Heart Defects Simplified

12. October 2009 William Davis (0)


For as long as I've known him, echocardiography technologist, Ken Heiden, has had a deep fascination with congenital heart disease. Ken has just written a wonderful book on congenital heart disease called Heart Defects Simplified.

While this is a bit off-topic for the Heart Scan Blog, I know that there is a serious lack of helpful information for people with congenital heart disease and parents of children with congenital heart defects. So I asked Ken to tell us something about his book.



WD: I've reviewed your book and have been thoroughly impressed with the clarity and detail with which you handle a complicated topic. You somehow manage to make it easy to grasp, far more than any other resource I've used in past. Do you feel that your book serves a previously unmet need?

KH: This book serves an unmet need in that it presents the complex subject of congenital heart defects in a simplified manner. Most books on this subject are anywhere from 300-1700 pages in length and tend to be written for doctors. Further, most of these books have very few diagrams, and they rely upon their explanations to describe these defects.

Heart Defects Simplified is 104 pages in length, describes the most common defects, including surgical repairs, in a two-page format with full-color diagrams on the left and complete descriptions on the right of each chapter. The book is particularly written for sonographers, nurses and parents, but it is valuable for anyone interested in this subject. It is particularly useful in clinical situations because it is convenient to lay out at your side with a coil-bound format and durable pages. Further, there are appendixes which include "Surgical Procedures in Alphabetical Order," "Prevalence of Congenital Heart Disease," "Scanning Protocols for Echocardiographers," "Imaging Tips," a glossary and a worksheet for echocardiographers.


WD: I know that many people with loved ones who have congenital heart defects, particularly parents of children with such conditions, are often kept in the dark about the details of the condition. Is your book suitable for the non-technical reader, such as parents?

KH: This book is an excellent resource for parents. It is written in language that is understandable by parents as well as technologists and nurses. The full-color diagrams provide invaluable insight into this very complex world. Most importantly, this book attempts to make the subject of congenital heart defects accessible to anyone who wishes to comprehend this subject.


WD: I understand that people with congenital heart defects and parents are active participants in online discussion groups. Will your book serve as a resource for people who participate in these groups?

KH: This book is not only a resource for sonographers and parents, but the book is accompanied by a blog (HeartDefectsforEveryone.blogspot.com) that attempts to address many of the concerns commonly encountered with congenital heart defects. This blog is a work in progress, but I hope to provide a forum for parents, healthcare personnel, and others to share their questions and concerns about congenital heart disease.
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Why average cholesterol values can be so bad

Why average cholesterol values can be so bad

30. August 2007 William Davis (23)
Jack had been told again and again that there was absolutely nothing wrong with his cholesterol panel. His numbers:

Total cholesterol 198 mg/dl

LDL cholesterol 119 mg/dl--actually below the national average (131 mg/dl).

HDL 48 mg/dl--actually above the average HDL for a male (42 mg/dl).

Triglycerides 153 ng/dl--right at the average.


So his primary care physician was totally stumped when Jack's heart scan revealed a score of 410.


Lipoprotein analysis (NMR) told an entirely different story:

LDL particle number 1880 nmol/l (take off the last digit to generate an approximate real LDL, i.e., 188 mg/dl).

Small LDL 95% of all LDL particles, a very severe pattern.

A severe excess of intermediate-density lipoprotein (218 nmol/l), suggesting that dietary fats are not cleared for 24 hours or so after a meal.

And those were just the major points. In other words, where conventional cholesterol values, or lipids, failed miserably, lipoprotein analysis can shine. The causes for Jack's high heart scan score become immediately apparent, even obvious. Jack's abnormalities are relatively easy to correct--but you have to know if they're present before they can be corrected. A shotgun statin drug approach could only hope to correct a portion of this pattern, but would unquestionably fail to fully correct the pattern.

As I've said before, standard cholesterol testing is a fool's game. You can squeeze a little bit of information out of them, but there's so much more information that can be easily obtained through lipoprotein testing like Jack had.
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Comments (23) -

  • DietKing2

    8/29/2007 9:56:00 PM |

    Doctor,
    Have you ever heard of this?
    I hear you talking about Lp(a) quite alot and I'm not counting on my daily dose of Lipitor to straighten out whatever else might be going on backstage in my bloodstream, you know?
    Let me know what you think.
    Adam
    http://www.thecureforheartdisease.com/pauling/lpatent.html

  • Dr. Davis

    8/30/2007 12:36:00 AM |

    Hi, Adam--

    Yes, we've tried the Rath/Pauling formula informally but have never seen any substantial effect.

    Lipoprotein(a) is a very real phenomenon that clusters in high-risk families with heart disease. The treatment is specific, e.g., niacin, testosterone, and others. However, it must be measured specifically. Be sure to see the extensive conversations on our website, www.trackyourplaque.com.

  • Anonymous

    8/30/2007 2:53:00 AM |

    hello- I am new to your blog and just wondering your opinion on "The South Beach Diet" or what diet/book you recommend.
    I am a 50 year old male on a statin with a calcium score of 2. My lipid numbers are OK now but I really want to get off the statin and am totally confused by all the contradicting diet info out forthe public.Help!

  • Anonymous

    8/30/2007 3:21:00 AM |

    Hi Dr. Davis,

    I joined TrackYourPlaque today and appreciate your insight there.

    The story you relate in this post is incredible really and one I can relate to...

    10 years ago I had a mild heart attack at 43 which led to 3 stents.  5 years ago, just symptoms which got me to the hospital which led to a triple bypass.

    I've met with a lot of doctors, including cardiologists who appear often to know less about what they're doing than I have come to know through research and reading on the internet.

    I guess it's understandable that every adult patient wouldn't get sophisticated lipoprotein subfraction analysis as a matter of course.

    But you'd think that someone in my situation would get sophisticated input.

    My HMO was and is great for emergency conditions and has highly qualified surgeons and facilities.

    But after reading this post, I was struck again by how little informed and significant knowledge about best practice treatment methods one can really get in some HMO contexts.

    I know that I've spent a lot of time doing my own research to learn everything I could ('cause I don't want to die young) and I have to wonder sometimes what happens to folks with issues similar to mine who don't have a research and read orientation or the time to learn enough to protect themselves with preventative measures.

    Mid Life Male in CA
    aka "wccaguy"

  • Dr. Davis

    8/30/2007 11:45:00 AM |

    South Beach Diet is a wonderful program, at least phases 1 and II. Phase III, in my opinion, is too lax by including too much wheat. However, it is an overall solid and healthy diet. Also beware of its over-reliance on processed foods. The best foods for all of us are in the produce aisle, the ones with no labels.

    Our principal website, www.trackyourplaque.com, will also soon be releasing the NEW Track Your Plaque Diet that incorporates many of the concepts discussed here to help achieve control over heart scan scores.

  • Dr. Davis

    8/30/2007 11:50:00 AM |

    Mid Life Male--

    Yes. Lipoprotein testing, in my view, can make or break success in gaining control over your disease.

    Unfortunately, the lack of knowledge in this area is not confined to the HMO's. HMO's are, in fact, poorly represented in Wisconsin, yet ignorance among my colleagues regarding lipoprotein testing and other advanced measures of risk persists outside of the HMO setting. In short, it's everywhere. It's up to us to talk about it and spread the word.

  • Anonymous

    8/30/2007 3:02:00 PM |

    Hello- Greg here- I posted the South beach Diet question- thanks so much for the response. A couple questions:
    - Is your new book coming out actually a book to purchase or part of your membership web-site?
    - Can you tell me when it will be available?
    - I know you don't recommend wheat flour products but can you comment on sprouted grain bread line Eziekiel or similar brands, are these any better in moderation? Or should I just forget about bread entirely?
    - My calcium score was 2. That was about 3 years ago, now at 50 when should I have it done again?
    Thanks!
    Greg

  • Anonymous

    8/30/2007 3:19:00 PM |

    Greg - again- sorry, I might be confused here. My calcium score was 2 is that the same as a heart scan score?
    I am not sure I know the difference.
    Thanks!

  • Anonymous

    8/30/2007 4:11:00 PM |

    Hello- sorry for all  my comments but I just found your site and I am very impressed.
    I did a search for Splenda and didn't come up with much- can you comment on this product and the use of it in your program.I have dessert issues... I did enjoy the ricotta dessert on South Beach but what do you think of jello and the use of Splenda in desserts without wheat!There is so much on the web about the evils of Splenda- who to believe?
    Thanks!
    I really should just become a member I suppose.
    Greg

  • Anonymous

    8/30/2007 6:48:00 PM |

    Another question- do you have any thoughts on Dr. Gott's "No Sugar, No Flour Diet"? He is coming out with a cookbook this December to compliment this book.
    Thanks!
    Greg

  • Dr. Davis

    8/30/2007 8:20:00 PM |

    Sorry, no. I've heard of it but haven't yet read it. I like the title, however!

  • Dr. Davis

    8/30/2007 8:22:00 PM |

    In my experience, I've not witnessed any ill effects from Splenda or Stevia. I have seen plenty of mental cloudiness, however, with aspartame. I still think it's a good idea to keep your sweeteners, natural or synthetic, to a minimum.

  • Dr. Davis

    8/30/2007 8:23:00 PM |

    Yes, a heart scan score and a calcium score are the same thing.

  • Dr. Davis

    8/30/2007 8:26:00 PM |

    The New Track Your Plaque Diet will be a Special Report posted on the www.trackyourplaque.com website sometime in the next few months.

    With a starting score of 2, I would not recommend another scan for 3 to 5 years.

    I actually have a 18-month old loaf of Ezekiel bread in my freezer that I have not yet had a chance to play around with. So, no, sorry, no experience nor much knowledge of this specific product yet.

  • Anonymous

    8/30/2007 8:28:00 PM |

    Thanks for the responses.
    Can you tell me, in general, how often a person should have a heart scan done. As I said my last one was at 48 ( a score of 2)  I am now 50.
    Thanks!
    Sorry if I already asked this.
    Greg

  • Anonymous

    8/30/2007 8:56:00 PM |

    OK- I have been reading many of your posts today and thanks for your patience with my posting enthusiasm... I think I asked the same question twice!
    I have beed struggling for sometime with diet and my physician is no help.
    I did lose on South Beach but gained much of it back.
    I see that you recommend South Beach but as I read your postings it seems you lean toward a vegetarian diet too or am I reading into this.
    By joining the web-site would I get access to recipes and meal plans?
    Thanks for help and patience with the new guy.
    Greg

  • Dr. Davis

    8/30/2007 9:17:00 PM |

    Greg--

    South Beach is a wonderful program. Following a vegetarian diet is a choice, but not a necessary part of doing well on our program.

    Unfortunately, meal programs will not be found on the Track Your Plaque website, just discussion of principles and occasional recipes. We are working towards that, however.

  • Anonymous

    8/30/2007 9:45:00 PM |

    Thanks!
    I think I have been reading too much over the years as I have dealing with higher blood lipids and weight gain.
    The whole vegan/vegetarian crowd can make me nervous - The China Study, Ornish, McDougall, Fuhrman, Esselstyn, Pritikin, etc.... they all say theirs is THE way. I had the nutritionist write me back from the Pritkin Center and say South Beach (in the one study done) showed no decrease in LDL and that it is a horrible diet.
    Also there was an article between Ornish and Agatston in Ornish's column he writes for Newsweek where Dr. Agatston said Ornishes approach was aggressive but perhaps he should offer it to those that want to try it in the future ( I am not quoting correctly but you can google Ornish and Agatston and find the article) It kind of made me feel like he wasn't too proud of his program or maybe he was just trying to appease Ornish.... urrhhh... not sure.
    I know as the public we are really lead down different paths and the more I read the more confused I get.
    Best- Greg

  • Dr. Davis

    8/31/2007 11:33:00 AM |

    I always remind people not to  confuse diets meant to achieve WEIGHT LOSS and diets that correct causes of HEART DISEASE. There is a good deal of overlap but there can be crucial differences.

    The inclusion of abundant grains, for instance, from whole wheat or whole grain bread and breakfast cereals, magnifies undesirable small LDL particles and raises triglycerides, both powerfully related to increased coronary plaque growth.

    We use the heart scan score as our endpoint and guided along the way by lipoprotein patterns. I think this makes us worlds smarter about diet, what works and what doesn't.

  • Anonymous

    8/31/2007 1:32:00 PM |

    Thanks so much for all your help.
    I am wondering if your counsel patients at your clinic- either you or your staff.
    I am near LaCrosse, WI so not that far away. Or is it better just to join your site?
    I did have the LDL test and my particle size were a bit on the small side and as you know I have a calcium score of 2.
    Just wondering about next steps for myself- I know you cannot counsel via this blog, just looking for a general recommendation.
    Thanks!
    Greg

  • Dr. Davis

    8/31/2007 2:14:00 PM |

    Hi, Greg--
    I would suggest using our website.

    In all honesty, I do not do the website work to increase my practice. My practice is already bursting to overflowing. I am confident that the Track Your Plaque website can serve your purposes quite well.

  • Ask A Doctor

    8/13/2009 3:10:50 PM |

    I think that the lipoprotien tests should be included in the standard list for testing Cholesterol.

  • buy jeans

    11/3/2010 8:43:25 PM |

    As I've said before, standard cholesterol testing is a fool's game. You can squeeze a little bit of information out of them, but there's so much more information that can be easily obtained through lipoprotein testing like Jack had.

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Small LDL--a persistent bugger

Small LDL--a persistent bugger

10. November 2006 William Davis (1)
Sometimes, small LDL is easy to get rid of. Take niacin, for instance, and it can simply disappear from your body.

But other times, it can be aggravatingly persistent. Several times every day, in fact, I need to run through the checklist of strategies to reduce small LDL with patients.

How important is small LDL? In my experience, it is among the most potent causes behind coronary plaque known. It's a big part of the explanation why some people at an LDL of cholesterol of X mg/dl will have heart disease, while others with the same X mg/dl of LDL will not. When present, small LDL particles are much more likely to trigger atherosclerotic plaque formation. Small LDL particles magnify Lp(a)'s ill-effects tremendously. The data vary but small LDL probably increases heart attack risk at least three-fold.



Here's a checklist of strategies that I advise patients to consider to minimize the small LDL pattern:


--Lose weight to ideal weight--This is very important and effective.


--Fish oil--A relatively small effect unless triglycerides are high to begin with.




--Reduction of wheat products--This can provide a BIG effect. More precisely, a reduction in high-glycemic index foods is effective. But the biggest day-to-day high-glycemic food culprits are wheat products like breads, pasta, crackers, chips, pretzels, and breakfast cereals. "You mean whole wheat bread makes small LDL?!" Yup.


--Reduction of sweets--For the same reasons as reducing wheat products.


--Add raw almonds and walnuts--1/4 to 1/2 cup per day.




--Replace wheat products with OAT products, especially oat bran. This does NOT mean oat-containing breakfast cereals with added sugar and wheat, e.g., Honey Nut Cheerios, Cracklin' Oat Bran Cereal, etc. You might as well eat candy. Buy oat bran as plain oat bran--nothing added. Use it as a hot cereal or added to yogurt, "breading" for chicken, etc.




--Vitamin D--A variable effect, likely resulting from its beneficial effects on "insulin resistance".


--Exercise


--Niacin--Very effective but not always enough.


Among the choices, my favorites are weight loss, niacin, and reduction of wheat products. Those will give you the biggest bang for your buck.
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Comments (1) -

  • Cindy

    11/24/2006 5:04:00 AM |

    I've read that excessive carbohydrates in general are linked to small LDL and that those following a low carb diet, or reduce carbs below a certain level will not have small particle LDL, but will instead produce large fluffy LDL.

    Is this true? Is there an "optimal" level"? And do you feel that the large, fulffy LDL are less dangerous?

    I've also read that if Triglycerides are below a certain leve, this pretty much ensures the LDL we produce will be large particles. Thoughts?

    Thanks!!

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