David Gottlieb: STEMI Heart Attack

Ever since he was in his 20s, David Gottlieb, 62, knew he had a family history of elevated cholesterol and heart disease. That’s why he has always tried to lead a healthy lifestyle, closely monitored his cholesterol levels and taken a prescribed statin medication to help keep them at optimal levels. As a chiropractor who works as a consultant on insurance claims for medical issues, he’s also very knowledgeable about his heart health and actively involved in his health care. 

So when David had a heart attack in November 2015 — despite having state-of-the-art medical care with annual physicals and having his cholesterol aggressively managed — it definitely caught him by surprise. Because of his family history, he had undergone regular treadmill stress tests and various imaging tests over the years “just to be safe,” and no heart problems of any significance had ever showed up. His heart attack symptoms were also different than he would’ve expected.

“I was taking my now 10-year-old godson to a Minnesota Wild hockey game on a Saturday night,” said David. “We parked about six blocks away from the Xcel Center, and I put him up on my shoulders. As we walked, I felt something kind of weird; I was short of breath all of a sudden. But we went to the game, and I brought him back home. I didn’t really feel much; I just didn’t feel quite right. I went to bed and when I got up the next day, I felt like I wasn’t on full cylinders, but didn’t have any pain.”

He continued, “As Sunday progressed, I started to feel like I was having the flu. I was sweaty, diaphoretic and nauseated. I might have had a little bit of discomfort between my shoulder blades, but certainly nothing in my chest, nothing in my arm, nothing up into my jaw … none of those more common symptoms. On a whim, I drove to Abbott Northwestern Hospital on Sunday afternoon and I’m sure I looked 10 shades of white when I walked into the emergency room. They had me down on a cart and within about 60 seconds, I had lines into me and the doctor told me, ‘Well, you’re having a heart attack.’ Thankfully, earlier in the day, I’d taken a full-dose aspirin as a precautionary measure, which turned out to have been a good idea.” 

David experienced a particularly dangerous type of heart attack called STEMI (ST-Elevated Myocardial Infarction), which is caused when a blood clot suddenly forms and completely blocks an artery in the heart. After receiving two stents and completing 12 weeks of cardiac rehab, David was referred to Dr. Thomas Knickelbine, a preventive cardiologist at Minneapolis Heart Institute® and researcher at the Minneapolis Heart Institute Foundation® (MHIF).

It was then that David learned of his problem: lab testing showed that he had an inherited condition where he has a high level of Lipoprotein(a) [Lp(a)] cholesterol. About one in five people have high levels of Lp(a) and most don’t know they have it. It’s purely genetic and unlike other types of cholesterol, healthy eating and activity or statins do not help reduce it. It puts someone at increased risk for heart disease at a younger age. 

Since that time, David has continued to work with Dr. Knickelbine and the other doctors on his health care team to monitor his heart health and lower his Lp(a) levels. They’re discussing an emerging new treatment called a PCSK9 inhibitor, which Dr. Knickelbine and other MHIF researchers have studied and presented at national cardiology conferences as well as MHIF professional education events. David has done his own research into the treatment as well and believes it will be “revolutionary” once it’s formally approved by the FDA for the Lp(a) condition.

Although David was not familiar with MHIF before his heart attack, he’s now attended various MHIF events and appreciates MHIF’s commitment to education, especially as it relates to helping other physicians and cardiologists learn about Lp(a). 

“I’m reasonably certain without the intervention that I’ve had over the years, I’d probably have had a much earlier and much more significant event than I did have,” said David. “I credit the Minneapolis Heart Institute® and Abbott Northwestern for saving my life and I’m thankful every day for them. The bottom line is, I feel blessed. I feel blessed that the Institute is there and the Foundation is there, continuing to promote heart health. My special thanks to Dr. Knickelbine for his early work and understanding of Lp(a) well before the general medical field came to understand and appreciate the condition.”