Health Blog : Tim Russert: One of a Kind; One of 300,000

Health Blog : Tim Russert: One of a Kind; One of 300,000

Prediman K. Shah, director of cardiology at Cedars-Sinai Heart Institute, Los Angeles, says it was a classic episode, the way 80% of cases of sudden cardiac arrest occur. He wasn’t impressed with the report of Russert’s recent successful treadmill test. Even if a test is normal, “You can still have plaque and be at risk,” he tells us. It wasn’t clear whether Russert had been taking a cholesterol-lowering statin, but even if his LDL or bad cholesterol was under control, that wouldn’t assure protection against a heart attack.

“Statins do stabilize plaque (and thus reduce chances of rupture), but they haven’t eliminated every heart attack or sudden death,” Shah says. “We have to look for other means.”

Bring on the coronary CT’s please.


Comments

  1. CardioNP says:

    CTA likely would not have changed the outcome.
    Based on what has been discussed in the press, he had known CAD, was asymptomatic and had achieved a high MET level on his ETT.

    CTA is good to r/o CAD in the right population, but is not great in differentiating whether a lesion is 60% vs 80%.
    Even if he had CTA showing calcification and moderate stenosis, his management would not have changed as he was asymptomatic (eg RF modification, medical mgt).
    As PK Shah was noted to say, we still aren’t good at preventing the deaths of those who have a first event w/ SCD.

    One of our cardiology staff’s significant other just had a similar event – first MI w/ SCD at an age much younger than Russert.

  2. Fidel, MD says:

    I’d bet on a PE with saddle embolus….he just got back from Italy, didn’t he? And he did seem to have all the benefits of non-governmental health care (despite advocating the little people get screwed).

  3. Peter Brandt says:

    As a layperson, how does one prevent sudden heart attack if one is asymptomatic, has done well on a stress test and whose cholesterol is pretty good LDL and total. I run 3 miles a day and I am 62. Should one get a CTA anyway or not? Should a CTA be considered part of cardiology care in addition to the echos and ekg??

  4. Mike Donovan says:

    Regarding the death Of Tim Russert:

    In the new issue of Newsweek, Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic told the magazine when asked about the role of STRESS and heart attacks:

    “Most of us do not think it is terribly relevant,” and explained this with a shocking lack of logical thinking: Newsweek writes, “After all, he notes, “many people in this world have stressful jobs,” and they don’t all die of of heart attacks.

    Time Magazine named Dr. Nissen one of the 100 Most Influential People In The World in their “Scientists and Thinkers” section.

    Think about that.

    Now, consider the completely illogical statement from Dr. Nissen bolded above. One thing should be made perfectly clear in light of this statement: He believes cholesterol as very relevant to heart attack risk. Yet, to turn his Newsweek comments around, “many people in this world have **high cholesterol**” and they don’t all die of heart attacks.

    In fact, study after study shows countries with the highest rates of fat intake and the highest average cholesterol rates have the lowest incidence of heart disease. Imagine that!

    Dr. Nissen’s irresponsible and illogical comments in Newsweek shows – again – the complete bamboozlement the cholesterol hypothesis has on western medicine just because, “everyone knows,” high cholesterol causes Coronary

    Heart Disease. How do they know this? “Because everyone knows.” Ad nauseum. With a little research, the facts show this is simply not true.

    What Dr. Nissen said about stress can be said about high cholesterol. Plenty of people live with both without having heart attacks.

    Maybe Mr. Russert’s death can help in bringing us back to real science as opposed to what Big Pharma dictates

    as what is science – and what is not.

    Follow the money.

  5. It’s so sad that he died so young, and that it wasn’t necesssary.

    Drs. Dean Ornish and Caldwell Esselstyn have independently, through 20 years of peer-reviewed research, proven that a low-fat vegan diet can not only reverse heart disease, but prevent the plaque issue, effectively heart-attack proofing yourself:

    http://www.heartattackproof.com

    I interviewed Essy after my father’s first heart event and tried hard to punch holes in his ideas:

    http://www.madcowboy.com/02_MCIview05.000.html

    It’s no joke… what’s more radical? Cutting open a person’s chest and attaching a leg vein to the heart, or eating right? You lose your taste for fat after around 12 weeks (worked for me), and, according to Dr. Esselstyn, effectively reverse the plaque issue in 3 to 4 weeks.

    Only thing is: hard for a hospital to make money off of this approach.

    FYI, Mark

  6. Great post!
    Russert represented pride, love, honesty, and friendship. In a world where those qualities are seen less and less, Russert remained an icon of integrity in this America. His passion for our country and all those who live here is an example to the world that America is a great country still.