It was a normal Saturday morning for Prem and Sangita in 2010. Their son, Arnav, was 15 months old, and the young family was looking forward to a weekend together. Prem, however, woke up feeling a little off. He was restless and felt a slight pain in his left shoulder. Figuring it was just acid reflux, Prem assured Sangita not to worry. But as he stepped into the living room, Prem started sweating – and then, he passed out. He was having a heart attack.
That day changed Prem's life, and also the lives of his family members. Prem had experienced firsthand the impact that high cholesterol can have. Now, he and Sangita are taking steps to give their son a chance at a healthier future.
A misunderstanding of lifestyle vs. genetics
Prior to his heart attack, Prem was aware he had high cholesterol. His mother had experienced a sudden heart attack just eight years earlier. Despite this, Prem was not concerned. He was young, fit and lived a healthy lifestyle.
"I didn't know how bad it was," Prem says. "I looked healthy. I biked all the time and ate well. It didn't seem like my risk factor was high."
After his heart attack, Prem and Sangita made an even stronger commitment to making healthy choices. But despite eating all the right foods and taking medication, Prem's cholesterol levels remained high. Because his high cholesterol was genetic, his doctor stressed the importance of telling his siblings to get screened. As Arnav grew older, it occurred to Prem and Sangita that this was something that could affect their son as well.
So at a routine check-up, they asked Arnav's pediatrician about checking his cholesterol levels.
"The doctor looked at Arnav, who played sports and was very active, and said he didn't think it was necessary," remembers Sangita. But then, they told him about Prem and his family history. "That was an important piece of information that his doctor was missing. Once he knew that, he agreed that we should get him checked."
When Arnav's test results came back, his parents were shocked and devastated. At just 8 years old, Arnav had extremely high cholesterol.
"I thought there must be something wrong with the blood test, because there's no way this small child could have cholesterol levels like that," Sangita says. "I felt like I failed."
Arnav's pediatrician referred the family to Sarah Blumenschein, M.D., a pediatric cardiologist at Children's Health℠ and Associate Professor at UT Southwestern who specializes in caring for children with lipid disorders. It was then that Sangita's perspective shifted. "I realized that at least we knew about Arnav's cholesterol now, instead of in 20 years when it was worse," she says.
Turning Arnav's diagnosis into an opportunity
Dr. Blumenschein worked with Arnav and his family to understand and treat his high cholesterol. She often starts her appointments by asking Prem how he's doing.
"We've been so impressed with Dr. Blumenschein," says Sangita. "She spends time talking with Prem because that gives her a better idea about what Arnav might have inherited, and I've not seen many doctors do that."
"Understanding family history is a vital part of heart health," says Dr. Blumenschein. "Arnav is such an important reminder that a child can look completely healthy and still have high cholesterol. Knowledge is power because once this condition is identified, we can make a plan to treat it."
Sangita also appreciates that Dr. Blumenschein listens to her own concerns as a mother. Even though Sangita understood that Arnav's cholesterol was genetic, she still hoped it could be managed with some lifestyle modifications.
"Dr. Blumenschein gave me six months to try other options, but once we saw that there was no improvement, she confirmed it was time to manage Arnav's condition with medication," says Sangita.
Since following Dr. Blumenschein's treatment recommendation, Arnav's cholesterol levels have lowered significantly. He's able to continue his active lifestyle of swimming, playing soccer, competitive archery, and hiking and traveling with his family. Looking toward the future, Arnav and his family feel hope.
"Whenever I see Dr. Blumenschein, I can tell there are so many developments happening, and I am positive that there will be some solutions for genetic conditions like Arnav's," says Sangita.
While Arnav's family does not discount the value in making healthy choices, they hope to raise awareness that with genetic conditions, that's often not enough. Knowing your family history is what could save a life.
"If you've had any family member – a grandmother, uncle, anybody – who had a condition, let your child's pediatrician know so that your child can be checked," Sangita shares. "Otherwise it could be late by the time you know."
The Preventative Cardiology Clinic at Children's Health helps children manage high cholesterol and their risk of heart disease. Learn more about all pediatric cardiology services at the Heart Center.