This is a guest blog from Dr. Robert Emerick, the Founder, President and Interventional Cardiologist at Choice Cardiovascular, a direct practice (also called concierge medicine or boutique medicine). Dr. Emerick’s website can be found at http://www.choicecardiovascular.com/.
James Gandolfini, well known to many of us as the likeable, yet brutal and sociopathic, family man, modern-day don of the HBO drama, The Sopranos, collapsed suddenly last Wednesday night in his Rome hotel bathroom. His thirteen-year-old son, who was his only travel companion on their father-son Italian vacation, found him initially conscious on the bathroom floor and quickly called the hotel lobby desk for help. The Italian paramedics arrived, collected him and transported him to the nearest hospital where subsequent heroic efforts – including open-chest cardiac massage — were administered in an ultimately unsuccessful attempt to revive him. Mr. Gandolfini was 51 years old and, according to a family spokesman, Michael Kobold, he had no known prior cardiovascular history, nor had he any prior symptoms to suggest his impending, catastrophic cardiac event. While the general public, as well as the overwhelming majority of today’s physicians and healthcare providers will process Mr. Gandolfini’s premature death as an unfortunate and incomprehensible tragedy that could not have been reliably predicted and thus averted; there are a few physicians practicing today, like myself, who know that Mr. Gandolfini’s short and long-term cardiovascular risk could have been accurately determined and successfully addressed, and had this early detection and treatment approach been used, his irreversible sudden cardiac death could have been prevented! How many more tragic, premature cardiac deaths must we be obliged to witness before we fully realize that our continued, misguided reliance on traditional cardiovascular risk factors – such as age, gender, tobacco use, blood pressure, cholesterol and obesity – as predictors of an individual’s personal risk for a future heart attack or stroke is simply not good enough; and that only through proper utilization of safe and innovative technologies and personalized medicine can we effectively prevent virtually all heart attacks and strokes?