Jul 03, 2008
The untimely and unfortunate death of NBC Meet The Press moderator and political analyst revealed an important fact.
Our ability to predict fatal heart attacks is at best an "evolving science". While the US is widely believed to be at the forefront of technology for developed countries, much room for improvement exists.
The problem is that even the current gold standard of cardiac catheterization falls short of identifying everyone who subsequently progresses to have a heart attack. Thats because of plaque rupture. Plaques, caused by cholesterol buildup, may lie dormant and not cause a problem until the previously stable plaque becomes unstable and ruptures.
What causes a plaque to become unstable is not completely understood. Furthermore, our ability to predict and identify the unstable plaques are limited. Take for instance, angiography or cardiac cath which demonstrates the degree of narrowing within the coronary artery. Unfortunately, this degree of narrowing does not necessarily correlate with the chance of plaque rupture. In fact, a mild narrowing can rupture and cause immediate inadequacy of the oxygen to the heart muscle.
Take a look at the NY times article below. It really provides the sobering picture of a man who battled with high blood pressure and cholesterol elevation. Despite having apparently the best physicians and medicine that we can hope to provide, he succumbed to heart disease.
Science still has a way to go to identify the vulnerable plaque. There are ways of predicting unstable plaque in the carotid vessel which causes stroke. Perhaps someday, this technology will be improved and applied to the heart which is more difficult to image deep within the chest an in motion
For right now, I think the most reliable method of individual prevention is on the front end with what you eat, how you exercise, eliminating stress and other behavioral strategies to decrease your risk of getting heart disease
The article also raises the question of the role of the heart scan, CT angiogram or calcium scoring. Ill talk about this topic again in a later blog
To learn more about Russert's pre existing medical condition including autopsy findings, click and paste