Why I wrote this
I was on an ER table at 1am on August 3, 2021, with my LAD 100% blocked. That's the widow maker. I walked out two days later with six stents and a bag of prescriptions, and I'd never been overweight, never smoked, never drank.
I did everything right and still needed six stents. So I started asking questions. Most of them I wish I'd asked in that first month, when I didn't even know what to ask.
This is that list. Print it, circle the ones that matter to you, and bring it to your next appointment. Your cardiologist is busy. These questions help you get the most out of the 15 minutes you have.
1. What actually happened to my heart?
I left the hospital knowing I had stents. It took me a long time to understand the rest.
Which arteries were blocked, and how badly? Can I get a copy of my cath report?
How many stents did I get, and where?
Was there any damage to the heart muscle?
What is my ejection fraction (EF), and when will you check it again? Mine dropped after my heart attack and later came back to normal. Nobody told me that was even possible.
Are there other blockages you're watching but didn't stent?
What do you think caused this in my case?
A standard cholesterol panel doesn't tell the whole story. The test that explained the most for me wasn't on my regular bloodwork.
What is my LDL right now, and what's my target now that I've had a heart attack? (Not my total cholesterol. Those are very different numbers.)
Can you test my Lp(a)? It's genetic, it usually only needs to be checked once, and the 2026 cholesterol guidelines now say every adult should have it done. Most people never have.
Can you check my ApoB? It counts the particles that actually get into artery walls.
What are my triglycerides and HDL, and what's my triglyceride-to-HDL ratio?
What's my A1C and fasting insulin? Is blood sugar part of my risk?
Should my kids, brothers or sisters get tested too?
3. Why am I taking each of these pills?
Meds are my safety net, not my plan. They kept me alive, and I take them today. My eventual goal is to get off them, one step at a time and only with my cardiologist's blessing. You still deserve to know what each one does. Bring your pill bottles or a list.
What is each medication for, in plain words?
Which ones are for life, and which ones are temporary? When will we review them?
What side effects should I watch for, and which ones mean I should call you?
Are any of these likely to affect my blood sugar, energy, sleep or muscles?
If a side effect bothers me, what are my other options? (Never stop a heart medication on your own. Call first.)
What would it take for me to safely need less medication someday?
4. What should we be watching?
Data before discipline. You can't change what you don't measure, and a lot of it you can track at home.
What follow-up tests do I need (echo, stress test, monitor, bloodwork), and when?
If I wear a heart monitor, what are you looking for? Should I log symptoms while I wear it?
What blood pressure should I aim for, and should I check it at home?
What resting heart rate is normal for me now?
Would a continuous glucose monitor (CGM) help me understand my blood sugar? My CGM changed how I eat more than anything else.
Which symptoms mean call the office, and which mean call 911?
Should I get checked for sleep apnea?
5. How do I get my life back?
The stent was the easy part. The part nobody hands you a plan for is everything after.
Can you refer me to cardiac rehab? When can I start?
How hard can I push when I exercise, and how will I know if it's too much?
When can I go back to work, drive, travel and have sex?
What should I eat? Can you refer me to someone who can help with food?
How much does sleep matter for my heart?
Is it normal to feel anxious, angry or down after a heart attack? Who can I talk to about it?
Is there a support group you recommend?
How to use this list
Pick your top 3. You won't get through all of these questions in one visit, so circle the ones that matter most right now.
Write the answers down, or ask if you can record the conversation on your phone.
Ask for copies of everything: your cath report, echo results and lab results.
If you don't understand an answer, say so. "Can you explain that a different way?" is a fair question.
Bring someone with you if you can. A second set of ears catches what you miss.
What's next
Every week in The Cardiac Survivor, I share what I've learned since my heart attack: my data, what's worked, what hasn't, and the questions I'm still asking. You're already on the list, so watch your inbox.
Hit reply from any of my emails, and tell me which question on this list you wish you'd asked first. I read every reply.
Dennis
The Cardiac Survivor
I'm a heart attack survivor, not a doctor. This guide is for educational purposes and isn't medical advice. Always talk with your own care team before changing anything about your treatment.