Re: Russert

On Jun 16, 9:52�pm, Maybe <Maybeso...@xxxxxxx> wrote:
On Jun 14, 1:33�am, katycren <Katyc...@xxxxxxx> wrote:
But couldn't someone have coronary artery blockages that wouldn't show
up on a stress test?
Actually, I'm thinking of Dave's massive heart attack. Since Dave was
(and, I assume, still is) in good shape, wasn't overweight, and, most
importantly, exercised regularly, if he had a stress test back then,
it would have been normal. But (I'm making more assumptions) since his
doctors knew his father died of a sudden heart attack when in his
fifties, they were extra careful and perhaps ordered a balloon
angiogram test for that reason. The test showed blockages that could
kill him any time so they immediately ordered bypass surgery. I saw
something about Russert dying from cholesterol plaque in a coronary
artery breaking away and causing the heart attack so maybe he should
have had the balloon test.
Or am I totally mixed up about this?

They answered your question tonight on Larry King with his doctor. �I
couldn't recreate the answer if I wanted to. �The transcript is not up
yet but I will copy & paste the relevant part and post it when the
transcript goes up.

Okay, here we go:

<OZ: Tim Russert died because this small vessel that brings life
supplying blood to this miraculous muscle closed off suddenly. It's
called the widow maker vessel. When this vessel closes off, the heart
will often create a rhythm change, which is what causes sudden
collapse that we often see. Unfortunately for a lot of Americans, we
think that you can get a stress test, as was done with Mr. Russert,
and that will show you have a blockage.

The reality is that often times the blockages are less than 50
percent. If that is the case, you exercise, the heart will go fast,
but you won't see any abnormalities. But what happens a lot of times,
and this is a reason you can't test yourself for safety, you have to
live for safety, is that you get a thrombus, an irritation on top of a
plaque that has been there for decades. But it when ruptures, that
plaque all of a sudden comes alive. When you get a cut, whether it's
inside the artery of the heart or on your skin, what do you do? You
form a scab. That scab inside a very small diameter vessel closes
suddenly. That's why Mr. Russert passed a stress test. That's why I
actually think he was getting pretty great care. Yet, out of the blue,
he's stripped from life.

KING: Would he have died, Dr. Oz, without pain?

OZ: I suspect he did not have much pain because as soon as you develop
fibrillation, within seconds you pass out. From that perspective, it's
the way I'd like to pass away, but I would rather do it when I'm 90
years of age. And that is the tragedy in America.

KING: More with our panel. If a stress test isn't an all clear, what
other tests can tell us about heart health? (COMMERCIAL BREAK)

KING: Dr. Newman, was Tim Russert a good patient?

NEWMAN: Tim was a great patient. Tim Russert as a patient was the Tim
Russert that we all know. He complied with almost everything that was
asked of him. He was well-informed, asked good questions. Tim was a
good patient. Are there things all of us as patients could be better
at? Sure. But Tim was a good patient.

KING: Do you ever think, Dr. Newman, in retrospect, I could have done
more? Should have done more?

NEWMAN: You know, as physicians, we always hope that we can change
people's lives, that we can make them feel better, live longer, that
we can intervene, and that's what our role is. Unfortunately, in many
instances, our hopes are not fulfilled. Absolutely, I wish Tim was
alive and with us today. And I think most physicians, whether people
-- patients die of heart disease or cancer, we all struggle with the
fact there are limits to what we can do.

KING: Dr. Shah, if the stress test isn't a good indicator, what is?

SHAH: If you want to really identify disease in the arteries before
even the arteries is narrowed or causes any symptoms or makes a stress
test abnormal, you have to go with non-invasive imaging technology,
which is currently available. A C.T. scan of the heart can look for
calcification, or buildup of calcium, which is really tracking
cholesterol buildup in the artery. That's one way to do it.

Another way is to do an ultrasound in the carotid arteries. And there
you can identify plaque. If you have it in the carotid artery, you are
very likely to have it elsewhere as well. You can detect these plaques
long before they narrow the artery or cause any symptoms.

KING: What about what I took today, an echo-cardiogram?

SHAH: Echo-cardiogram is primarily used to check the function of the
heart, the size of the heart and the valves of the heart. In your
case, I know what your arteries look like, like on the palm of my
hand, because we have examined them with CT and angiogram before, so
we didn't need to do that for you. <

The whole transcript is here:
http://transcripts.cnn.com/TRANSCRIPTS/0806/16/lkl.01.html

Maybe...hoping that helps
.

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