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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 healthcare discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.
My name is Doctor Warrick Bishop. I'd like to welcome you to my consulting room today. I'd like to give you a little bit of insight into a book I've written called, "Have you planned your heart attack?". The introduction for the book begins with a story from 2005 where I was driving to work on a weekend I stopped at a commotion at a fun run. A man had fallen while running, dead! He had a heart attack and was being resuscitated by ambulance crews and passers-by, people who were doctors or medically trained. I stopped to help out, that man did so well that two days later he was on the front page of the local newspaper.
I was quite proud to be part of that resuscitation and shared that information with my staff who pointed out that two years earlier I had seen the very same patient. I had undertaken the treadmill tests and had reassured him that everything was fine. As you can imagine this was a confronting thing to realize and it really opened my mind to what can we do differently and what can the technology that we have available today offer that can improve the way we make predictions for men like this man who collapsed during the race. Our current approach to understanding the risk for individuals is to use what we call a risk calculator. Those risk calculators take information like cholesterol, age, blood pressure, diabetic status, smoking status and we put that information into an algorithm or a data set to come up with a likelihood of an event.
We've been using risk calculators for over 25 to 30 years. The trouble is that those risk calculators are not precise for the individual. What they provide us is information on the population that that individual resides in. And so if we take a 50-year-old male with average cholesterol average blood pressure etc. who don't smoke we could tell him that his risk of an event is in the order of 10 percent in 10 years, this is based on a standard risk calculator formula. However, we can't tell him if, in fact, he is one of the 10 out of the 100 who will have an event or one of the 90 who won't have anything. This is because his actuality is either going to be a 100 percent, he has an event or zero percent he doesn't have an event. It's very hard to have a 10 percent heart attack. What's happened is that in the last years we've now had available to use the technology called Cardiac CT which allows us to literally take pictures of the heart so we can be more precise about exactly what's going on in the arteries and exactly who is going to be at greatest risk of having an event.
This book is about that technology and how it can bring precision to an individual's care. I talk about why the tests are not more broadly used but I also talk about who it may be beneficial for. I try and cover where statins fit in and where family history fits in. Also if you are just wanting to be ahead of the game and proactive with your own health or fitness. I've put plenty of references in this book so it is supported by good data. I also reflect on exactly how I approach patients in my own clinic. I've written it for general consumption. There are plenty of diagrams and pictures and explanations in there so it's accessible to you as an individual. It gives you the chance to engage with your doctor about a conversation about the relevance of future testing for your health benefit your education and your choice to be proactive. I really hope you find the book an interesting read. Thank you for taking the time to listen. I wish you the best.
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