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What does your practice do to focus on preventive cardiology, that a standard cardiology practice may not cover?
We go into areas of risk that are not routine, including, for example, sleep and stress, and our history is detailed. The quality of sleep, as well as sleep apnea, are possible contributing factors to inflammation, which is a significant factor of cardiovascular disease. We often try to understand the sources and levels of a patient’s stressors, so that we can track progress over time in dealing with it.
What is the method of diagnosing the level of risk a patient faces from their cardiovascular condition?
It starts with a detailed history. We encourage patients to provide their medical records, and those are organized and reviewed, either at the initial consultation or whenever they are made available. We have a lab flow chart that organizes all the prior and current lab work into the tests and values that we consider significant, along with certain ratios that are calculated. We use several diagnostic tests, and those have evolved over time. We look at lab tests and imaging studies that we consider important. We encourage patients to have those tests, because they allow a precise assessment of risk. They also allow us to track progress by repeating them over time.
Do you also use alternative therapies or lifestyle modifications?
Yes, we have incorporated various alternatives over time. For example, the recent study announced by the American Heart Association in mid November 2019 about managing heart disease with lifestyle and medication showed that this approach, which is the one we use, is as effective as stents or bypass in prolonging life. This was a blockbuster study in that it was so large (over 5000 patients tracked for several years).
But the study also raised the issue of how to address patient discomfort from angina (chest pain from blocked arteries)? We have an alternative therapy in our practice, the external counterpulsation (ECP) bed, that enhances circulation and was designed to create new pathways in the heart, but noninvasively. This is therapy is an alternative to bypass or stents and allows a patient to avoid the risks of surgery.
We have given second opinions where a stent or bypass has been recommended and where we disagreed. Those patients have been successful in achieving progress without invasive procedures and are doing fine some years later.
We also have suggestions on how to manage stress and enhance sleep, and on other aspects of cardiovascular disease. We have dietary suggestions based on the lab results. Patients are not alike; some should reduce sugar and others should reduce fat intake for example. Some patients have optimal test results and should keep doing whatever they are doing.
What is the advantage of a consultation with Dr. Michael J. Wong?
We all develop habits. They can be habits of how we deal with stress, how we sleep, what we eat or drink, and these all may persist for decades without being questioned. And those habits can determine whether we are healthy or at risk. So the advantage of seeing us is first, to determine what level of risk a patient faces. Cardiovascular disease is invisible and affects the functioning of the entire system. We can tell you if you are at risk, and if so, how to halt or reverse that risk. We can pinpoint the areas of lifestyle that may need change. And we can help you change, over time.