Heart to Heart Talk

Patient Mentoring to Maximize Compliance DZMM Teleradio

Understanding the meaning high and very high 10-year risk for heart attack, stroke and sudden cardiac death.

High risk means 20% or more likelihood (or at least 1 in 5 chances) of suffering from a heart attack, stroke or sudden cardiac death between this year and 10 years from now. Very high risk means 30% or more (or at least 1 in 4 chances). Comprehend this statistics compared to the lifetime risk dying from a car accident. Depending on where you live, your age, your diving habits, where and when you drive, on the average, it is about 1 in 2,000. But if it were 1 in 5 or 1 in 4, instead of 1 in 2,000, most of us will be driving as little as possible.

Or you will to be determined to drive as safely as possible - do whatever it takes to lower your risk to more acceptable levels. Heart attack, stroke and sudden cardiac death as largely preventable catastrophic events. We have been helping our patients since 2001 do exactly that and have accumulated a lot of experience including two published performance data. Medicare data also confirmed that we saved many thousands of healthcare dollars per Medicare beneficiaries with diagnosis of CHD and Medicare beneficiaries with diagnosis of diabetes.

Correcting widespread misinformation or disinformation about statins and diabetes.

Some patients who are at high risk for heart attack and stroke have stopped on their own or were told to stopped taking their statin medications - Lipitor (atorvastatin), Crestor (rosuvastatin), Zocor (simvastatin), etc. They were told that “statins are bad of you because they cause diabetes”.

1 in 100 patients taking a statin will develop diabetes over a period of 10 years. For every one patient that develop diabetes, there are 9 patients in whom statin therapy prevented a heart attack, a stroke, sudden death, the need for a stent or heart bypass. Clearly, the benefits far outweighs the risk. 

AA: I had a triple coronary artery bypass surgery two years ago at 37. I know I have a strong family history of premature heart disease - several men in my family died or had a heart attack before the age of 50. Is it possible for me to escape the same fate?

Dr.RdG:  If you had quite smoking and if you were receiving optimal medical therapy several years before, it is likely that we could have prevented or at least delayed the need for heart bypass surgery by by 10 to 20 years or even longer. Quitting smoking, heart healthy diet, regular exercise, diabetic control, optimizing all important lipid parameters can alter the natural progressive course of atherosclerosis - prevent plaque rupture, stop plaque progression and even induce plaque regression. I am optimistic that we can help you.

GH: Why did the hospital changed me (my Medicare) $20,000 for a 48-Hour Holter Monitor?

Dr. RdG: The bad news is that nowadays the hospital charges whatever it wants. $20,000 is a ridiculously large amount of money that almost pays for half the cost of the entire Holter Monitor system. The good news is Medicare will reimburse a “reasonable fee” which is less that $150! The bad news: If you have no insurance, you are not protected from this exorbitant charge. You will have to negotiate with the business office and get a “deal” - a discount fee plus installment plan that may cost you 5 to 10 times more what Medicare will pay. Hospital medical bills are the most common causes of personal bankruptcy in the US.

© Rolando L. deGoma MD  2019     www.deGomaMD.com     Capital Cardiology Associates     Princeton Physicians' Organization