Israeli Woman Suffers Heart Attack, Cites Ignored Genetic Risk Factor

Orly Erez, a 50-year-old Israeli woman who maintained a healthy lifestyle, experienced a sudden, severe heart attack during a gym workout. Despite her fitness, the attack came as a shock, initially mistaken for a muscle strain. Symptoms progressed to nausea and intense pain, leading her to call a volunteer ambulance neighbor who alerted emergency services. At Beilinson Hospital in Petah Tikva, doctors discovered a complete blockage in one coronary artery and a 75% blockage in another. Erez underwent emergency catheterization and later another procedure. She was discharged after several days in intensive cardiac care but now suffers from heart failure with only 25% heart function and persistent cough, anticipating a future need for a pacemaker.

Following her ordeal, Erez learned about a simple blood test measuring lipoprotein (a), or Lp(a), a level found to be elevated in her blood. She believes that earlier knowledge of this genetic risk factor, which is independent of diet and exercise, could have led to earlier detection of her arterial narrowing and prevented the heart attack. "A simple analysis would have saved me," she stated, emphasizing the importance of this test for everyone, especially given that high Lp(a) can predict cardiovascular disease years in advance, even with normal cholesterol levels.

Dr. Hen Gurevitz, head of ambulatory cardiology at Beilinson Hospital, explained that Lp(a) is a lipoprotein particle that can accumulate in and block blood vessels, with levels determined by genetics from birth. High Lp(a) is linked to increased risk of heart attack, stroke, and premature death from cardiac conditions. She noted that Lp(a) is not typically included in standard blood tests, meaning individuals can be at risk despite seemingly good results from basic check-ups. Approximately 20% of the population has elevated Lp(a) levels.

While awareness and testing for Lp(a) are growing in Israel, with a significant increase in tests performed by Clalit health fund from 2020 to 2026, both patients and many physicians remain insufficiently informed. The test is particularly crucial for individuals with a family history of early heart attacks or those who have already experienced one. Dr. Gurevitz highlighted that Beilinson Hospital is participating in an international project to develop medication for lowering Lp(a), though recent trial results for one drug showed it lowered Lp(a) but did not significantly reduce heart attacks. Several other new treatments are currently under investigation.

In the absence of a definitive Lp(a)-lowering drug, treatment focuses on aggressively managing other risk factors like high LDL cholesterol, blood pressure, and promoting smoking cessation. Patients with elevated Lp(a) are closely monitored, and preventative measures, including imaging tests to detect early atherosclerosis, are employed to mitigate future cardiovascular events.