Preventive Cardiology

From 2001 to present

In 2001, I wanted to develop a different approach to cardiology - one that also prevents most heart attacks and strokes in addition to diagnosing and treating heart disease. Because the same medical treatment that prevents heart attack also prevents stroke, it was doubly important to me.

Our Dual Approach3

For most patients, the first symptom of a heart problem is a heart attack. Coronary calcium scan is an important tool in detecting heart disease in the early stages - many years before a heart attack. A stress test detects heart disease only when it is in the advanced stage already - when the artery has narrowed by 60% to 70% or more by plaque build up. A stress test can cost 10 times more than a 15 second coronary calcium scan which usually costs between $50 to $100. Since plaque is the cause of heart attack, stroke and sudden cardiac death, risk assessment using this test is more accurate because it is based on the actual presence or absence of plaques. A ZERO score confers the lowest risk; the higher the score, the higher the risk and the more intensive the medical therapy.  

Another method of predicting the likelihood of having a heart attack, stroke and sudden cardiac death is based on the presence or absence of traditional risk factors rather than the presence or absence of plaques.      

10 Year CV Risk Estimator

There are many versions of this and many disagreements about it. This creates a confusion among many physicians and nurse practitioners. It is a guesstimate or reading the patient’s palm - “Your risk is 21% which puts you on high risk and high intensity statin is recommended. You may or may not have any plaques.” To compound the problem, some will order a stress test.      

Preventive Cardiology

This slide explains itself and outlines what preventive cardiology aims for.

The foundation of heart attack and stroke prevention is optimal cholesterol management which leads me to become a lipidologist and develop a proprietary clinical management system to successfully treat most high risk patients to their optimal treatment goals.

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