People like me with psoriasis and psoriatic arthritis (PsA) have a greater risk of developing other serious health conditions. It’s known as comorbidity, which is the presence of one or more diseases co-occurring with a primary disease.
Known comorbidities for psoriatic disease include cardiovascular disease, cancer, Crohn’s Disease, depression, diabetes, metabolic syndrome, obesity, osteoporosis, uveitis, liver disease, kidney disease (psoriasis only) and hearing loss (psoriatic arthritis only).
But honestly, I’d never paid much attention to the issue…until I had a heart attack.
Last December, I went for a routine checkup at my cardiologist. I didn’t expect him to tell me that he found abnormalities on my electrocardiogram (EKG) and echocardiogram and to send me to the emergency room. The tests had shown evidence of a recent heart attack!
He asked if I had recently experienced any severe pain, dizziness or shortness of breath. In fact, I had. About two weeks earlier, I’d had a migraine on the way to a gig and the next day had two more – and I’d never had three migraines in 24 hours before.
Two days later, I was signing holiday cards, causing the bursitis (inflammation of the fluid-filled pads or bursae that act as cushions at the joints) in my left shoulder to act up. I went to a concert that night to see The Front Bottoms, a clever, quirky indie band I absolutely love. A half-hour into the concert, my left shoulder and left side started to really, really hurt.
In what was one of the most reckless decisions of my life, I decided to have a beer and a bourbon to ease what I thought was bursitis pain. A half hour later, I felt fine, literally shrugged the episode off and was standing among the crowd digging The Front Bottoms.
Neither of those events led me to think I would be going to the emergency room three days later with an abnormal EKG and an elevated troponin level. (Troponins are released when the heart muscle has been damaged.) The doctors decided to do an angioplasty and put a stent – a tiny tube – into an artery that was severely blocked. They also discovered I had two other blocked arteries!
Shortly thereafter, I felt chest pain and had to go back into the ER. After seeing more cardiac issues, the doctors ordered another angioplasty and a second stent. A few days later, I experienced another bout of chest pain and had to go to the ER again, for another angioplasty and stent! I was one of those rare cases where having one artery narrowing can set off others in quick succession.
There’s nothing like a brush with mortality to make you think
I’m feeling fine now. But after going through that ordeal, I’ve asked myself dozens of times: Why did I have a heart attack?
I’m in good shape and have been taking cholesterol medicine. My doctor told me why: genetics. Both my parents have a history of heart disease. My mother has psoriasis, and one of the comorbidities of psoriasis and psoriatic arthritis is an increased risk of heart disease.
Can it be proven that psoriasis and PSO caused my heart attack? It can’t. Also, I’m taking a biologic drug that acts as a TNF (tumor necrosis factor) blocker, and this type of drug is believed to reduce the risk of a heart attack.
But it can’t be disproven either.
One of the lessons I’ve learned is that if you have psoriasis and psoriatic arthritis, you have to be aware of the possibility for comorbidities. Like it or not, you are more at risk for other serious medical conditions.
I’m not saying those of us with psoriasis and PsA should become neurotic hypochondriacs. But we also shouldn’t ignore any potential warning signs for comorbidity-related issues. It was monumentally stupid of me to not call 911 when I felt that crushing pain in my left side. But it’s been smart for me to regularly see my cardiologist, who is aware I have psoriasis and PsA.
Be aware of the possibilities, be vigilant and if a medical issue develops, explain to your doctor that you have psoriasis or PsA so he or she knows they may be a factor.
I will certainly not be cavalier about comorbidities anymore. That routine visit to my cardiologist might have saved my life.
The opinions expressed by NPF Blog contributors are their own and do not reflect the opinions or positions of the National Psoriasis Foundation. The information posted on the NPF Blog is not intended as, and is not, a substitute for professional medical advice.
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