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One of the ways doctors look
for evidence of cardiovascular

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disease is by conducting a
stress test. Lloyd Alamsha's

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stress test led to a hospital
admission for more detailed

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tests. “Well, what they
found out was that there was

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blockages. They said some of
them were 80%, some were more

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than that. They came out
and said to my wife and our

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daughter, “this is what we have
found, and this is extremely

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serious and we don't know
whether the patient, that I,

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would survive from the
surgery.”” Dr. Jorge Castriz is

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viewing recent footage of a
patient whose arteries are not

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all that dissimilar from when
Lloyd Alamsha's blockages were

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first discovered. “This is a
patient that came to me because

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of symptoms of angina which,
basically, shortness of breath

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and a little bit of a chest
discomfort, not really a pain or

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tightness. This is probably
one of the better views of that

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blockage. You can see the
blockage right here it's a

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little bit of a string sign and
it's hard to see. Our catheter

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is right at the mouth of where
the artery should start, and

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here's the actual vessel itself,
the narrowing is right in this

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area here.” These blockages in
the coronary arteries can lead

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to a heart attack. If the
arteries to the brain contain

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blockages, then you are at high
risk for a stroke. In addition

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to healthy cholesterol
levels, other risk factors for

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atherosclerosis include chronic
high blood pressure, smoking,

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lack of physical activity, and
being overweight or obese. In

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Lloyd's case surgery was the
best answer for dealing with his

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blocked arteries. “They did
quadruple bypass surgery because

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the arteries were so plugged
up that they just could not

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function.” In addition to
lifestyle factors like diet and

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exercise, genetics can also play
a part in regulating cholesterol

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levels. For example, some
people may have a genetic

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predisposition that keeps cells
from removing LDL from the blood

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effectively, or, the liver
may be producing too much

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cholesterol altogether. “I
learned that heart disease has

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been a part of my family,
that my father died of a heart

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attack, my mother, had heart
problems.” “So family history

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plays a big part as to when this
process happens. Also, things in

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our lifestyle like smoking play
a big part as well.” “One of the

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things that several of the
doctors that I saw when I was in

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the hospital they told me that
they were glad that I stopped

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smoking.” Gail Smith is a
retired Miami-Dade County

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employee, and recently has
had to deal with an arterial

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blockage in her left leg.
“The story behind it was, I just

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happened to go to the doctor for
a regular checkup and I was told

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I had high cholesterol. That was
about 10 years ago.” Gail was

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aware of her elevated
cholesterol levels. But her bad

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diet and smoking habits,
continued to add to her

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problems. “I went to the doctor
because I was having problems

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with my left leg. I could walk
just so far and then I would

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have to stop and have to rest,
not that I was short of breath,

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but it was just the fact that
my leg was hurting. So I finally

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went to the doctor the latter
part of November, they had some

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tests were done, then I found
out that I would have to have

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surgery because I was not
getting circulation basically,

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to my left leg. Then I went
to the hospital and I had the

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femoral bypass that was
successful, and now I'm trying

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get back to normal.” Gail's
femoral bypass was a wake-up

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call for several changes she
had to make in her life. Her

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cardiologist, Dr. Perry
Krichmar, keeps her up-to-date

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on her risk factors. “High
cholesterol and you got rid of

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the smoking. So the two risk
factors we have left are the

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high blood pressure, which
is well-controlled, and your

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cholesterol.” In addition to
blood cholesterol levels and

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smoking, doctors also take age,
gender, race, blood pressure,

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blood pressure medications,
and whether or not a person has

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diabetes into account when
assessing heart disease risk.