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Welcome to Doctor Warrick’s Podcast Channel.

Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, and welcome to my consulting room. My name is Dr. Warrick Bishop. And thank you for joining me. Today I’d like to cover what is an angiogram. Well very simply ‘angio’ means vessel or blood vessel and ‘gram’ means picture. So an angiogram simply means a blood vessel picture. Historically the only way we’ve been able to take and you grams in a living person is by passing a tube – a small thin tube which we can squirt dye down into the arteries of the heart and take a picture. We can do that by accessing the circulation. From a puncture in the leg. Or a puncture in the arm, most commonly in the wrist. We pass that thin tube towards the body; towards the heart and engage the origin or the beginnings of the coronary arteries as they arise just above the aortic valve. We squirt dye directly into them while the patient’s still awake. And we take images by an X-ray camera that shoots X-rays through at the time that we inject the contrast. We then move that camera around so they’re able to obtain different views from different angles of the blood vessels. This is called an invasive coronary angiogram. However, for many years because it is the only way we could look at the coronary arteries, it’s just been called an angiogram or Coronary Angiogram. It gives us very good pictures. So it’s a very precise test at seeing exactly what’s going on with the arteries. But it isn’t without risk.

We do have to stick a tube into an artery. That artery can bleed. As we pass our catheter; our small tubes up towards the heart; we can damage the blood vessels along the way, and so we can almost damage any of the blood vessels between the puncture site. And the origin of the artery that we’re injecting contrast into. So when I ask the patient for consent, I let them know that we see a complication rate of about one in two thousand of a major adverse event which can include things such as damage to the heart blood vessels. This would be a heart attack and it can cause death. We can damage the blood vessels going to the brain. This can cause stroke or blindness. We can damage the blood vessels going to the gut the kidneys, and of course, at the puncture site, the artery can be damaged.

So, an invasive coronary angiogram is a great test for getting great pictures and seeing what we may or may not be able to do with the coronary arteries in the setting if someone who has symptoms and clear evidence or other from other sources that they need to have their arteries evaluated. However, it isn’t a test without risk.

In more recent times, there is another way we can get an angiogram of the coronary arteries. In more recent times, our CT technology or CAT scan technology has improved, and a CAT scan has a rotating array of X-ray cameras that spin around the body, take a set of images, and then step to one side to take another set of images and stitch those images together. The CAT scan generates three-dimensional images. The CAT scan takes the pictures of the coronary arteries after an injection of contrast into the vein of the arm of the patient. So we wait about 10 to 15 seconds for that contrast bolus to go from the arm to travel back to the heart to the right side of the heart out to the lungs back to the heart and out through the arteries. And this is when we take a picture.

The CT coronary angiogram doesn’t give us as precise images as the invasive angiogram, as you would imagine. It’s not directly in the artery when we squirt the contrast in, but it does give us pretty good images. It’s a much safer test with a risk of about 1 in 200000 have a severe adverse complication. This means the risks of things like stroke or heart attack or damage to blood vessels are much much much much less likely. So. Angiogram means picture.

There are two types of angiograms. One is the invasive coronary angiogram and the other is the CT coronary angiogram. Your doctor or cardiologist will know which is the most appropriate test to do in your situation, but as a general rule, a CT angiogram is a great way to get an idea as to whether there’s a problem there or not. And an invasive coronary angiogram is a great way to get even more information and detail if we suspect there’s a problem and we’re looking to do something further. I hope you’ve enjoyed this little piece on angiograms. I hope it makes sense and as always I wish you good health. Thank you for joining me.

You have been listening to another podcast from Dr. Warrick. Visit his website at www.drwarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.

Check out my book at http://drwarrickbishop.com/books/

Listen to Audio:

Welcome to Doctor Warrick’s Podcast Channel.

Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, I’m Dr. Warrick Bishop and welcome to my consulting room. Today I’d like to talk a little bit more about atrial fibrillation and one of the things that people often ask is “who gets it?.” Well, men and women get it. Men – probably slightly more if you look at the numbers. Women interestingly when they suffer the condition run a higher risk of complication. So although there are more men in numbers actually suffer with atrial fibrillation, women have a higher rate of complication and therefore are impacted equally. This is particularly the case as people get older because one of the things that we see with atrial fibrillation is an increasing incidence of the condition as people age. We do see a genetic predisposition and there are certain families where a genetic link can have a significant up regulation of the likelihood of someone within their family developing that condition. This is not the most common situation but it certainly is important to be aware of. When we think about the things that are likely to increase the likelihood of atrial fibrillation, then we can think of “aetiologies” or causes that impact the structure and function of the atrium, the top chamber f the heart. Simple things like high blood pressure where the back pressure has a stretching effect on the atrium, over time will change the shape of the atrium and by changing the shape of the atrium, increase the likelihood of developing an abnormal rhythm within. The change of shape is often associated with scarring – microscopic scarring nonetheless but scarring that affects the way that electricity flows through the atrium and again starts to push that risk of developing atrial fibrillation up.

So age, with a little bit of micro scarring, general wear and tear with time, high blood pressure leading to pressures affecting the atrium. The valves being abnormal can also have an effect on the pressures within the heart and so abnormality of the valves and how they work can lead to back pressures that again impact on the atrium and therefore the structure and subsequently the function. Of course things like cardiac failure or abnormality if the muscle of the heart can also be implicated and associated with an increased likelihood of developing atrial fibrillation. We can also think of things that cause atrial fibrillation in the context of external factors or things outside the heart that impact the heart. It turns out things like diabetes over the long term seem to impact the heart possibly with byproducts of diabetic metabolism ending up within the structure and the fibres of the myocardium, therefore impacting how the atria and the muscles work. We see that obesity is linked with an increased likelihood of atrial fibrillation and obesity together with obstructive sleep apnea a condition where people obstruct their respiratory system at night while they’re asleep and really suffer with low levels of oxygen overnight. These situations trigger a very brisk response of the autonomic nervous system so the body is heightened although the person is asleep and can increase blood pressure and it can drive scarring and inflammation within the heart. Again all contributing to the possibility of developing atrial fibrillation.

We see that people with bad kidney function over a period of time have a high propensity to develop atrial fibrillation – nearly 20 percent of people with chronic renal disease  will develop the condition and this is a complication of multiple things: elevated blood pressure, inflammation, general propensity to scarring and change within the heart. We also know that external toxins – and probably the most common is alcohol – can raise the likelihood of development of actual fibrillation. So, a boozy night out with a lot of snoring and bad sleep is exactly the sort of thing that could trigger off enough electrical activity within the heart to kick off an episode of atrial fibrillation. In fact we do see it not uncommonly that people will turn up on a Monday morning with a Saturday night arrythmia from exactly that. We see other stresses on the heart also have an effect in the likelihood of atrial fibrillation being present or being precipitated by such things as surgery; whether it be bowel surgery but of course very commonly, any surgery on the heart where the atrium are actually manhandled and touched during the process markedly increase the risk of development of atrial fibrillation, as you’d expect. Infections can do it as being a trigger as severe infection of any sort. In actual fact because the body is responding in such a way that extra adrenaline, extra nervous activity is all being generated and that can increase the likelihood of abnormal rhythm within the heart – particularly atrial fibrillation. We know that other conditions such as pancreatitis, for example, could also lead to atrial fibrillation.

So anything within the body that can really increase what we call the autonomic nervous system – which is the fight or flight nervous system – can kick off an episode of atrial fibrillation.

Lastly and really importantly emotional stress can do it as well and it is not uncommon for me to see patients who for various reasons had a significant emotional impact – whatever that might be – and they literally felt that in their heart with their heart jumping and fluttering. And that emotional stressor it being the precipitant for actual fibrillation to kick off in that individual.

So what can we do. Well, age we cannot avoid. It will lower our threshold of development of atrial fibrillation no matter what. So age is one that we can do little about. But things like blood pressure, weight control, good sleep, not too much alcohol, not too much emotional stress and being aware of where actual fibrillation can occur is a really important first step.

One of the areas where atrial fibrillation occurs – which is really surprising so I’ve left it to the end – is that we can sometimes see it in endurance athletes, so we know that exercise in general is very good for our health, no question about that. Normal levels of exercise, moderate on a weekly basis or several times a week will lower our risk of coronary artery disease, lower our risk of heart related illness, and in fact lower our risk of atrial fibrillation. However in a specific subset of athletes who train for endurance events or long protracted training sessions and long events these people have been shown for multiple reasons to run a higher risk of atrial fibrillation in the longer term. And this is possibly related to that endurance activity leading to significant stress on the heart with return of blood that acts as its own impact on the chambers of the heart leading to dilation and compensation of the heart. That long term exercise seems, together with a change in the neurological way that the heart responds with a tendency towards the Parasympathetic nervous system (slows the body down) which is the opposite of the Sympathetic Nervous System (speeds the body up), seems to lower the threshold for development of atrial fibrillation, and so quite surprisingly, the last group who may get atrial fibrillation is the group of people who are actually very well trained athletes.

So be aware of atrial fibrillation and who gets it, I hope that all make sense. Thank you very much for your time.

You have been listening to another podcast from Dr. Warrick. Visit his website at. www.drwarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.

Check out my book at http://drwarrickbishop.com/books/

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Welcome to Warrick’s Podcast Channel. 
Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their hot health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. 
Hi, my name’s Dr Warrick Bishop and I’d like to welcome you to my consulting room. Today, I’d like to speak with you about a conversation I’ve had with a number of patients in recent time. That conversation is about having a medication for anti-coagulation and having available for that medication, an anti-dote. There are two groups of anticoagulant that we use at the moment. Historically, and currently we’ve use Warfarin. Warfarin is a drug that works through the vitamin K dependent factors of the coagulation cascade. The newer group of agents, which we’re going to call the NOACs, Novel Oral AntiCoagulants, work at precise locations within the calculation cascade. When it comes to reversing anticoagulation, the simplest way to do it is to just withhold the medication. With time, the body produces the factors involved in the coagulation cascade, and the system returns to normal. This can be a matter of days for most of those agents. 
In an emergency setting, if you’ve broken a leg, or if you’re bleeding internally, or need urgent surgery and there’s a requirement to reverse that anticoagulation urgently, particularly in a situation of severe hemorrhage, then one thing we can do regardless of whether it’s Warfarin or one of the NOACs is take fresh frozen blood products and put those products which include the factors for coagulation into the patient so that it provides what’s needed to stop bleeding and return the coagulations system or the clotting system back to normal. 
Some of my patients say look, I’d rather stay on Warfarin because we can use vitamin K as an antidote. Well, that is partly true but not fully correct. The reality is that vitamin K dependent factors take time to produce. So if someone does have bleeding problems with Warfarin and you give them Vitamin K to overcome the blocking effect of Warfarin to try and restore the coagulation system, then the liver actually has to produce those factors to have the system working again. Vitamin K dependent co-factors can take six hours or more to start being produced. So in the acute, very urgent setting of severe hemorrhage, that’s just not quick enough and in that setting, the blood products injected into the blood stream do the job. In the situation of the NOACs, one of the agents, called the Dabigatran, has had a particular agent made, which, when it’s injected into the body, binds with the Dabigatran and makes it inactive. This particular agent called Praxbind works almost immediately, and is an ideal solution in the setting of uncontrollable bleeding. 
There are two other NOACs – one called Rivaroxaban and one called a apixiban, and both of these agents have an antidote on the horizon called Andexinate.  Andexinate is not yet available in Australia. It is undergoing trials at the moment, and it does look promising, and if Andexinate does prove to be effective, then it will have a similar role in being able to be injected, and provided decoy protein for absorbing these particular agents and restoring the coagulation system very rapidly. 
So, as much as it would be nice to think that there’s an antidote for Warfarin, there sort of is but it doesn’t work quickly enough to be effective. 
With regard to our NOACs, Dabigatran has Praxbind available, and this is a fantastic agent that really works. It is available in the Australia, and particularly in major centres. The other NOACs may well have an agent available in the next couple of years. In the meantime, if Praxbind is not available, and you’re on Dabigatran or if you’re on Warfarin or one of the other two NOACs, then injection of blood products to restore and replace the coagulation cascade is really the only option. 
I’m afraid Vitamin K is just not an adequate antidote for Warfarin reversal in the the acute setting, it can be helpful however in some less urgent situations
Little bit of a complex subject, hope it makes some sense and I hope you enjoyed it. Thank you so much for listening and I wish you the very best. Thank you. 
You’ve been listening to another podcast from Dr. Warrick. Visit his website at www.drwarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review. 

Check out my book at http://drwarrickbishop.com/books/

DrWarrickPodcastS1E10 from Dr Warrick Bishop on Vimeo.

Listen to Audio:

Welcome to Dr. Warrick’s Podcast Channel. 
He’s a practicing cardiologist with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. 
Hi, my name’s Dr. Warrick Bishop and I’d like to welcome you to my consulting room. 
TodayI’d like to speak about the topic that I haven’t seen much written about but something that I see through my consulting rooms on a regular basis. And that’s the role of women in heart health, and of course in other health. Through my own practice, in my rooms – though I’ve gotten no documentation of this but I do see it – I find that regularly women are the driver for best health care within the family. 
This may be the case in your family. I have two seats in my consulting room, one for partners. Often, if a woman comes she’ll come by herself. Most often, if a man comes to see me, particularly in a preventative role, or really in anything that could be to do with their heart, it’s his wife or partner who is driving him to be there. 
So, it seems to me that women are really tuned into prevention and taking the steps that are required. They seem to be interested and engaged a little bit more than men and I don’t know why that is. It is a sweeping generalization but it’s an observation. I’m not going to try and justify it. I have men come in and basically say that they’re here because their wife has told them to or has made them or has read – in fact – has read my book and told them that they need to come and see me. 
I have to laugh because when I was in the early stages of producing this book, I took it to a group of friends, and out of that group of friends everyone said bits and pieces, some of the men actually were taking a step back rather than taking a step forward, but one of the women turned around and said this is a book you would buy for someone you love
And that was so powerful that I actually put on the front cover of the book, because I understand that if you do love someone, you want to see the best for them and you want them around for as long as possible to be with you. 
Sothe statistics over and over tell us that men in happy married relationships live longer than singles. We know this. We see it not only intuitively, but that is supported by data, and we know that having someone loving us is a huge thing in our life, but in my observation, often women are driving good health care, and that’s probably also helping our married men live longer. 
So, if you’ve got a wife who’s driving you to be in better health, thank her and go with the flow. 
I hope that makes a bit of sense and starts a conversation at home. I wish you the best. Take care and bye for now. 
You have been listening to another podcast from Dr Warrick. Visit his website at www.DrWarwickBishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review. 

Check out my book at http://drwarrickbishop.com/books/


Welcome to Dr. Warrick’s Podcast Channel.

Warrick is a practicing cardiologist an author with a passion for improving care by helping patients understand their heart health through education work believes educated patients get the best health care discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, I’m Dr. Warrick, and I’d like to welcome you to my consulting room today. I’d like to talk about treadmill testing and in particular, the preparation that you may need to undertake with regard to treadmill testing and your medications. We do plenty of treadmill tests through this unit. That’s a big part of the service we provide, and so it’s not uncommon for me to have patients come in thinking that they have done the right thing by stopping their medication or taking medication before the test and they’re not exactly sure what’s right and what’s wrong. I’m going to try and explain that today. When we do a treadmill test there are really two main things that we’re looking to find out. In one situation, we’re trying to see if a symptom of chest pain or shortness of breath is related to the heart. So we put a patient through a treadmill to invoke exercise because their history has been one of chest pain or shortness of breath on exercise. If they’re able to reproduce that symptom of shortness of breath or chest pain during exercise and we can demonstrate an abnormality of the heart by the ECG being abnormal or when we ultrasound the heart seeing that the heart doesn’t move normally, indicating a lack of blood flow then we can confirm the diagnosis. That lack of blood flow is the cause of the symptom. In that situation, the treadmill test is a diagnostic test. So one of the reasons we do treadmill testing is for diagnosis.

In the setting of diagnosis, we want as much information as possible and we want the clearest information as possible to make that diagnosis. We don’t want anything clouding the water. We want the patient’s heart rate to go as high as possible and we want a really good feel of the patient “in their natural state”. Almost invariably we want the patient off any medication that could slow their heart rate down when we’re doing a diagnostic test because slowing the heart rate down will make the test less precise and we might be less able to pick up abnormality because the test is less sensitive. So for diagnostic tests, across the board if you’re on a tablet that could slow your heart rate down please check because there’s a very good chance whoever is doing the test would want you not to be on it in the days leading up to that test so they can see your heart in its natural state and get your heart rate up as appropriate to give them the best sensitivity of that test, to give you the best information. So, stress testing for diagnostic purposes, well that’s the first reason, we do stress testing.

The second reason we do stress testing is for prognosis. Prognosis is to tell how well you’re going to do in the long term. In the prognostic setting more often than not we’ve clearly indicated or confirmed a diagnosis that there is a problem with the arteries and maybe some sort of flow limitation. For example, someone who’s had a stent had a bypass or had a CT scan and there is evidence that we know that there may or may not be a blockage there. We put the patient on treatment to manage that in the prognostic setting.

What we are interested in finding out more often than not is how does this patient behave in the real world on their usual tablets, when pushed to a high workload so that if on medication at a high workload does the heart appear to be working well. We as the doctors can be reassured that we’ve got that patient’s heart well protected. So in the prognostic setting, we generally want to see patient not miss any of their usual medications. Those are the heart rate regulators and the anti-anginal tablets, the tablets that affect how the heart works and reduce the impact of the shortage of blood flow. The very thing we’re trying to check and make sure is working properly for that individual. Also, we want to check that we’ve reduced that patient’s symptoms. So that their chest pain or the shortness of breath is improved based on the therapeutic intervention. So, generally in the prognostic setting for stress testing, we want you on medication. So diagnostic off medication, prognostic on medication.

If you are not sure….. please ask. A quick phone call and we’d love to tell you. I hope that makes a bit of sense. Thank you for joining me, and good health.

You have been listening to another podcast from Dr. Warrick visit his website at DrWarrickBishop.com for the latest news on heart disease. If you love this podcast feel free to leave us a Review.

Check out my book at http://drwarrickbishop.com/books/

Welcome to Dr. Warrick’s Podcast Channel.

Warrick is a practicing cardiologist an author with a passion for improving care by helping patients understand their heart health through education work believes educated patients get the best health care discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, my name is Dr. Warrick and I’d like to welcome you to my consulting room today. I’d like to talk a little bit about blood pressure which is pretty common. So what is it? Blood pressure is what we measure to give us an appreciation of the pressure of the blood flowing through the main arteries. You’ve probably heard of the upper blood pressure measurement and the lower blood pressure measurement and these are called systolic for the upper one and diastolic for the lower one. Systolic is the higher one you tend to remember. Diastolic is the lower one. Systolic pressure reflects the blood pressure through the circulation at that time when the full force of the contraction of the heart is expelling blood. The aortic valve is open and blood is flowing through it, this is when we are seeing the highest pressure in the system. This is called the systolic blood pressure. Things that would affect the systolic blood pressure are how stiff the aorta is and how stiff some of the other pipes (blood vessels) are.

Think of the circulation like an irrigation system, as if you were trying to push water into an irrigation system. If the pipes have some elasticity then the pressure within those pipes would be less because some of the energy would be absorbed by the expansion of the pipes. This is why as people get older and your arteries get stiffer their systolic blood pressure gets higher and higher because as the heart compresses and squirts blood into a stiff tube which really doesn’t stretch or gives less than when that person was much younger. So the systolic pressure goes up. The diastolic pressure is then the pressure that we see when the aortic valve of the heart is closed. It’s the pressure that the circulation rests at before the next beat. This is really defined by the recoil within the major arteries.

So if there is an elastic recoil within the arteries then that will maintain the diastolic pressure but it’s also related to the resistance within the circulation. So if the small blood vessels that the blood is flowing into, if they are tight then there is a resistance within the system and that will keep the blood pressure up. If those small blood vessels are relaxed and open then the blood will flow freely into the vascular space and that will lower the blood pressure.

So Systolic is the highest blood pressure. It’s the measurement on top and it’s related to the contraction of the heart, diastolic the lower measurement is related to the pressure within the system when the heart’s relaxing and refilling ready for the next compression. Well, why do we bother about blood pressure? We talk about it a lot and this piece is raising awareness about it. So what’s the big deal? Why do we worry about it.

Well, we know that blood pressure is very important in the stress forces that it applies to the blood vessels and so can apply stress force to the blood vessels of the neck and of the heart. It can also put blood pressure blood vessels under strain within the brain.

So elevated BP is a very significant driver of stroke and heart attack. Stroke is the formation of a clot in the carotid artery that occurs subsequent to the artery being damaged from high blood pressure, less likely a rupture of an artery can occur in the brain because of elevated blood pressure. So in terms of reducing the risk of stroke and heart attack, we really want to keep the blood pressure down. We also know that elevated blood pressure is closely linked with the development of atrial fibrillation, this is a condition that is common and so the better we can manage blood pressure within the population the better we can reduce the burden of this condition. Lastly one of the really important reasons for keeping blood pressure down is in regard to the development of cardiac failure. This can occur gradually as the heart stiffens is in response to long-term pressure overload required to deal with elevated blood pressure within the blood vessels. As the heart becomes stiffer, it can also thicken and when this occurs it just doesn’t work as well. It is common to see in the elderly particularly those who have had elevated blood pressure that they develop symptoms related to this, this particular type of blood pressure is characterised by well-maintained contraction of the heart it’s just that it is stiff and doesn’t relax properly. The impact of this on the population is huge and I cannot underscore enough the importance of maintaining good blood pressure control to avoid this in later life.

So, I have told you what blood pressure is and I have explained why we’re concerned about it. Well, how do we check it?

Most commonly it will be your GP who will put the cuff on around your arm and listen to the arterial pulse at the elbow to check both systolic and diastolic blood pressure. This is the most common way to measure and is a really good start. It is what we have done for many years. The limitation, however, is that BP can vary considerably from minute to minute, hour to hour and day-to-day. As many as 20 people in the 100 or 20% of the population will have significant variability which we call “white coat” syndrome. It is important to understand this as a measurement taken could well define management for the patient for many years to come.

One way to get around this variability is to use home blood pressure measurements. The availability of cheap accurate automated machines means that this is far more accessible these days. It is very reassuring to have good home blood pressure measurements which would suggest that the patient does have a component of “whitecoat” hypertension.

The other way that we may measure blood pressure is if we are particularly interested in having as much information as possible is to arrange for a 24-hour ambulatory blood pressure monitor. This is an excellent device for providing multiple blood pressure readings throughout the 24 hour period, both daytime and nighttime, so we get an exquisite profile of exactly what is going on for the individual. My own preference is to use information from ambulatory blood pressure monitoring to make decisions about long-term therapy for patients as I believe it provides the best information.

I do like to remind patients that BP is important and we do need to follow through to make sure it is well managed in the longer term, because patients don’t suffer symptoms from BP, in most cases, it is easy to be complacent about it.

The take-home message, however, is that BP is very very important and really does need to be properly assessed and managed in the long-term for the best possible outcome for the individual. It is a condition that both the patient and Dr have to work together to find the best solution for the individual patient having obtained as much information as possible to inform the decision-making.

I hope you’ve found this interesting, I hope it has encouraged you to go and make sure your blood pressure is well controlled and of course as always I wish you good health. Thank you for taking the time to read this.

You have been listening to another podcast from Dr. Warrick visit his website at DrWarrickBishop.com for the latest news on heart disease. If you love this podcast feel free to leave us a Review.

Check out my book at http://drwarrickbishop.com/books/

Welcome to Dr. Warrick’s Podcast Channel.

Warrick is a practicing cardiologist an author with a passion for improving care by helping patients understand their heart health through education work believes educated patients get the best health care discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

This is a radio interview I did with ABC about my book, I hope you find it interesting.

I wish you the very best. Bye For Now.

You have been listening to another podcast from Dr. Warrick visit his website at DrWarrickBishop.com for the latest news on heart disease. If you love this podcast feel free to leave us a Review.

Check out my book at http://drwarrickbishop.com/books/