Scare tactics

"You're a walking time bomb."

"I can't be responsible for what happens to you."

"Your blockage is in the artery called the 'widow-maker.'"




Familiar lines? These are the well-rehearsed warnings commonly used by cardiologists to persuade a patient to undergo a procedure (heart catheterization and all that follow).

Something happens when you hear these words about your health. Most people's resolve to explore alternatives, get another opinion, think it over, promptly crumbles when they hear these words. These particular warnings have been time-tested and are surprisingly effective.

Unlike many other conditions, heart disease does indeed result in catastrophic events without warning. Unlike, say, cancer, heart disease can wreak damage suddenly. That's all true.

What bothers me is the vigor with which the opportunity for hospital procedures is pursued.

The thinking is that hospitals procedures = saving a life. In the vast majority of people, this is nonsense. Procedures like heart catheterization, stents, bypass, do save lives if someone is in the throes of a catastrophe. The problem is that most people who undergo procedures are not in the midst of catastrophe and have every hope of avoiding it altogether with some simple efforts towards prevention.

Imagine this conversation: "Yes, Mr. Smith, you do have heart disease, Even though you have no symptoms and your stress test is normal, I believe that we should 1) identify the causes of your heart disease, then 2) correct them. Of course, if you don't want to engage in this prevention process, then there may be a point at which heart procedures may be necessary. But I believe that you have great hopes of avoiding them and avoiding heart attack."
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Heart Scan Curiosities #6

Heart Scan Curiosities #6
















This is a "slice" from a normal heart scan in a 58 year old woman. Heart scan score zero. Look at the lungs, the dark areas left and right of the heart in the center. The lungs are also normal. Black represents normal density, healthy lung tissue. The white streaking is just normal lung blood vessels. This person doesn't smoke.


















This woman smokes a pack of cigarettes a day and has done so for 45 years ("45 pack-years"). She had a surprisingly low heart scan score (at age 64) of only 71, despite the smoking. However, look at this woman's lungs. It's a little tough to make out, since the computer graphics loses some of the resolution. But you can see the near absence of lung tissue on both sides. This is an advanced phase of the destructive lung disease, emphysema, from smoking. Even if she quit smoking today, the destroyed lung tissue never grows back. She literally has huge gaps or holes in her lungs where lung tissue used to be.

Smoking is among the most destructive, terrible things you can do to your body, short of swallowing strychnine or jumping off a building. Stay as far the heck away from cigarettes as you possibly can. If you are exposed to "secondary" smoke, insist that the person never smoke in your presence. It's not the smell that destroys your lungs or causes coronary plaque (though it is indeed foul), it's the actual smoke.
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