Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I want to talk about protecting your heart. 

I have been blessed with friends/colleagues who rally behind the prevention of disease. When it comes to heart health, cardiology specialist, Dr. Herb Ladley, MD is one of the best. Herb became a cardiologist because he was fascinated by the heart’s anatomy and physiology. He loves his work and believes that taking time to listen to his patients helps him understand how best to treat them. My kind of guy! With 45 years of experience in the medical field, I value his advice on the subject.

I encourage you to listen to the full podcast and take notes. Cardiovascular Disease (CVD) remains the leading cause of death in the United States accounting for 928,741 deaths in the year 2020 (American Heart Association Update 2023). What can we do to help lower these numbers? Protect Your Heart. 



On Advancements In Cardiology


  • One of the main things Dr. Ladley has seen in the advancement of cardiology has been the ability to revascularize the heart without surgery. The development of coronary angioplasty and stenting, as a discipline, has grown. 
  • The impact of the electrical arena (heart rhythm problems and device management) has been huge. When the heart becomes diseased and damaged, it may need some kind of electrical intervention, or a management of electrical instability that goes along with the structural heart problems. 


On Prevention 


  • For prevention, Dr. Ladley emphasized the importance of a metabolic panel and some simple screening, like coronary calcium scoring. This is an excellent screening tool for patients that do not yet have symptomatic coronary disease, but may be at risk in terms of their risk factor profile
  • Recognize how late in the process of coronary disease (an abnormal calcium score) you are. By the time you’ve had a plaque that has ruptured, and some calcium build up, you’re down the road in terms of heart disease. 
  • Trying to identify the earlier indicators and deal with them are even more important than some of the screening tests that pick up the disease later. CT Calcium scoring is helpful, but it’s just another tool. Note: I do a Cleveland Heart Panel on most of my patients, which gives me a vast array of numbers to look at, from inflammatory markers to how thick your blood is, to the size of your LDL and how oxidized it is. PLUS insulin resistance. 
  • We all are developing atherosclerosis as we age. 
  • Coronary disease is a lagging indicator of the metabolic syndrome and inflammatory state that people have had. 
  • The more you wrestle with the downstream manifestations of heart disease, the more interested you have to become in the upstream prevention (the panels, metabolic management, the role of exercise and strength training). 
  • One of the things we’ve learned about heart disease is that it’s not linear. It’s a disease of events. Things are fine, then there’s an event. Aspirin is probably one of the agents that helps to quiet the events. Statins are probably another. 

Other topics touched on in this episode include: 

  • GLP-1 medications
  • Sleep studies 
  • Omega-3 controversy 
  • Low fat diets 

A great podcast with lots of gems! I want to publicly thank Dr. Ladley and Cardiovascular Associates in Kingsport, TN for everything they do in our region. Working together, we can help prevent heart disease. 

As always, stay educated, stay healthy. 

Till next week. 

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