Doctor’s Tip: We doctors can/should do a better job of heart attack prevention
Enjoy Optimal Health
What: PowerPoint presentation
Who: Dr. Greg Feinsinger
When: 6:30 p.m. Thursday, Feb. 28
Where: Compass Peak Imaging, 120 Midland Ave. #260, Glenwood Springs
February is heart month, and this is the fourth and final column about heart attack prevention.
Here’s a true story by MSNBC correspondent Trymaine Lee, printed in the Sunday Review section of the New York Times on Jan. 20, titled “Life After a Heart Attack at Age 38.” The author was a nonsmoking former high school athlete, with allegedly normal cholesterol and blood pressure, no diabetes, and no family history of heart disease. At yearly checkups no mention was ever made of heart disease — but on the other hand it was not screened for. A year and a half ago, Trymaine developed mild chest pain for a day and a half, and when he also developed dizziness he went to a clinic. A practitioner performed an EKG and told him that it showed he had mild enlargement of the left side of his heart, but that otherwise his heart was fine and that he shouldn’t worry — the discomfort was probably just due to gas (note that a single normal EKG does not rule out a pending heart attack). Two days later he was awakened early in the morning by severe chest pressure, associated with nausea, sweating and dizziness. These symptoms subsequently lessened, and because he had been reassured his heart was OK he delayed going to the hospital for six hours. He finely ended up in a hospital and was told he was having a heart attack. An interventional cardiologist found a complete blockage of his LAD (main coronary artery), and two stents opened the blockage and saved his heart muscle and his life. Now, 18 months later, Trymaine is experiencing PTSD.
This is a lucky man, in that 20 percent of heart attacks result in sudden death. The positive lesson from this story is that modern, high-tech medicine can save the lives of people in the throes of an acute heart attack. We’re fortunate that Heart and Vascular at Valley View Hospital has this capability.
However, this story also illustrates several problems with our health care system, which we can and should correct:
• We don’t have a health care system but rather a disease management system — we wait until diseases occur and then spend lots of money and effort trying to manage them. This results in many needless deaths as well as needless disability (e.g. strokes — which are usually preventable — are the main cause of long-term disability).
• If this patient were plant-based all his life, he never would have developed heart disease.
• Screening for atherosclerosis, such as by carotid IMT, would have most likely have been positive, and appropriate treatment would have stabilized and even reversed his disease.
• The first provider made a potentially fatal misdiagnosis and should have been more thorough. Diagnostic errors are one of the reasons that the third most common cause of death in the U.S. (after heart attacks and cancer) is complications from our medical system. Just because a patient who presents with chest pain is a woman or young (as in this case) doesn’t mean the pain couldn’t be from heart disease.
• This patient had been told for years on routine exams that he was healthy when he really wasn’t. The plaque in his coronary artery didn’t suddenly appear out of nowhere, but no doubt started to develop years before. There’s always a reason someone develops atherosclerosis, whether it’s the standard American diet; pre-diabetes or diabetes — both underdiagnosed; hypertension (was his blood pressure really normal — less than 120/80?); dyslipidemia (patients are often told their cholesterol is fine if their LDL (bad cholesterol) is normal, even if they have low HDL (good cholesterol) and/or high triglycerides; chronic inflammation from something like rheumatoid arthritis or dental disease; or other issues such as sleep apnea.
• The PTSD this patient is currently experiencing is common after near-death experiences like this. Too often people who have heart attacks are not given the tools to prevent another one, leaving them feeling scared and helpless. Heart disease tends to be looked at as a plumbing problem, with blockages that need to be fixed, instead of a medical disease that can be prevented, stabilized and reversed through lifestyle changes and programs such as the Bale-Doneen Method of heart attack prevention (authors of “Beat the Heart Attack Gene”).
Almost all of the of the 805,000 heart attacks that American’s suffer from every year are preventable. That’s not going to change unless medical education and our health care system focus more on prevention and nutrition.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and other medical issues. Call 970-379-5718 for an appointment. For questions about his columns, email him at firstname.lastname@example.org.