For Dr. Christian G. Schrock’s family Lipoprotein(a) was discovered very suddenly after his oldest son had a heart attack at only 41 years of age. Up until this point they knew nothing about Lp(a) and the dangers it posed. This incident occurred in July of 2016, and he had no known medical problems or previous symptoms that suggested cardiac disease.
It was not a quick diagnosis to figure out that the culprit was Lp(a). The only symptom that raised awareness was mild upper back pain. A Google search turned up results including possible heart attack which prompted him to head to the Emergency Department. The hospital performed several tests which showed no answers as to why a seemingly healthy 41-year-old would be having a heart attack. An EKG was normal, a cardiac exam appeared normal, and blood work came back mostly normal. The blood work showed that a cardiac enzyme called Troponin was slightly elevated. This prompted a cardiac angiogram to look at his heart’s blood vessels.
The angiogram revealed blockage in all three major coronary arteries: 95%, 100%, and 40%. His initial lab studies included a lipid panel with normal levels. (Total cholesterol of 140; anything under 200 is OK.) Two stents were successfully placed and luckily he has no heart damage. He does receive treatment for this.
The question was how did this happen with normal cholesterol levels? The family sent his history, lab studies and angiogram to one of the largest referral centers in the US and the cardiologists could not recommend any additional risk factors or tests to be run. Luckily the immediate family includes three physicians, so they persisted in their quest and had an extended lipid profile done (Cardio IQ through Quest Laboratories) which revealed a lipid called Lipoprotein(a) {Lp(a)} that was 4 times normal. Through this test they also found out that elevated Lp(a) is genetic.
The next step was to have an Lp(a) test done on the parents which established his mother as the carrier with a level 6 times normal. Thankfully, she is healthy and has no cardiovascular disease, established by a CT Angiogram, a CAT scan of the heart.
Subsequently the mother’s five siblings were tested and all have elevated Lipoprotein(a), which is an unusual inheritance pattern. Genetics experts we have spoken with are very interested in understanding this inheritance.
After their son's heart attack in 2016 Dr. Christian G. Schrock retired from his Infections Disease practice and began studying Lipidology, a sub-specialty of Cardiology and has continued nonstop. He now communicates frequently via email with Lipoprotein(a) experts around the world, has given a talk in Russia and published a paper in the European Heart Journal. The Schrock family has a mission to educate American physicians and the public about this unappreciated lipid time bomb being carried by 20% of the world's population.
There are thousands like Dr. Schrock’s son out there and now there are treatments available and more in the pipeline to treat elevated Lp(a). To that end the Schrock family has established a nonprofit 501(c)3 foundation, The Lipoprotein(a) Center and Research Institute {Lp(a)CARE}. The first project is reaching as many members of their family tree to see if the unusual inheritance pattern (100% of the 22 family members tested have elevated Lp(a) rather than the usual 50%) persists. Genetic studies may reveal what the mechanisms might be and why some family members, despite having very high levels, have not had coronary disease. This genetic research may discover additional unknown pathways that block production of Lp(a) which could help in developing more medications to treat this lipid.