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Introduction

The first 20 years of my practice (1980 to 2000) were devoted to the diagnosis and treatment of advanced coronary artery disease (CAD) decades after coronary plaques started forming and growing until the disease manifests itself as sudden death, angina or heart attack. Each of these events was caused by the rupture of a coronary plaque that formed and grew silently over the previous 10 years or more but was undetectable by symptoms, EKG or stress testing. There was plenty of time between when the plaques started forming and when one of the plaques suddenly ruptured and caused a life threatening problem - a heart attack and all it consequences.


What if...

What if it is possible to detect these plaques many years before?

Yes, it is possible. A $49, 15 second ultra-fast CT scan of the coronary arteries can do just that.


What if…

What if, after early coronary plaque detection, it is possible to prevent plaque rupture and stop plaques from growing?

Yes, it has been a reality since around 2001, using now mostly generic drugs, not stents and not heart bypass surgeries.


So, why earlier plaque detection and earlier medical treatment?

This approach is a game-changer. If made widely available, it will disrupt the entire cardiovascular healthcare system. No more waiting until a heart attack or stroke happens; no more waiting until stent or heart  bypass is needed. The old and still prevalent approach, while generating hundreds of billions of revenues for the healthcare industry, causes many hundreds of thousands of preventable premature deaths and disabilities in the US alone.  

Just look at the above slide showing the data from the American Heart Association - 580,000 new or first heart attacks every year. These people already have many plaques and high calcium score but just did not know it. Had they known, they would have the option to choose comprehensive medical therapy so they did not have to have a heart attack, not to have a stent or heart bypass.


So, why isn’t this treatment approach more known and more widely  available?

In 2012, there was a federal initiative called The Million Hearts Initiative to prevent 1,000,000 heart attacks and strokes in just five years. It could have succeeded but it did not. Evidence-based prevention has two sides of the same coin - one side is the saving of lives, etc. and lower healthcare cost and the other side is the lost of healthcare revenues from 1,000,000 Americans not having heart attacks and stroke and therefore not needing expensive hospitalizations, procedures, stents and heart bypass surgeries - that is over a $100 billion in 5 years. Hospitals can’t afford to lose that much income and therefore, they are not enthusiastic supporters of large-scale heart attack and stroke prevention.


So, as healthcare consumers, the choice is yours. A heart attack and stroke-free life is your option.

Once you are informed like you are now, you can exercise your option.     

© Rolando deGoma MD 2019     Disclaimer