According to the Australian Heart Foundation, 55,000 Australians suffer a heart attack each year. While this event is never planned, cardiologist Dr Warrick Bishop looks at how we could be more aware of our risk. Why not read this short extract from his book – Have You Planned Your Heart Attack?
Let’s avoid the first event …
My objective in this book is to explore how to avoid the first event. When coronary artery disease is diagnosed at the time of the event, the time the patient has chest pain or shortness of breath or a major adverse coronary event, the patient has already developed a ‘disease’. For me, to prevent chest pain or heart attack in the first place, to prevent the development of ‘disease’, is the Holy Grail of preventative cardiology.
Current primary prevention practice is based on risk assessments. I believe this has scope for re-evaluation.
The way we evaluate and calculate risk in individuals is based on observational data. This means that, over the years, databases have been compiled of features and factors found in individuals who have had coronary artery disease. The occurrence of those features and factors then lends weight to their being used as predictors for people before they have an event. Observational data collected from a large number of patients who have had heart attacks indicate that factors such as:
-
increasing age
-
being male
-
cholesterol levels
-
increased blood pressure
-
diabetic status
-
smoking.
All feature as associations of having a possible coronary event. The important thing is that these associations are not necessarily what caused the problem. This means that there can be people who are high-risk based on such factors, yet they will not have an event.
Understanding that our risk evaluation is based on associations and not causations is central to the following discussion. Another significant factor is that today’s CT imaging of the heart offers us an ability to evaluate the health of an individual’s arteries before the onset of a problem. This is a paradigm shift in the conventional management of coronary artery disease. Yet, although cardiac CT imaging has been generally available for the past five to 10 years, it has not yet been broadly taken up.
An exploration of the exciting opportunities that cardiac imaging offers is also crucial to this book. Although formalised guidelines or recommendations do not exist for some of the issues I will cover, I plan to use a logical and systematic approach, based on science that is available today, to discuss the case for a much broader understanding and application of preventative cardiology. Based on this information, I extend a two-fold invitation:
- to patients, to engage their doctors in a meaningful discussion about their heart health and well-being, and
- to doctors, to look into these issues with an open mind, with the best patient outcome as a priority.
It is a win-win situation for everyone.
Published with permission
Have you planned your heart attack?
Dr Warrick Bishop
Distributor: Dennis Jones
RRP: $34.99
Would you like to win one of six copies of Dr Bishop’s Have You Planned Your Heart Attack? Then, simply email [email protected] with the answer to the question below. Don’t forget to include your full name and postal address.
Q. How many Australians have a heart attack each year?
Entries close 19 March 2017
Related articles:
Cardiac arrest or heart attack?
Female heart attacks
