My grandfather, who had a great sense of humor, had heart disease and was a frequent visitor to the cardiologist office.  One day we were sitting in the cardiologist's waiting room and I was reading an article on doctors that get sued for malpractice.  In it was a list of doctors more likely to be sued and those not.  Leading the list of doctors least likely to be sued for malpractice was cardiologist.  I pointed this out and granddads response was, "That's because cardiologists are better at burying their mistakes."

I'm guessing the best way to make cardiologists change their ways is by using the court system - unfortunately.  Just a few weeks ago I encouraged my mom to talk to her long time friend about doing that.  The friend’s father was on a hunting trip when he experienced chest pains.  He was rushed out of the woods to his hospital.  Cardiologists performed tests and everything came back normal.  No measures were taken.  A few weeks later the guy died from a heart attack.  As I told mom, a simple CT scan would have shown he had plaque and needed to immediately take preventive measures.  With all that is known now about detection and prevention it was criminal what was done and not done to that man.

It's sad and unfortunate, but sometimes your hand is forced. I agree: Legal action in selected cases may be necessary to obtain justice and raise public awareness of the magnitude of this wrongful activity.

Dear Dr Davis; I enjoy your column...  my question is this; I lap swim three days a week. I consider it to be a every other day stress test. i can certainly tell rapidly what foods are not good for: Red meat, butter, ice cream, shrimp, those are the biggys. Certainly the other meats that i eat have cholesterol; why dont they bother me? Ive had friends that swim relate the same to me: Beef and dairy is OUT.

Hi Dr. Davis,

Speaking of prevention - at what age should we start thinking about getting a CT Heart Scan? Also, would the scan show if there were heart problems other than plaque build-up?

Thanks!

I'm a 45 yr old female with diabetes, but no history of heart disease in my family even in the other diabetics.  Obviously, I didn't die from my heart attack in May, but...

I went to the ER complaining of recurrent chest pain, got an EKG and blood work, and was sent home with an antacid for my "heartburn."

A couple days later, after vomiting and screaming off-and-on for a couple hours at a time all night, my husband took me back to the ER.  He carefully explained we already *knew* it wasn't a heart attack, but something is really wrong here - he had to speak for me because I could neither walk nor speak when we went to the ER the second time.  

This time, I was transported to another hospital for an emergency angio and subsequent bypass for my so-called "heartburn."  

Pretty amazing that I developed a heart condition requiring two surgeries two days after I didn't have a heart condition, eh?

I remember being really terrified when the surgeon told me there was a 5% chance of dying during the bypass.  She thought I misunderstood, that a 95% chance of living was good, but no... 5% *is* BAD.  I don't normally do things that have a one in twenty chance of killing me!  

It was much later at home learning about heart disease that I discovered I'd had a 50% chance of dying just from the heart attack itself; sudden death is the first symptom in half of the folks with heart disease.  

I'm a very lucky chick that my husband isn't currently suing someone for letting me die.

As the holiday approaches here in the states, I was asked what I am thankful for.  This year, just being alive at all qualifies as something I have profound gratitude for.

You are a survivor of a flawed system. To me, even worse than the mis-diagnosis of the ER, is why wasn't your heart disease diagnosed during the DECADE before your heart attack?

Have you looked at Jenny Ruhl's wonderful Diabetes Update Blog and the associated website? It provides interesting commentary on diabetes, with intelligent nutritional commentary that flies in the face of the idiocy coming from the American Diabetes Association.

Summersam--I wonder if you are just among the people who struggle with digestion of fats, regardless of type.

Paul-Men, 40 and over, women 50 and over, earlier if an outstanding source of risk is present. For other abnormalities seen on heart scans, please refer to my Heart Scan Curiosities posts on this Blog.

can you please comment on the latest study out that says the Ornish diet is best for hesrt disease. I think it ranked south beach and atkins very low. I know Dr. Ornish has a new book out soon "The Spectrum Diet" these findings were presented at the AHA.
Thoughts?

The study I believe you are referring to was a University of Massachusetts rating system, not truly a study. They simply gave grades of presumed health factors, using the so-called "Alternate Healthy Eating Index (AHEI)" that ranks fiber content and other healthy ingredients. It was NOT a real world comparison of diets, nor did it study effects on heart disease. In other words, it was just a speculative discussion.

Dr. Mike Eades blogged about the anti-Atkins poster presentation here:
http://www.proteinpower.com/drmike/2007/11/06/does-the-atkins-diet-damage-blood-vessels/

and here: http://www.proteinpower.com/drmike/2007/11/08/more-on-the-low-carb-study-at-the-aha-meeting/

And I agree, Dr. Davis, Jenny's site and blog (and her previous sites and Usenet posts) are a great resource for diabetics.

I had 2 CABG and have researched like crazy. Conclusions: we still don't know much. Cytokines & etc. from stress can be lethal regardless. 256 slice CT scan is best test but only one machine in USA. VAP combined with LIPOPRINT best blood tests. Antioxidants understudied. Mainstream medicine is mercenary, more concerned with profit that healing.

Hi, Richard--

I'm afraid you are right. However, I do believe that we still do know a fair amount. I would encourage you to read prior Heart Scan Blog posts, along with the www.trackyourplaque.com website. Our philosophy is that heart disease can be halted or reversed in most people (not all). While not perfect, it is the best approach I am aware of. It is certainly better than the "take Lipitor and pray" mentality of conventional, "mercenary," medicine.

I am not a fan of any drugs, and as a result, I change primary care physician regularly, usually after two visits.
ON THE FIRST VISIT, I explain to the new doctor that I do not, and will not, take prescription medications. I explain that the only reason I am in their office is to get orders for lab work, so that I can review the results and make my own decisions about lifestyle changes, especially diet. The doctor then calls me" non-compliant" and prints numerous computer-generated prescriptions anyway. Obviously, it is the doctor who is non-compliant, since I have already said I do not want drugs.
ON THE SECOND VISIT, the doctor asks, "Have you been taking your medications as ordered?" When I tell the doctor again, as I did at the first visit, that I do not take medications, the doctor says, "You're crazy and suicidal." I then find the next doctor, and the cycle starts over.
As I see things, I have two choices when I feel ill:
1. I could attack my body with some bizarre BigPharma chemicals that our ancestors' bodies have never dealt with in millions of years of evolution (Oxycodone, hydrocodone? Really? Are doctors nuts?).
2. Or I could get out of the way and let my body heal itself as has been done over many millions of years of evolution. All I want to do is support that process by making sure to give my body the proper nutrition in the form of the appropriate whole foods.

Wow, Jim. Creepy.

Don't despair: I'm confident that you will eventually find a healthcare practitioner who will act as your advocate, not a provider of drugs. It may take, unfortunately, going through quite a few practitioners before you come on such a person.

Great post. I am starting to think there are two kinds of people - those who seek drugs and those who run from them. LOL.
Among other occupations, I am an OR nurse. I have been wined and dined by the best reps ever, to buy their wares for surgery. It's all about the money.The drug companies have a lot to lose if we all quit taking their meds. Which is exactly what I want to do. I do not want to be a slave to a diagnosis and accompanying pill bottle. I want to be freeeeee.
This is not to say there is a time and place for medicine. There IS. But not for every sniffle.

Boy Suze, I can relate!  I'm a nurse as well and spent lots of years in NICU, but a change to chemical dependancy/psych was eye opening and downright disgusting in the amount of meds handed out.

I used to ask patients if they were hungry when dispensing a 6oz. Cup FULL of various pills before breakfast!
Couldn't take it and quit. Couldn't be a party to pharm management over real therapy.  I also take as few pills as possible, especially antibiotics.

Hi Doc,

I just visited my parents, and my mom shared her recent blood work with me.
Her cholesterol was a mere 210, and her doc (general practitioner), put her on a statin !!!
I told her about your blog a bit and particle size, but of course she's hesitant since her doctor obviously has more credibility than me.

Outside of eating better, what next steps should I advise her to take?  She agreed to request a cholesterol particle size test (is there an official name for this?).

Yes, N: Lipoprotein testing, such as NMR Lipoprofile or Atherotech VAP.

It really shouldn't be that tough, but we are battling the incredible ignorance in the primary care community who is spread too thin to master any one area.