“Of the patients in our practice who have followed Dr. Gaskill’s cardiovascular prevention methods none have had a heart attack or stroke in almost 11 years. This is the first day of the rest of your life, so seize the opportunity to prevent a disaster!"
A personalized treatment strategy for Johns Creek patients for heart attack prevention based on each patient’s lifestyle, and physical measures including genetic and inflammatory markers from the blood.
Let’s face it, there is a real problem in our country with prevention of cardiovascular disease. In fact, heart disease is the number one cause of death in our country. Yes, it is true that as individuals we need to be more diligent about healthy lifestyles including exercise and eating right. However, how does one explain the incidents which are realistically represented in the following examples:
A 41 Year Old Marathon Runner
Joe S. who was 41, a marathon runner, vegetarian, non diabetic, great blood pressure, excellent weight, normal EKG, non smoker, no alcohol, no drugs, with a low cholesterol, and no family history of diabetes, heart attack, or stroke, and who just recently had a normal nuclear cardiac stress test and suddenly dropped dead of a massive heart attack while out walking his dog?
Clearly there must be other key pieces of information for heart attack prevention that were not detected in this individual. Well, you say, he didn’t even have any genetic or family history of this kind of event, ..so what’s up?
Well, your original assumption was not necessarily true. Just because there was no family history of cardiovascular disease known for 25+ generations back, does not mean there is no genetic risk. We have, and have had genetic and inflammatory markers that can be detected despite no known family history. As a result, we can help protect patients from their genetic risks!
So, Joe S. could have been a picture of health, but he may have carried one of the very risky cardiac genes detected in blood! Wouldn’t you rather find this out about yourself, your wife, your husband, dad, mom etc., BEFORE you get that call from the emergency room? If not, then that call may well go something like this: I am sorry, Mrs. S., but you need to come to the hospital ASAP. Your husband has suffered a severe heart attack, and we do not know if he will survive. It happens every single day….
33 Year Old Daily Tennis Player
Let’s consider Miss Mary J., a 32 year old, healthy, daily tennis player in excellent condition. She had all the normal tests above except the stress test. However, she did have a normal Doppler study of her carotid arteries at her church fair that indicated her carotid arteries were completely normal indicating her stroke risk was as low as possible.
So, you talk to Mary on Monday, and two days later you call her house only to find out from her Mom that Mary is in the ICU having suffered a severe debilitating stroke. “We think she will live”, says her mom, “but the doctor doesn’t think her mental status will ever return to normal. She will not be able to walk, talk, or feed herself. She will need diapers for the rest of her life. She will likely have some partial movement of the right side of her body.”
Doppler Carotid Artery Scan
Tragic! So you think, Wait a minute. I thought all her tests were normal, including her Doppler carotid artery scan /screen for stroke. Yes, you thought exactly right. Remember this: her carotid Doppler ultrasound was normal. People have strokes with completely normal carotid Doppler duplex ultrasounds. Does this mean that the carotid Doppler ultrasound is a bad test? No. It is not a bad test.
Coronary Calcium ScoreHmm, Have you ever heard about the most vulnerable plaque, the soft plaque, and what we know about it? What are the best ways to look for soft plaque? These are some critical pieces of information that we can discuss with you. In fact, Tim Russert, the well known news moderator from Meet the Press, died from ruptured plaque that resulted in a clot causing his heart attack. How can we go about detecting your risks of developing plaque, and your soft plaque in particular? All plaque is dangerous. Soft plaque is REALLY dangerous!
The coronary calcium score (EBCT), detects your “hard” or “calcified” plaque. “But wait”, you think, “I thought you just told me that the ‘soft’ is very dangerous and the most vulnerable plaque”. Your thoughts were correct.The calcium score test (EBCT) tells you nothing about soft plaque. Does this mean it is a bad test. No. But, a normal coronary calcium score does not mean that you may not still have cardiovascular risks.
Now, back to Mary J: There are, some very important pieces of information missing on this lady in terms of her stroke risk and heart attack risks. Many of the traditionally used tests do not really give a patient’s overall risk assessment. What about her genetic risks? What about her CIMT ultrasound? Is the CIMT a new test? No! Are all the genetic markers new tests? No. Is it always necessary to have a complete carotid duplex Doppler, a CIMT, cardiac stress test, and a coronary calcium score? NO!