Meghan Markle's father allegedly skipping the royal wedding to have heart surgery

Meghan Markle’s father will not attend the royal wedding after all, because he’s undergoing a heart procedure.

On Tuesday, Thomas Markle, 73, told TMZ he’s having heart surgery at 7:30 a.m. Wednesday to repair his heart from a previous attack that did “significant damage,” adding, “They [doctors] will go in and clear blockage, repair damage and put a stent where it is needed.”

Thomas broke the news only hours after telling TMZ, “I hate the idea of missing one of the greatest moments in history and walking my daughter down the aisle.” On Monday, he also told the website he was experiencing chest pains and had been “popping Valium for the pain.”

Over the past week, the health of Thomas —and the status of his wedding RSVP — has been confusing.

After the Daily Mail revealed on Saturday that Meghan’s dad had staged paparazzi photos of him viewing images of Meghan and fiancé Prince Harry at an internet cafe (an event that reportedly made the queen “very angry”), Thomas revealed that he suffered a heart attack six days earlier and was skipping the nuptials to avoid causing his daughter further embarrassment.

On Tuesday, Meghan’s half sister, Samantha Markle, told the television show Good Morning Britain that her father was facing “unbelievable” stress from being thrust into the spotlight.

Here’s a primer on Thomas’s health:

A heart attack can occur due to physiological and emotional factors.

Heart attacks usually occur when the blood vessels that pump blood into the heart thicken from plaque that eventually ruptures, forming a clot. While a person of any age can experience a heart attack, they’re more common among older men: Most men who have a heart attack have their first one at age 65.

Stress, like what is affecting Thomas Markle, is also a factor. According to Steven Gundry, heart surgeon and cardiologist and author of The Plant Paradox, an intense emotional state can cause blood pressure to spike (which can harm the heart) or trigger unhealthy eating and drinking habits that can damage the heart or blood vessels.

Cholesterol as a heart attack trigger is debatable.

Gundry says “50 percent of people presenting with a heart attack or acute coronary syndrome (a pre-heart attack) have normal levels of cholesterol [a fatty substance the body requires to build cells]. It’s a bit of a myth that too much cholesterol causes heart attacks.”

Popping Valium wasn’t helping Thomas’s health.

Valium, a drug in the benzodiazepine family, is typically used to treat seizures and anxiety and, according to Gundry, Thomas was likely masking his chest pain, not eradicating it. “The rule of thumb is, if you feel chest pains, chew on an aspirin to thin the blood rapidly.”

Calling Thomas’s procedure “heart surgery” may be a stretch.

According to TMZ, doctors will insert tubes called stents (“Think of them as scaffolding,” says Gundry) in Thomas’s body to reopen the blood vessels. The stents, which aren’t typically used during open-heart surgery, remain in the body to keep arteries from narrowing again.

Thomas can help prevent another heart attack.

Avoiding smoking, stress, and trans fats (those found in fried or processed food) and sticking to a regular exercise regime will help stave off future heart attacks.

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