :(

Third, wait I'm fourth. Thanks Doc.

I appreciate your kind, human demeanour and outlook on life, as well as the amazing video content, thank you !

Thank you, very well explained. Greetings fromMelbourne❤

This was my situation, went in with a STEMI in the LAD but they also found a CTO in the Lcx that was mitigated by collateral vessels. Very informative channel, thanks for doing it and all your other good work.

Thank you, Dr. Gupta, for 'drawing us a picture'! It helps me to understand so much more easily when I can picture it in my mind.

Thank you for this great message. I had a heart attack two years ago when I was 69. My LAD was completely blocked. I was lucky to be flown in a helicopter to the nearest hospital. Three stents were introduced. After three days in hospital my LV election fraction was 45%. I started a heart rehabilitation program, educating me to do the appropriate exercise. I do now 50 minutes of cardio training every day (HR at 110-115). After a year my LV ejection fraction was back up to 55-60. I know that I’ve been extremely lucky. It was mysterious how I could have so little damage to my heart after such a significant blockage. I understand now that I had perhaps some secondary circulation in place, and it was further developed by the regular exercise I’ve been doing since the heart attack. Your explanations are always the best I find on RU-vid.

Excellent presentation! So much potential for patient education and primary and secondary prevention and tertiary prevention treatment rehabilitation post stent or CABG! 👍

And second! Man, I was on time. I love this channel.

You are my favourite UK Doc and and helped me understand my sister low pulse ✌️

I read an article on the New Atlas website the other day which seems promising! I don't think RU-vid allows links in comments, so I can tell you the article title is: Technique reverses heart attack damage by reprogramming scar cells. The study is being overseen by Conrad Hodgkinson, an associate professor of medicine and pathology at Duke University in Australia. I thought it might be of interest to you :)

Can chronic severe emotional stress kill you? I have arrhythmias and I’m afraid.. I feel like my hands are tied because I cannot fully control my stress

Dr. Gupta, Love your channel, thanks for sharing so many amazing insights. I had a heart attack Acute MI 3 months ago, Was released from hospital the next day, thought I had a second one very mild if at all a month later, but the hospital could not find evidence I had one, and said I was good To Go, possibly anxiety and stress? I had covid when the heart attack hit and have also been under tremendous stress since my sister passed away in November 2022. I Lost my mother in 2020 as well. Checked out good on Echocardiogram and several other tests, only the stress test was negative. Now my cardiologist wants me to do an angiogram with possible/probable stenting. I have no Angina at all and can exercise pretty well, only on an aspirin a day and a statin. With no symptoms since would I be considered stable? And do you think I really need the angiogram and stenting, since I feel, no symptoms and have been doing very well in the medications and have no symptoms? Would greatly appreciate any feedback. Thanks, Rob... Cardiologist never showed me any test results either, is that common?

Amazing presentation! We are the ones who are immensely grateful and beyond blessed to have you. Thank you!!!

Hmm, amazing.. It also means artificially induced controlled progressive blockage in main artery can lead to many natural bypasses & will protect humans from sudden collapse in case main artery gets blocked due to any reason? More research is needed, isn't it? Can become preventive remedy in future, as at least as of now to my knowledge damaged heart muscles can't recover by their own..

First! ❤

Thank you Dr Gupta amazing video. You are truly looking out for us.

I hve prediabetes, non hodgins lymphoma lung 5 yrs not treated, high bp, glaucoma, and have been inactive recovering from hip surgery. After surgery i exoerienced in hospital short breath when i walked, burning lungs, profuse sweating, when i lay down i recovered. Had an occasional bout since. But since last werk it has become often 3x in one week. Visited ER was given bp quite high 150over 95. However i was still waiting after 10 hrs. I left as i was exhsusted. Saw gp he irdered ekg bloods but hes leaving on vacation in 3 days. I must brush it off as some unusual anxiety as no professional has shown any urgency bsides nurses at the health line. Anyone have this isdue.? Note i have lost 40 pounds on a vlc low carb 900 csl diet. My glucose is 4.3 now from 6.7. This month weight loss increased from 6 lbs to 12 which was quite unusual. 🤔

Thank you! I’ve also been following Dr. Esselstyn’s studies and book on reversing heart disease. He is almost 90, a Yale graduate and spent decades with studies on the network you speak of. The assiduous dietary change in diet to a no oil, no sugar, not added salt Whole Foods plant based diet over time has reversed many cases. Thanks again.

Thank You for this great VIDIO!

sir can CILNIDIPINE be used for variant angina???? Please shed some light sir. Am in india and diltiazem and verapamil aint suiting me! God bless you.

I really appreciate this information. Thank you, Doctor.

I am taking Pantoprazole Teva since 2019 following a Heart attack; is this too long, should I stop taking it as the side effects are very unpleasant. Why am I taking Pantoprazole Teva?

If it wasn’t for collateral I would not be around today. I had 2 blockages in my RCA. One was a 100% CTO at the top of the RCA and the other was 95% blockage lower down. These were not seen on any of the stress test I had. But were found after a Cath was done. 3 stents later I’m doing better.

Fascinating. I have controlled hypertension but a high diastolic and av nicking on my retina although systolic is good my diastolic is stubbornly at 85-90. It's not uncommon after exercise for my pulse pressure to be low as my systolic falls more than diastolic. I think this all points to stiffening of my smaller arteries and arterioles. This is encouraging if i take regular exercise i can reduce my resting heart rate (increase the length of diastole) and create a bit of oxygen insufficiency in my body to encourage collateral growth.. and even if it doesn't happen its still the right thing to do. Really well presented thank you

Hi.....i had a stemi heart attack only just made it to the hospital in time snd had a stent, a few months later had an ICD. I used to take 3.75 bisopropol 😮 it was awful, permanently made me crazy dizzy so after a few months went to 2.5 at night, it was ok for a year now I'm crazy dizzy again so then my cardio nurse said 1.25 in the morning and same at night, a bit better but still I'm laying down 20 hours a day just so light headed, is it safe just to take one dose Thanks so much

I had a heart Tranlant 23 years ago 7 years ago my arteries were crystal clear. On this previos chrismass I went to Toronto General with serios chest pain. They didnt sense a heart attack. But my arteries are now 95 percent clogged on the Recent scan. Still trying to figure out why. Maybe untreated Parathyroid disease. I bike reguraly and try pushing I also used to take supplents A recent study found Berberine reduce bloockages by 4 percent. And Statins worsesend blockaches by 1.2 percent

Many are having difficulties with there heart more recently. Do u have any good links on inflammation of the heart? I caught Covid a couple of years ago and often feel like that has affected me. I have no evidence nor have I had any special examination. I put my trust in God and have faith but still research and seek natural remedies for it. God bless you

Thank you for you posts, ive learned so much from them. Youve given me alot of peace concerning my health, and life. I had a heart attack in 2018 i believe the RCA was blocked ( i was a hard cigar smoker, was) they stinted the artery, The doctor said the LAD was also blocked 69%, but did not stint. For the last 5 years ive been worried about the LAD. My Cardiologist gives me no answers. What should i do? Should i push for a heart cath? I have no symptoms, i stopped smoking the day of the event. I do drink. though. and i try to get exercise, but this is often on my mind.

Oh the Cat arrived!! And it’s Gorgeous! 👍🏽😻😻😻

Yet again many thanks for another great video Im rather hoping that my Collateralization is helping me 10yrs on from stenting !!!Also the video on K2 we have located some live Kimchi and embarking on a de calcification program Many thanks for you work

Many years ago I was told I had angina. A swelling became of a bad couch I had. I will probably get it checked.

Can you cover fluid on the lungs sometime please? I'm 80 I went to emergency care for 4 nights having a diuretic through a canula in my wrist. I was told that I had a leaky valve and first signs of heart failure. Sent home after 4 days and just told that if I felt a punch like thump in my chest or bad headache to ring 999. No care package and left on my own at home.

You are a genius, your explanation of heart is excellent. Thanks a lot for your advice on exercise as a potential solution in increasing the blood flow and recovery process.

I am Having issues been to the er 5 times in two weeks my problems are getting worse with no help from ER Dr. my heart rate is going to 200 bpm and fluctuating up n down then stops after 4 or 5 hrs. then they send me home have a good night follow up with your cardio dr. I am struggling here any help is greatly appreciated. symptoms high heart rate once starts don't stop for hours comes after eating or exercise about 30 mins after each. was in a bad racing quad accident thrown off at 60 mph laded on arms chest then rolled very fast for 10 to 20 ft. I have had a heart pet scan a chemical stress test and the lit up all the veins around my heart passed them all no signs of heart disease no blockages. I was however I was in a bad racing quad accident. landed on my chest rolled around 30 feet flipped it at 63 mph.

Exercise makes a huge difference! I just went through a CABG triple bipass. My surgeon said I had very well developed side arteries which prevented me from having a major heart attack. I was jump roping daily and doing 50 meter sprints 3 sets 3 times a week before my chest tightness caused me to look into the problem. I hope to get back to challenging cardio once I'm healed from the surgery. I will always wonder what if I never elected to have the surgery. I made the best choice with the information I had and I hope it pays off.

Good morning Dr. Gupta! How are you today? This information is so great! I may be seeing a cardiologist in the future. Appreciate you and what a pleasant an kind face to see first thing in the morning ! Have a wonderful day!

Can collateralization DEVELOP as a result of ischemia?

Im 70% through this video and with all the talk about improved auxilary flow options we havent gotten to te part where im to learn how to do this. At this pointbid ratherbdie than listen to more.

Dr Gupta, I would appreciate your explanation of the Third Brain.

Thank you doctor im going in for a triple by pass ive always exercised but got angina .its got better on medication i was scared to exercise since but will carry on slowly now

First!

You say so much in such a small space; Much Appreciated

You seem to have moved to doing shorts, which I don't watch.

Explained so wonderfully. Thank you!

Explain how the Japanese use 5 pressure points to diagnose the patient.

Thank you. Very, very interesting.

Can brain arties develop collaterals like carotid

This is a really important video, pure genius.

Thanks Doctor. Can you please tell, how long it takes collateral to develop, for a 60 year old, 3 VD & calcification (so cannot put stent), male (avoided CABG) , who has made lifestyle changes & does exercise , including walking twice a day & takes necessary Cardiologist advised medicines.

Oh! Love your sweatshirt!

Do you ever use HBOT?

Love listening to you Doc 🤗 when I can 💜

Thank you for all of your great work!

Very informative, many thanks.

Thank you for the hopeful message.

Have you been playing xbox?

Really appreciate your clear, concise explanations.

Dear Doctor, I am from India. So far I have been free of any symptoms. I have a positive family history (my mother had a stroke and died 30 years ago when I was a child), father was free of any cardiovascular symptoms and died in 2020. I am probably a carrier of the 9p21.3 region gene associated with CAD and premature CAD which is common in an Asian Indian population. Your advice will be greatly appreciated. So far I have been free of any symptoms. I have a positive family history (my mother had a stroke and died 30 years ago when I was a child), father was free of any cardiovascular symptoms and died in 2020. I am probably a carrier of the 9p21.3 region gene associated with CAD and premature CAD which is common in an Asian Indian population. I am also taking Niacin 500 mg 2xd , Vitamin K2 and D3. I am scared of the surgery as well as of a heart attack. Your advice will be greatly appreciated. I had an angiography 2 weeks ago Coronary angiography: Left main stem unobstructed. Left coronary artery: 70% stenosis of prox. RIVA, 50% stenosis of prox. RIM. 70% stenosis of LCX - Proximal. 70% stenosis of Mid.LCX Right coronary artery: 80% stenosis of dist. RCA. 70% stenosis of med RCA. Diagnoses: 1. coronary triple barrel disease. - Coronary angiography elective with diagnosis of CHD on cardiac CT on 13.07.2023: - Sign. proximal RIVA stenosis. - RCX with long wall changes and sign. Stenoses proximal and in the middle section - RIM with intermediate stenosis proximally - RCA diffuse wall-angulated with sign. Stenoses proximal and distal - Lavographically normal LVEF. no reg. motility impulses - Cardiac CT in advance (Chur) with electrically path. Ergometry: diagnosis of CHD, Ca-score >1000 - CyRF: Art. Hypertension Assessment: The 47-year-old patient is found to have quite advanced coronary three-vessel disease for his age with significant stenoses in the proximal RIVA, RCX and RCA. Stenoses in the proximal RIVA, RCX and RCA. The vessels have diffuse wall changes, but the connecting segments for an ACBP would be relatively small. The LVEF is normal. I discussed the findings with the patient at length and told him that the findings were not suitable for percutaneous revascularization. With the patient completely symptom-free, we decided to perform a cardiac MRI with a question about the extent of ischaemia. Then we discussed ACBP vs. drug therapy. In addition to the established medication, I prescribed atorvastatin and bisoprolol.

Dear Dr Sanjay .. ur right on point in explaining the arterial collaterals which my body had developed around the 100% blockage in LAD . As i was previously diagnosed with CAD 3 years ago in ER and i refuse to get any stent or by-pass back then i was 168 lbs . Since that time i had lifestyle change ( plant base 70% of my food intake , low salt, minimal to low or no sugar , olive or avocado oil only ) , regular weight training and cardio exercise , medication management ( aspirin 325 mg for 6 months and statins 10-20 mg for 6 months then i wean down to 81-100 mg Aspirin + pantoprazole and 5-10 mg statin ) and taking amlodipine then switched to diovan angiotensin ) plus other naturopathic ( niacin, omega 3, berberine , vit k2 + vit D3 , turmeric, magnesium , iv therapy ( glutathione, vit c , b12 ) daily juicing ( celery , cucumber, flaxseed, mix vege, avocado, banana n other fruits etc ) plus Intermittent fasting

This indeed appears to be the explanation why in spite of 80-90% blockage in LAD proximal segment my heart functioned normally and there was no myocardium infarction!!! As explained here my exercise regimen was fairly steady for nearly 7 years and I was often pushing my bpm to nearly 130 bpm without causing stress or distress!! And my age is 82 now!! Thank you doctor for this revelatory explanation.

2 things 1. I noticed you game. My respect for you quadrupled!! 2. Thank you for making this vid ru-vid.com4GW_K5HbiVI?feature=share years ago. I just came to the inflammation conclusion this year and am cutting out carbs. Be blessed Doc.

I had a ECG at Leics Infirmary. The Cardiologist wouldn't talk through the results - just said it wasn't optimum - effectively just take the meds, don't ask about possible side effects and don't use the Internet to find out for myself. The results suggest I previously had a MI some time ago - BBB between the left and right ventricle. It was symptomless - the ECG was done because my GP took my Blood pressure and it was 230/110 - tad high. How can one get a comprehensive analysis of any results - and thus optimise any treatments that may be required?.

Dr Sanjay gupta sir very important and some thing new for me it enhances my knowledge about aur body and heart in particulars thanks 06/05/2023

You have a way of teaching that is informative and your gentle kindness is always present too. Thank you Dr. Gupta.

Would BFR (blood flow restriction ) bands during workout create the same collateralization as EECP?

I was getting a much needed hernia repair. Bad ecg sent me to cardiologist. More tests and was denied the surgery. Recommended double bypass surgery. I feel great except for large painful hernia. I'm 76 workout(just weights now, because cardio has become too painful with hernia and work full-time standing at my shop. Even with bypass he said he might not approve hernia repair. I am totally asymptomatic and enjoy a good quality of life. I feel even with the invasive bypass procedure, I will be in more danger of stroke etc. because I'm unable to walk any distance painfree(because of the hernia). I wish I had more say so over my health at this point in my life. I'm more concerned about quality of life than tacking on a couple of years. Thanks for at least looking at the big picture.

I am 62, male, with no medical issues. I wonder if "DNR" is respected by medical emergency personnel. I do not want to be kept alive by modern medicine. I am happy to die naturally when my time comes. I only wish for strength to endure the pain of a heart attack if I get one. I am of the view that voluntary euthanasia should be legal for everyone over 60.

Dr. Gupta, how does fasting help with all these issues? Like 12-14 hour fasting before the first meal of the day.

Is this what my doctor means when they tell me not to worry because I have distal flow? I had a SCAD in my LAD with 99% occlusion and TMI but was able to walk to the hospital. I was in great pain, but I was not short of breath. I had no stent put in but have struggled great;y with vasospasmic angina since. I can work out with out any feelings of shortness of breath but often have pain at rest or when getting up from a resting state.

RCA CTO (40mm) here. Coronary collaterals saved me. My only symptom was chest pressure that only occurred four or five times in one year. Each time the chest pressure just went away and I continued on with whatever I was doing. Blood work x-rays all came back good but the stress test was abnormal. Cardiac catheter identified the problem. I exercise 3 to 5 days a week with the encouragement of my cardiologist. I was diagnosed with bradycardia (slow heart rate) at the same time. I checked my Garmin watch heart rate data and my heart rate lowered about six months before.

Can you tell me, if I have been diagnosed with congestive heart failure what hope do I have of life span? Is it only 5 years. I am 49, never smoke or drank, but am overweight-- my current BMI is 32

That was the best video on heart disease I've found. How long does it take collaterals to form if we are doing 1 hr of aerobics most days? Your kindness and gentleness knocked me out!!And I find it very healing besides!!!

Thank you so much for your detailed explanation about our precious hearts. I watch so many of your videos and am amazed at your dedication and caring. I wonder if someone can answer this, is having what the cardiologist terms a "very large Ramus" which is a "variant" artery a collateral artery? I have such artery and understand that it emanates from the left main in the space between the LCx and LAD. My other question is, having this artery is it protective in the event of an occlusion in the LAD? Thank you!

Can you share your experience with coronary artery artasia? I just got diagnosed with this. My EKG was abnormal but an echo and angiogram showed me in the clear except for increased artery size

Can you explain more about cardiac ablation for SVT? Im having one and im terrified.😢

I am 65, and had whats called CTO ( Chronic Total Obstruction) in the right coronary artery and also narrowing of LAD artery, I underwent stents, all that before 5 years. After the stent by 6 to 7 months I started strenghts exercises with dumbbells and barbell, but mostly dumbbells and some days in between I do walking and also do HIIT exercises. I like to watch your videos. I am diabetic and take Metformin and heart medicines( almlodipine and bisoprolol). For how long should I exercise?❤❤

You are AMAZING! Thank you so much for your extension knowledge & care ❤

I think this applies to me I’m on drugs to slow the heart down reduce blood pressure and exercise daily. Thank you Dr Gupta for this explanatory video.

Hi Sanjay. hope you are well, we spoke 2 years ago about a heart topic and i respect your work, i,ve been on propranolol for 3 years for anxiety which keeps my heart rate down, is this damaging my heart, i still excersice a bit and walk regular and don,t get out of breath easy so does this mean my heart is still benefitting whilst on this medication, dosage is 80 mgs, would love your view

Unfortunately my brother passed away this week due to a blockage, only 50. wish he had got checked out, please get checked if you are in any doubt

I made a previous comment for this video. I should've mentioned that I am among the 20-25% of people who have a third major branch from the left coronary artery, referred to as a "ramus intermedius." For some reason it seems to be free of narrowing or calcification, and I suspect it may be supplying a significant blood supply to the front of my heart. Others who are concerned about their coronary disease might want to review their imaging studies and see whether they have a ramus intermedius artery.

Give a briefing on Calcium Score and the severity of the CAD and modes of any possible reversal

Hi Doctor. Is there any way to get referred to yourself on the NHS for a tilt table test to diagnose pots? It seems to not be a very understood illness. I could email you more information on what caused my problems and what test results I have thus far, cardiac MRI etc. Thank you doctor.

Dr. Gupta, would you please explain arrhythmias such as inverted T-waves and ST depressions? Are they evidence of past heart attacks or an indication of one to come? Thank you.

Thank you so much for sharing. Have you heard about the Medical Medium? I’m very curious to hear your take on his info