The Quiet Power of Preventive Medicine
"It is hard to deny that we live in an era of almost miraculous cardiovascular interventions," states Dr. Atul R. Chugh, a cardiologist with Franciscan Physician Network Indiana Heart Physicians in Crawfordsville. "Cardiovascular specialists can fix cardiac valves without opening the chest. We can visualize the heart in real-time and in three-dimensions, sending patients home with a 3D 'printout' of their own hearts to lodge on the mantle alongside other mementos."
But What If It Wasn't Needed?
Dr. Chugh acknowledges technology today can fix a lot of what's wrong with our hearts, but where cardiologists often falter, is how to help patients avoid heroic measures in the first place. Cardiovascular disease remains the No. 1 killer in the U.S.
"One of the reasons why we fail to adequately emphasize prevention may be because the work of preventive medicine is seldom captivating enough to make our collective imaginations spring to life," he says. "Most efforts to prevent a cardiac event, such as a heart attack are done by self-disciplined patients themselves. Patients such as an obese diabetic mother of three who wants to live to see her grandchildren go to school, or a man with high blood pressure who doesn’t want to follow in his father's footsteps of dying from a heart attack at the age of 54. These types of patients, taking the quiet, brave steps of making hard life changes, are my heroes."
Dr. Chugh suggests that for a very long time, physicians within the preventive realm did not have much to offer. But emerging disease markers, such as coronary calcium scores, carotid intimal thickness, aortic stiffness indices, hs-CRP, Lp-PLA2, among others, allow cardiologists to pinpoint risk and augment therapies as needed.
"Our increasing knowledge of exercise physiology allows workouts to be more efficient and effective so that an exercise regimen can be more than a January resolution that fizzles by February," he says. "For blood pressure control, we now perform 24-hour blood pressure monitoring and encourage the use of Wi-Fi-enabled measurement devices, giving us a detailed picture of whether blood pressure is controlled consistently as a patient goes about her routine day rather than the mere snapshot we get during an office visit."