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4 Aug. 2020

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Risks, CT Scanning

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients.

Podcast Episode Summary

Introduction: This episode features a cardiologist reflecting on a pivotal experience from 2005 when a patient he had previously given cardiac clearance to suffered a heart attack during a fun run. Though the patient was successfully resuscitated, the incident prompted the speaker to recognize the limitations of his prior assessment and motivated him to explore how modern technology can improve cardiac risk detection and management. The episode introduces the broader context of heart disease in Australia, where approximately 55,000 people suffer heart attacks annually—roughly one every 10 minutes.

Key Takeaways:

Early cardiac testing results (like exercise treadmill tests) can appear normal yet miss significant coronary artery disease that may develop or be undetected at the time.
Even appropriate medical assessment and reassurance based on available information at the time can have limitations that become apparent in hindsight.
The speaker's experience highlights the emotional and professional impact of reassuring patients who later experience cardiac events.
Modern medical technology has evolved significantly over the past 10-15 years, offering new opportunities for better cardiac risk assessment and management.
Heart attacks typically result from narrowing or blockage of coronary arteries and can require various interventions including medication, hospitalization, balloon angioplasty, stents, or bypass surgery.
Patients typically do not expect to experience cardiac problems, suggesting a gap between actual risk and perceived risk in the general population.
There is a need for improved methods of dealing with cardiac risk through better investigation protocols and management strategies.

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Transcript English

Introduction Not Good Enough On a Saturday in May of 2005, a 52-year-old man collapsed, having had a cardiac arrest during a fun run. I noticed the commotion as I was driving past on my way to work and stopped. Several other runners, including a general practitioner, had already stopped to help and the ambulance service was in attendance. I'm pleased to report that with everyone's input, the man was resuscitated, taken to hospital, and received stenting to the main artery down the front of his heart. The outcome was so good that it later made the front page of the local newspaper. When I arrived at work on Monday, I felt fairly pleased to have been a contributor to such a positive outcome. Before I could become too proud, however, One of my staff pointed out that I had seen the very same gentleman two years earlier for an exercise treadmill test. The test had been normal, and I had reassured him that everything's okay. This revelation shocked me. Had I done the wrong thing by this man? Had I misinterpreted the test? Were there other factors of which I had not been aware? As it turned out, I had done nothing wrong. The test was appropriately reported and he was given reassurance consistent with his risk assessment at that time. In fact, I had suggested he start low-dose aspirin because of his history of mildly elevated blood pressure, for which he was on treatment. Not good enough. My original assessment in 2003 had limitations. This book is about how, with today's technology, we can do better, potentially much better. It's about improved dealing with risk through investigation and management. I do not wish ever to be in a situation again when I reassure a patient and then find that person has suffered a heart attack, let alone be involved in that person's resuscitation. That man's collapse was over 10 years ago. and technology has changed so that we can deal with these situations in a different way. According to the Heart Foundation, about 55,000 Australians suffer a heart attack each year. This equates to one heart attack every 10 minutes. Heart attack is a layman's term referring to a narrowing or blockage of the coronary arteries that can kill or require some form of medical intervention such as medication, time in a hospital, balloons or stents, or coronary artery bypass grafting. As a cardiologist, I have not yet met a patient who expected to have a problem.