In "The Heart of the Matter," Dr. Peter Salgo, associate director of the Open Heart ICU at New York Presbyterian Hospital, offers a simple formula to treat people before they get sick, which in turn will prevent heart attacks before they occur. Here's an excerpt:
Something new has happened. There is a buzz in the air in medical meetings all across the country. It's a familiar and wonderful feeling. Where we are with heart disease in the year 2003 is the same place we were with infectious diseases just before the discovery of penicillin, where we were with dentistry just before the advent of fluoridation, where we were with polio on the eve of the Salk vaccine -- which is to say, we are on the cusp of an enormous breakthrough. We are about to treat people for heart attack before they get sick. We are about to prevent them from dying. This is the work of the oldest brother in the Chinese parable.
After the widespread introduction of fluoridated water, tooth decay all but disappeared as an American health problem. I'm told dental income (for general practitioners, of course) dropped precipitously, and that's why today everyone seems to be an orthodontist. With any luck it's going to be the same with cardiac specialists. I run a cardiac surgery intensive care unit (ICU). Follow the program in this book and you can put me out of business. That's okay. In fact, I'd be thrilled. I've seen enough damage. I've seen enough people die before their time.
There are two distinct parts to The Heart of the Matter: the premise and the promise.
The premise is this: Nobody has ever fully understood what causes heart attacks. It's surprising but true. And because we didn't understand what caused them, we couldn't really get a handle on how to prevent them. All that has changed radically and recently. The past few years have seen an explosion of research papers and presentations confirming the new heart attack theory. We now know what causes heart attacks. The answer is probably going to surprise you (it certainly surprised most doctors). And because we know what causes them, we know how to protect you from them. I will show you what you need to do. It's an amazingly simple and straightforward program.
Through an astounding stroke of good fortune, our new understanding of heart attacks has occurred at the same time when we have found new medicines that can target the heart attack mechanism precisely and powerfully. Our understanding has also led us to use older medications in new ways, to turn off the heart attack mechanism.
The promise is this: Ours will be the last generation to die of premature heart disease in this country.
Bold talk? Not really. In this book you'll find an easily administered self-test -- so that you can assess your own susceptibility to heart disease -- as well as a formula for beating the disease and a clear, concise explanation for why this formula will work.
To understand how excited I am about this new program, you need to "walk a mile in my shoes" and see heart disease as I have seen it during my career. By training I am an internist and an anesthesiologist. That makes me an intensivist. My specialty is cardiac care. As a director of the open heart intensive care unit at Columbia Presbyterian Hospital in New York, I witness daily the destruction wrought by heart disease. I see the devastation and debris caused by the major killer known to humankind, and it sickens me.
Each day as I make rounds I see the shattered lives and devastated hopes and dreams of people who are just like you and me. They have wives, husbands, children; they have plans. They have wept at weddings, cheered at football games; they have spilled food on the Thanksgiving tablecloth. Now they are at the brink of death. They depend upon ventilators to breathe. They depend upon powerful medications to circulate their blood. Many will not survive. When people do not take care of themselves, or their bodies malfunction despite their best intentions, I see the sad results: patients who need heart transplants, artificial hearts, open heart surgery; patients who are desperately ill.
I see people like Jose Rodriguez, who told me one day through a weary, postsurgical smile that he now knew what it felt like to have an elephant sit on his chest. Two days later, despite the love of his family and the best efforts of medical science, Jose was dead.
People like Josephine Smith, who showed up in the ICU a few hours after collapsing in the produce aisle of her local A & P. Or Howard Martin, a man in his late forties whose weekly round of golf was interrupted by a massive coronary. Imagine the shock! You're out on a sun-splashed par five in the middle of the afternoon, and the next thing you know, you're hooked up to a heart-lung bypass machine. It's that traumatic, that disturbing.
I have seen too much of this. I speak to patients, and I hear a familiar story: "Everything was fine, and then all of a sudden, I got this pain." I speak to families and I hear it again: "He was such an active, vigorous man. Now look at him. I don't know how I'm going to get through this."
As I spoke to those patients who could speak, and as I sought to comfort the families of those who might die, I became angry. I didn't know where to direct my anger, at first. It seemed easy to blame the victims. After all, they had smoked or eaten fatty food or rarely exercised. Eventually I realized anger wasn't going to get me anywhere.
Excerpted from “The Heart of the Matter” by Peter Salgo and Joe Layden. Copyright © 2004 by Peter Salgo and Joe Layden. Published by William Morrow, a division of HarperCollins, Inc. All rights reserved. No part of this book may be used or reproduced without written permission from the publisher.