Heart Care – Expert Advice From a Surgeon

How to stay out of my Operating room (by a heart surgeon)

Heart disease is the leading cause of death for both men and women in the US, with one in four deaths attributed to it.

The culprit, generally, is coronary artery disease, in which plaque builds up in your arteries, blocking blood supply to this most vital organ. It can cause heart attack, heart failure and arrhythmias.

Aside from being deadly, coronary heart disease was projected to have cost the country more than $108 billion in 2010. This includes the cost of health-care services, medication and lost productivity.

Imminent Threat

Who’s most at risk for a heart attack? Those of us with high blood pressure, diabetes, high cholesterol or a smoking habit, and those of us who are obese.

Unfortunately, more than 90 percent of Americans are not as healthy as they could be, according to a paper published in Circulation, a journal of the American Heart Association.

When many Americans go to the doctor, they get a standard physical exam without tests to check their hemoglobin A1c and their fasting glucose, which can reveal whether they have diabetes. Also overlooked, oftentimes, are blood-pressure readings that are taken on three separate visits, which can reveal hypertension, or even fasting blood tests to assess the ratio of good cholesterol to bad cholesterol.

Most patients sitting in the doctor’s office are obese and yet have never had their body mass index calculated nor had it explained to them.

In our office, we do the belly-button check. If you can’t see it, then yes you are overweight. Belly fat is worse than any other fat on your body because it indicates fat around your vital organs.

Smoking is obviously a problem, and it’s also something that people tend to lie to themselves about. So when patients tell me they smoke half a pack a day, I round it up to a pack a day.

In all fairness, patients can’t be blamed for not knowing their true health status. Unfortunately, most doctor visits are targeted to a patient’s complaint. For example, someone who has come in complaining of a sinus problem will be treated for a sinus problem and will not be risk-stratified for heart disease, even though he or she may be obese or may smoke.

There are numerous reasons people don’t get a comprehensive evaluation, such as insurance coverage, time constraints and reimbursement. ...
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by Moses DeGraft-Johnson, MD




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