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Could Bernie Sanders Heart Attack Have Been Prevented?

  • Gregg M. Yamada, MD FACC
  • Jan 1, 2020
  • 3 min read

Predicted or Prevented?

Bernie Sander's heart attack could have been predicted and also prevented.


The Preventive Paradox In Amercia: Preventive Cardiac Testing is Not Supported by Medicare or Private Insurance

  • Ironically, Senator Bernie Sander's Bill 'Medicare-for-All' will not cover cardiac preventive testing. Be aware that I am a staunch supporter of Medicare-for-All. However, Medicare still does not pay for a simple test known as a calcium score which determines if you have heart blockages. I have been an advocate of the calcium score for over 24 years since I started practicing cardiology in Hawaii.

  • For patients with risk factors for coronary artery disease such as HTN, hypercholesterolemia, diabetes, smoking, family history, a simple calcium score will determine your future risk of suffering a heart attack.

  • The 2018 AHA/ACC Cholesterol Management Guidelines advocate using the calcium score to determine statin use.

  • A calcium score costs around $200 dollars in Hawaii, but only around $70 dollars on the mainland. It may or may not be covered by insurance so be ready to cover this cost yourself. It is worth it!

The Calcium Score: An Old, But Useful Test

  • The calcium score is a decades old test which simply determines the presence of absence of heart disease.

  • It is superior to cholesterol lab tests, CIMT, LDL subfractionation.

  • There are far better tests than a calcium score, but it is inexpensive and very easy to do.

Who Typically Gets A Calcium Score?

  • Presidents of the United States, CEOs, the top 10 earners of any large company, the super-rich, VIPs...people like Bernie Sanders.

  • This is because the 'key man (or woman)' in a business cannot suffer a debilitating illness as Bernie Sanders just did.

  • So the difference between the average person and the richest person in the country is $70 dollars? Sadly...yes.

Cardiac Prevention for the Asymptomatic Patient

  • For Men over 45 and Women over 50 with intermediate pre-test likelihood for CAD perform a calcium score. A calcium score is not for patients with bypass surgery, stents, younger patients, or those who are at low risk for CAD.

  • If the calcium score is >0, be referred to a cardiologist.

  • Follow the recommendations I outlined for cholesterol management.

  • The very same stratification tools used to determine if you require a statin are the basis of preventive evaluations.

Summary:

  • If Bernie Sanders had performed a calcium score last year, a stress test would have been performed, and his stents placed electively.

  • His cardiologist would have aggressively lowered his risk factors and performed more frequent surveillance testing.

  • If Bernie had performed a calcium score 20 years ago, he would not have needed coronary stents or suffered an MI.

More Info:

  • To learn more about the benefits of a calcium score, read any of the attached links.

  • To learn more about why Americans do not do more to prevent heart disease, read my book.


Stay Healthy!


Gregg M. Yamada MD FACC


Disclaimer: I hope you find my medical blogs to be educational, pertinent, interesting, and thought provoking. The information provided is educational and should not be taken as medical advice. I am a doctor, but I am not your doctor. Please schedule an appointment with your doctor to discuss these issues and to determine what is right for you.


© 2019. Gregg M. Yamada, MD FACC. All rights reserved


 
 
 

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© 2019 Gregg Yamada MD FACC. All rights reserved.

Disclaimer: This website and my statements are educational only and not intended as medical recommendations or advice for any specific patient or a specific condition. I am a cardiologist, but I am not your cardiologist. You must discuss with your personal cardiologist if information you obtain is pertinent to your specific condition and situation. Never begin a diet or exercise program, or change/modify/discontinue any therapy or treatment without the approval of your personal physician. I do not endorse the products or services advertised on this website.

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