Could Bernie Sanders Heart Attack Have Been Prevented?

Predicted or Prevented?

• Heart disease is #1 killer of men and women in America.

• In the U.S., someone suffers a heart attack every 30 seconds and dies from one every 60 seconds.

• The first time your doctor knows you have heart disease...is when you present to the ER with a heart attack...and the most likely outome of your heart attack is death." -- from 'Prevention: The Most Important Treatment of Heart Disease'

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

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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