Medical Mystery Story: "I could have died"

A medical mystery story of a man who had 'symptoms' of a heart attack—but why? Did the 200 pounds lost on an unsupervised weight loss program provide a clue?

Here's the story, from some years back, in The New York Times: 

1. Symptoms 

""I was just walking, and out of nowhere I got this pain in my chest -- not exactly a pain, a heaviness. And I was weak. I had to sit down, pronto."" The young man looked up from the bed. His eyes were sunken and the bones beneath the skin were prominent, making him appear older than 25. 

""That's when you called your doctor?"" the medical resident, Dr. Dan Costa, prompted. 

The patient looked away. ""No."" ... ""I just didn't want to know."" 

As he listened, the medical resident was struck by the man's unusual appearance. Although he had a large frame, his upper body was thin: his face gaunt, his arm and shoulder muscles wasted. By comparison, his lower body—his abdomen and especially his legs—seemed huge. 

The patient had been sent to the emergency room... The resident reviewed the patient's (earlier medical) records. There wasn't much: he had a history of asthma... 

Back then, he weighed more than 400 pounds. Now he weighed about half that. 

2. Investigation 

""I'd always been a big person, and I just got to hate it,"" he told the resident. ""One day last year I sat down for my dinner and—it was strange—I looked at the food and I just didn't want it."" He bought some books, tried some diets, but nothing seemed to work. So, he invented a diet of his own: very low in calories, almost no fat. He ate as little as he could ... Soon the weight started to come off. 

As the resident turned to leave, the patient spoke again: ""I thought I was making myself healthier. Could I really have had a heart attack?"" 

The resident wasn't sure (the clues were mixed). One sensitive test that looked for evidence of injury to the heart muscle came back positive.  At least for now, they had to assume that his heart had been damaged.

But how? 

The resident scheduled an echocardiogram—an ultrasound of the heart—to see how well it was beating... 

Overnight, the young man worsened. The alarm by his bed sounded, and nurses rushed to his bedside. The patient's heart rate dropped to the 40’s—a normal rate is usually in the 60's. His blood pressure plummeted. 

The echocardiogram finally revealed the problem... The walls of the left side of the heart—the side responsible for most of the push—were thin and weak. 

But why?

3. Resolution 

The cardiology team came to see the patient later that day. Like the resident, they were struck by his strangely wasted body and the story of his severe weight loss. This, they thought, was the key:  the patient was starving himself (as part of the diet). Malnutrition can eat away heart muscle the same way it wastes other muscle. Without the proper intake of calories and protein, the body turns to muscle to provide the necessary nutrients. 

Two years later, the patient's weight remained stable. ""I guess I got a little crazy trying to lose that weight,"" he says now. ""I could have died."" 

During any period of rapid weight loss, we recommend getting 90 grams or more of high-quality protein per day, ideally 30 grams at a time, spread out across the day. If you use UNJURY® Protein powder, that would be about 3 to 5 scoops, depending on whether you are mixing it with milk. 

If you get a little extra protein (unless you have an unusual medical condition), there is no harm done. However, if you are a little short on the protein you need long term, the harm could be great (as the story shows). You also should not cut back farther than recommended on total calories. 

If you have any questions, feel free to email  Nutrition@UNJURY.com or call 1-800-517-5111, Monday through Friday 9:00 AM to 5:30 PM ET.