–It all comes down to this.
Once muscle has died then, like any other tissue, it cannot be regenerated. Once dead, it stays dead. The heart consists largely of a special muscle, and unlike, say, the liver, it does not have any redundancy : it is all used all the time. It follows, therefore that when heart tissue dies, the heart effectively becomes smaller and has a correspondingly reduced capacity. This dead heart tissue is called an infarction, hence Myocardial Infarction –> M.I. –> Heart Attack.
Jack opened his eyes. He had no idea where he was or what had happened. He had a large tube down his throat (he didn’t know it but this was keeping him breathing) yet felt no discomfort. He was strangely calm. There were machines. The machines were in control. All was well.
Jack’s ECG looked like it had been drawn by a dyslexic child (or a Doctor writing a prescription) .
Jack’s blood tested positive for troponin, confirming that he’d suffered an M.I., and given the degree of abnormality of the ECG, a pretty large one. Next the echo.
The ultrasound showed the degree and position of the infarction: the amount of heart tissue (muscle) that had died. If luck is ever the right word in situations like this, Jack had been lucky: the blockage in the artery had occured half way up the heart, as opposed to at the top : about a third of his heart was dead.
Two week after being discharged from the hospital, Jack is back in it: Cardiac rehab. This consists of a relaxing chat with the cardiac nurse, a palatable chat with the cardiac dietician and some light excercise with a Welshman (no chatting). All the blood tests (prepared earlier) are encouraging: liver function is good, kidney function is excellent and there are no traces of the dreaded troponin. Weight is down (we’ll have to do something about that) and there are some side-effects from the medication (but that’s to be expected) … so all that’s left is a quick ECG and that’ll be that for another six weeks. The ECG: “All over the place” was the phrase used and hushed were the tones used to say it. Even compared with the (by no means usual) baseline from a fortnight before (a flit back to A&E following some “adjustment”), concerns were raised to the point that a further echo was deemed necessary. Right now. So, back across the lift well to the imaging cubby and a short wait for the senior Cardiologist (happily diverted from his meandering “rounds”).
“Turn the gain up.” “Take one there” “Don’t waste a shot” “Get round the side” “How does this compare …” “Well …” Jack’s heart had begun to heal: the infarction had started to reverse itself, which was impossible. As Sherlock Holmes was fond of saying: “When you have exhausted all other possibilities, whatever is left, however unlikely, must be …”. As dead tissue cannot regenerate itself, it must not have been dead – it must have just looked dead … it must have been “stunned”. Suffice to say, a significant amount of “infarcted tissue” was now un-dead, which is not to say it’s vampiric but rather alive, in the sense that it is now functioning as heart muscle tissue should (obviously a heart with “heart”): about ten percent of his heart remained dead. Decimated but not out. Jack was used to being decimated: definitely something he could live with.
“It’s just me, holding my hand on my heart.” Jack sung to himself as he wandered off …