Peter Salgo M.D. - The Heart of the Matter: The Three Key Breakthroughs to Preventing Heart Attacks

THE HEART OF THE MATTER

THE THREE KEY BREAKTHROUGHS TO PREVENTING HEART ATTACKS

Peter Salgo, M.D.
WITH JOE LAYDEN

For Heidi

You changed my book and my life and made them both better

Contents

O ne day the emperor summoned to his palace the most famous doctor in all of China and asked the healer a question: Who is the greatest doctor in our land? No fool this emperor, for here he was, face-to-face with the most famous doctor in his country, but clearly he, the emperor, was able to make the distinction between fame and greatness. So he had asked a very subtle question, perhaps with the hope of tricking the doctor. But the doctor was no fool, either, and he answered as follows:

I see people at deaths door, in their most dire moments. I operate on them, I draw blood from them. Occasionally I bring them back from the brink of death. And I am the most famous doctor in all of China.

At this, the emperor nodded. But I have an older brother, the doctor continued, and my older brother sees people who are not quite as sick. He sees the earliest forms of their illnesses. He is able to intervene before they knock at deaths door, and he saves far more people than I. And he is famous in my village.

Again, the emperor nodded. But I have an older brother still, older than he, the doctor added, and he sees the conditions in our country that make our people sick. He changes these conditions before the people become ill. He has saved millions of lives.

The emperor cocked an eyebrow as the doctor paused. And this man, the oldest of my brothers, is well known in my family, the doctor finally said. So I ask you, Emperor, to tell me: Who is the greatest doctor in all of China?

At this, the emperor merely smiled and nodded.

Chapter One
The Heart of the Matter

S omething new has happened. There is a buzz in the air in medical meetings all across the country. Its a familiar and wonderful feeling. Where we are with heart disease in the year 2003 is the same place we were with infectious diseases just before the discovery of penicillin, where we were with dentistry just before the advent of fluoridation, where we were with polio on the eve of the Salk vaccinewhich is to say, we are on the cusp of an enormous breakthrough. We are about to treat people for heart attack before they get sick. We are about to prevent them from dying. This is the work of the oldest brother in the Chinese parable.

After the widespread introduction of fluoridated water, tooth decay all but disappeared as an American health problem. Im told dental income (for general practitioners, of course) dropped precipitously, and thats why today everyone seems to be an orthodontist. With any luck its going to be the same with cardiac specialists. I run a cardiac surgery intensive care unit (ICU). Follow the program in this book and you can put me out of business. Thats okay. In fact, Id be thrilled. Ive seen enough damage. Ive seen enough people die before their time.

There are two distinct parts to The Heart of the Matter: the premise and the promise.

The premise is this: Nobody has ever fully understood what causes heart attacks. Its surprising but true. And because we didnt understand what caused them, we couldnt really get a handle on how to prevent them. All that has changed radically and recently. The past few years have seen an explosion of research papers and presentations confirming the new heart attack theory. We now know what causes heart attacks. The answer is probably going to surprise you (it certainly surprised most doctors). And because we know what causes them, we know how to protect you from them. I will show you what you need to do. Its an amazingly simple and straightforward program.

Through an astounding stroke of good fortune, our new understanding of heart attacks has occurred at the same time when we have found new medicines that can target the heart attack mechanism precisely and powerfully. Our understanding has also led us to use older medications in new ways, to turn off the heart attack mechanism.

The promise is this: Ours will be the last generation to die of premature heart disease in this country.

Bold talk? Not really. In this book youll find an easily administered self-testso that you can assess your own susceptibility to heart diseaseas well as a formula for beating the disease and a clear, concise explanation for why this formula will work.

To understand how excited I am about this new program, you need to walk a mile in my shoes and see heart disease as I have seen it during my career. By training I am an internist and an anesthesiologist. That makes me an intensivist. My specialty is cardiac care. As a director of the open heart intensive care unit at Columbia Presbyterian Hospital in New York, I witness daily the destruction wrought by heart disease. I see the devastation and debris caused by the major killer known to humankind, and it sickens me.

Each day as I make rounds I see the shattered lives and devastated hopes and dreams of people who are just like you and me. They have wives, husbands, children; they have plans. They have wept at weddings, cheered at football games; they have spilled food on the Thanksgiving tablecloth. Now they are at the brink of death. They depend upon ventilators to breathe. They depend upon powerful medications to circulate their blood. Many will not survive. When people do not take care of themselves, or their bodies malfunction despite their best intentions, I see the sad results: patients who need heart transplants, artificial hearts, open heart surgery; patients who are desperately ill.

I see people like Jose Rodriguez, who told me one day through a weary, postsurgical smile that he now knew what it felt like to have an elephant sit on his chest. Two days later, despite the love of his family and the best efforts of medical science, Jose was dead.

People like Josephine Smith, who showed up in the ICU a few hours after collapsing in the produce aisle of her local A & P. Or Howard Martin, a man in his late forties whose weekly round of golf was interrupted by a massive coronary. Imagine the shock! Youre out on a sun-splashed par five in the middle of the afternoon, and the next thing you know, youre hooked up to a heart-lung bypass machine. Its that traumatic, that disturbing.

I have seen too much of this. I speak to patients, and I hear a familiar story: Everything was fine, and then all of a sudden, I got this pain. I speak to families and I hear it again: He was such an active, vigorous man. Now look at him. I dont know how Im going to get through this.

As I spoke to those patients who could speak, and as I sought to comfort the families of those who might die, I became angry. I didnt know where to direct my anger, at first. It seemed easy to blame the victims. After all, they had smoked or eaten fatty food or rarely exercised. Eventually I realized anger wasnt going to get me anywhere. If I wanted to help my patients, I needed to focus on the real culprit: the disease itself. As I read the latest reports from the labs and went to conferences across the country, I began to see that something was changing rapidly. I saw optimistic news appearing in forums that usually offered only gloom and doom.

The good newsand believe me, there is remarkably good newsis that we now have the ability to prevent you from dying before your time. Am I promising to save your life? Well, yes, in a manner of speaking, although I find that phrase to be a bit misleading, because, ultimately, nobody is savedwe all die someday. But I can assure you that this book will vastly improve the quality of your life and give you many more good years on this beautiful planet. Heard that one before? Maybe so. But Im not talking about some new-age psychobabble designed merely to give you peace of mind, a better outlook on life, and thinner thighs in thirty days. Im talking about extending your life by as much as twenty to thirty years. I can tell you, in good faith and good conscience, there is absolutely no reason for you to die of premature heart disease.