Tom Pepin knows a lot about heart disease, and not just because his family's name is on a cardiac care institution.
His father, Art "Pep" Pepin, the founder of Pepin Distributing Co., started what is now known as Pepin Heart Hospital at University Community Hospital in the late 1980s. Tom became one of the hospital's biggest boosters and speaks knowledgeably about what it offers, from research trials and minimally invasive procedures to digital technology and robotic surgery.
Heart disease runs in the Pepin family. Still, Tom Pepin never expected to wind up at the hospital as a patient.
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Pepin has a genetic condition that makes his cholesterol abnormally high. He does everything in his power to prevent problems. He stays on top of his regular screenings, exercises faithfully, follows a heart-healthy diet and takes powerful cholesterol-lowering medication.
Yet in January, when he went to the hospital complaining of fatigue and heartburn, he learned he was actually having a heart attack.
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The cardiologist who took care of Pepin, Dr. Kevin Klein, hears it all the time.
"People say, 'I've done everything right, I eat right, exercise, I'm not overweight. Are you sure it's happening?' " Klein said.
He tells those patients that everyone has some risk of heart disease, and even thin people who watch their weight are not immune. "Add on risk factors like smoking or family history, and you increase the likelihood of having a cardiac event."
Pepin, 57, had been feeling unusually tired for several days, but thought it was just a natural part of getting older. Then he developed what he describes as "wicked heartburn" that wouldn't go away. He waited three days before he let his wife take him to the emergency department at UCH.
"When that 15-pound weight on my chest turned into 30 pounds, I decided to go in," he said of the intensifying "heartburn.''
His symptoms were classic, said Klein, who adds that any persistent chest pain or discomfort should be a red flag that warrants a call to 911.
"Especially if it's new or unusual pain and lasts more than 15 minutes. If it persists or gets worse and if there's shortness of breath or heavy perspiration, get to a hospital."
Waiting delays treatment and increases the chances of permanent damage to the heart muscle. Klein said another big problem he sees is people who finally give in to the pain and drive themselves to the hospital. That's a really bad idea, not only for yourself, but for everyone else on the road. So call 911, he urges.
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Fifteen minutes after Pepin was evaluated, he was rushed to the cardiac catheterization lab, astonished to learn he was in the middle of a heart attack.
"I even asked the doctor, 'Are you sure?' " Pepin said. "I know heart disease. I'm immersed in it. I should have known it was coming.''
Pepin had what Klein calls a minor heart attack. He had only one blocked vessel, which was opened with a balloon and reinforced by placement of a wire mesh tube known as a stent.
So, was all his hard work protecting his heart health for nothing?
No way, Klein said. People with family histories of heart disease who are not vigilant "end up having heart attacks earlier in life, which have more of an impact on the patient's quality of life and the patient's family."
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"Tom was set up for heart disease," said Pepin Heart Hospital's medical director, Dr. Charles Lambert. "He has a genetic predisposition for it. So despite having good control of most of his risk factors, genetics still play a part."
Pepin's mother has cardiac vessel blockages and his father had a condition known as cardiomyopathy (a weakened, enlarged heart), which eventually led to a heart transplant in 1986. Because he was in his late 60s, most cardiac transplant programs wouldn't take him. But he persuaded famed Houston heart surgeon Denton A. Cooley to take him as a patient. When Pepin returned home two months later, he gave UCH $1 million to start building a specialty heart center. The Pepin family foundation continues to support the hospital today.
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Tom Pepin is back up to full speed, dividing his time among Pepin Distributing, philanthropic work and leisure activities like skiing and fishing. "I have stress pretty well managed," he said.
But he still is surprised that he had a heart attack.
"I'm not sure why I was chosen," he said. "Hopefully, to get the message out that it can happen to anybody and don't ignore the warning signs."
Irene Maher can be reached at firstname.lastname@example.org.