Michelle Rupp: For today’s catch up on your checkup segment, we are talking all things cardiology. Joining us now is Dr. Andre Paixao from the Arkansas Heart Hospital, who is an interventional cardiologist. Dr. Paixao, thank you so much for joining us today.
Dr. Andre Paixao: Hi Michelle, thanks for having me.
MR: So, I’m curious because some people who see their primary care doctor on an annual basis, by doing that they might think, “oh, my heart is good,” but is that the case?
AP: That’s a complicated question. If you just look at the recommendations from the United States Preventive Task Force, you wouldn’t necessarily be recommended to see a cardiologist unless you have symptoms of heart disease. Most of the tests that even a cardiologist would do for a person who does not have symptoms of heart disease are the things that can be done in a primary care setting. And those will be checking your blood pressure, checking your cholesterol levels, and screening for diabetes, if you have risk factors for diabetes. They would use all this information along with your family history to calculate your 10-year risk for a stroke or a heart attack using widely available tools. You may choose to get some additional testing for people at higher risk, which we can go into later.
The main thing is it’s going to be up to each individual to improve their chances of avoiding a stroke or heart attack. The screening is less important than the lifestyle changes that will probably come out of any discussion with your primary care physician or a cardiologist. So, I would say the average person, without a strong family history of heart disease, who’s not having chest pain or increasing shortness of breath with physical activity, can probably just continue their routine visits with a primary care physician. They can have their cholesterol checked once every five years, have their blood pressure recorded every year, be screened for diabetes. Be mindful of those symptoms. If they develop into something coming from heart disease, they should be referred to a cardiologist.
MR: So, it sounds like having this baseline reading might be the best way to start either a relationship with a cardiologist or just to get an idea of how things stand. You know what you’re working with.
AP: Yeah. And the way I would start this, for someone is in their forties or fifties, have a sit down with your primary care physician. Mention that you worry about your future risk for heart attack. You can even bring up that you heard of this calcium scores screening. That screening can be initiated by a primary care physician or by the patient. There are many facilities like the Heart Hospital that offer this without a doctor’s request. So, you can just call a number and ask for the “Keep the Beat” screening. You want a non-contrasted cat scan like this. You get your number along with an estimate of your future risk. If your score is zero, you probably don’t need to do anything other than maintain a healthy lifestyle. If your number is particularly high, you should see a cardiologist at that point because then you’re someone who will likely benefit from more aggressive upfront treatment.
MR: What a great way to not have a surprise heart attack in the middle of the night. Or a great way to minimize perhaps having a surprise heart attack in the middle of the night because nobody wants that.
AP: Nobody wants that. To add just another thing, another way of thinking that I see in the office sometimes is, “I can live my life however I want as long as I catch a blockage early.” You can’t do that. That doesn’t work. The blockages that cause heart attacks often give you no warning. A stent in a stable blockage will not prevent a heart attack. The only way to minimize the chances of a stroke or heart attack is through hard work – exercising, having a healthy diet, and not smoking. Try to cultivate those healthy habits that will prolong your life. You can’t rely on modern medicine’s ability to keep you from having a heart attack. Only our own choices can do that.
MR: And that has been the theme throughout all the catch up on your checkups. It all goes back to diet and exercise. So, thank you, Dr. Paixao, for reiterating that fact and letting us know some of the valuable tools you have at Arkansas Heart Hospital. Thank you so much for joining us.
AP: Thanks, Michelle, it was a pleasure.