About HeartCare - Preventive Cardiology
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Testimonials

Pamela J – Filmmaker
patient_pamela_jI really didn't like taking thirteen pills every day to control my irregular heartbeat, so I was delighted that just three months after seeing Dr. Wong and following his recommendations, I was able to cut my arrhythmia medications down to just two pills a day. With Dr. Wong's attentive and sensitive care, I have seen a huge improvement in my heart condition and my health in general. I have lost weight and improved my physical stamina. Best of all, I no longer have the unsettling arrhythmic heartbeats and can once again enjoy chocolate. I hope to further cut down on medicines using Dr. Wong's guidelines for diet and exercise. I am very encouraged to discover that I can control my condition and enjoy more energy and stamina.

Eugenia V- CEO
patient_eugenia_vIt worked so well, I should have stuck with Dr. Wong's Low Glycemic Diet. Instead, after dropping 15 pounds and controlling my blood sugar levels, I stopped following the diet. Two years later, my blood sugar reading surged to a dangerous 350! Once diagnosed as borderline diabetic, I was diagnosed with Type 2 Diabetes. I started taking medication but it did not help fast enough. So I went back to what worked -- Dr. Wong's Low Glycemic Diet. Within a few weeks my blood sugar levels dropped to the 200s. After a month, my blood sugar readings dropped even further. By sticking to the diet, I am now 40 pounds lighter and my blood sugar readings average 84 to 94. Best of all, I did not need to make a major lifestyle adjustment. By simply following the diet, I don't have to shoot insulin and my diabetes is under control.

Dennis W – Business Owner
patient_dennis_wI decided to have a heart scan when I was only 38 years old due to my family history of strokes and heart attacks. The radiologist said my heart scan showed dangerous levels of calcified plaque blocking my arteries and he referred me to HeartCare. Dr. Wong administered blood tests and explained that my good cholesterol (HDL) was too low. The HeartCare staff helped me with dietary and other counseling. I see the results in my lab work and have learned to like the healthy dietary choices I am now making: lean protein, fish, and complex carbohydrates. I now see Dr.Wong several times a year. I have experienced a dramatic difference in my blood chemistry -my HDL has doubled - and I have had no events to report over the years.

Robert C – Business Owner
patient_robert_cMy adventure began with a helicopter ride to Cedars-Sinai after severe chest pain seized me during a hike. I had three diseased vessels, requiring a stent and an angioplasty (a balloon inserted to open up the arteries). My physical therapist referred me to Dr. Wong who analyzed my blood and explained I had very low HDL (good cholesterol), high LDL (bad cholesterol), high triglycerides and elevated insulin levels: a dangerous combination. He said to stop taking Vitamins C and E because they were suppressing my good HDL. He prescribed medications to control my lipid (blood) abnormalities and recommended changes to my diet. In just six months, my HDL level increased, and my LDL level, triglycerides and insulin levels lowered. I now visit Dr. Wong about three times a year to keep me on track. I am confident that his diagnosis and treatment have been effective in maintaining my good health.

Mike M – Non-profit Administrator
patient_mike_mAs an ex-smoker with high cholesterol, I was concerned about my risk factors for cardiovascular disease. After being treated by several cardiologists for dizziness, chest pain, and stress, I decided to see Dr. Michael Wong, who specializes in prevention of cardiac events. Dr. Wong's approach to diagnosing my condition was scientific and methodical yet he was good at explaining in lay terms what was going on inside my body. He involved me in my own health management, developing a care plan with precise recommendations based on lab results, my input and his observations. He clearly described the range of consequences that could result from neglecting my health but he was never pushy or condescending about my shortcomings in following his directions. Dr. Wong is competent, compassionate and committed. He helped me understand and control my risk factors, and now visits to HeartCare are a regular part of my healthcare routine.

Dr. Tim T - Cardiothoracic Surgeon
patient_tim_tI first went to see Dr. Wong over thirty years ago because of hypertension and my family history of heart disease. My father had his first heart attack at age 58. Dr. Wong conducted a series of tests that provided evidence of life-threatening plaque that was building up in my arteries. It wasn't hard to convince me to follow Dr. Wong's recommendations for lifestyle changes and medication. I am happy to report that under his close monitoring, I have never had a heart attack or stroke. I credit Dr. Mike Wong for helping me achieve the cardiovascular health to recently celebrate my 85th birthday.

Miguel M. – Construction Worker
I had a body scan at age 45 which identified health issues involving my heart that needed immediate attention. Fortunately I was referred to Dr. Wong and his world class HeartCare team. I was amazed how well Dr. Wong explained in understandable terms the complex factors that can lead to heart problems. In just a short time under his guidance, I changed my diet and drinking habits and adjusted my vitamins and medications. The results were astounding. My total cholesterol dropped from 215 down to 116 and my triglycerides went from 210 down to 34. The changes I made would not have been possible without Dr. Wong and I plan to continue a long relationship with him to keep me on track.

Maria P. - Former Marketing Coordinator
patient_maria_pI decided to see Dr. Michael Wong because I was suffering from very disconcerting  "heart flutters"  and high cholesterol. Plus my family history of stroke really concerned me.

After I moved away from the Los Angeles area, friends and relatives questioned why I continued to drive 200 miles roundtrip to see Dr. Wong. Though I am sure there are competent cardiologists in my area, I simply trust Dr. Wong with my life. He is a true professional, rare in this day and age, and he really cares. He is straight to the point and tells you the truth so you better listen to him. I believe that if I hadn't been referred to Dr. Wong I would not be experiencing the quality of life I enjoy today.

Rodolfo A. - Maintenance Worker
patient_rodolfo_aMy need for ongoing cardiac care brought me to Dr. Wong. I had a pacemaker implanted and I suffered from coronary artery disease. Dr. Wong recommended this special treatment called ECP therapy for me because of my plugged arteries and my off and on chest pains. His office staff provided great service. I received a kind reminder call before each appointment and when I came to the office, one of the medical assistants would help me get set up on the therapy bed. The ECP therapy was magnificent. I did the recommended thirty-five sessions but I started feeling better after just a few days of therapy. I had more energy and could walk longer without feeling tired or out of breath. Dr. Wong is a highly experienced, efficient and knowledgeable doctor who is the reason I feel so much better.

Terri M. - Pharmacy Technician
patient_terri_mAfter dealing with a weakened heart for over 30 years, today I feel like a new person.

I had a history of congestive heart issues when I started seeing Dr. Wong in 2005. My shortness of breath was severe enough to require hospital admissions. Over the years I had a pacemaker implanted and a valve in my heart repaired. Dr. Wong helped manage my care with medications, diagnostic tests, and various treatments. I trusted his advice when in 2011 he said that a heart transplant was my best and perhaps only alternative. By some miracle, only two weeks after being put on the transplant list, I was given the heart of someone 20 years younger. Dr. Wong and his staff helped me keep my own heart going for all those years until I received the transplant. Now I get the support I need to keep my new heart going strong.

Glossary

Disease States

Angina
Aortic Aneurysm
Atherosclerosis
Cardiovascular Disease
Coronary Artery Disease
Heart Attack
Metabolic Syndrome
Plaque
Stroke
Transient Ischemic Attack (TIA)

Risk Factors

Cardiovascular Risk Factors
Cholesterol (low density lipoproteins, high density lipoproteins, triglycerides)
Diabetes
Family History
High Blood Pressure or Hypertension
Smoking

Diagnostic Tests

Abdominal Ultrasound
Carotid Ultrasound
CT Coronary Scan
CT Cardiac Scan
Echocardiogram
Stress Echo

 

Disease States

Angina
Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. Angina is a symptom of a condition called myocardial ischemia. It occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs. This usually happens because one or more of the heart's arteries (blood vessels that supply blood to the heart muscle) is narrowed or blocked. Insufficient blood supply is called ischemia.

Aortic Aneurysm
An aortic aneurysm is a bulge in a section of the aorta, the body's main artery. The aorta carries oxygen-rich blood from the heart to the rest of the body. Because the section with the aneurysm is stretched and weakened, it can burst. If the aorta bursts, it can cause serious bleeding that can quickly lead to death.

Aneurysms can form in any section of the aorta, but they are common in the belly area (abdominal aortic aneurysm) and upper body (thoracic aortic aneurysm).

Atherosclerosis
Atherosclerosis (ath"er-o-skleh-RO'sis) comes from the Greek words athero (meaning gruel or paste) and sclerosis (hardness). It's the name of the process in which deposits of fatty substances, cholesterol, cellular waste products, calcium and other substances build up in the inner lining of an artery. This buildup is called plaque.

Cardiovascular Disease
Cardiovascular disease includes a number of conditions affecting the structures or function of the heart. They can include: coronary artery disease (including heart attack); abnormal heart rhythms/arrythmias, heart failure, heart valve disease, congenital heart disease, cardiomyopathy, pericardial disease, aorta disease and vascular disease.

Coronary Artery Disease
Coronary artery disease is atherosclerosis of the coronary arteries. Atherosclerosis occurs when the arteries become clogged and narrowed, and this can restrict blood flow to the heart. Without adequate blood, the heart becomes starved of oxygen and the vital nutrients it needs to work properly.

Heart Attack
A heart attack, or myocardial infarction (MI) is permanent damage to the heart muscle. "Myo" means muscle, "cardial" refers to the heart and "infarction" means death of tissue due to lack of blood supply. The heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical blood supply. If you have heart disease, those arteries become narrow with plaque and blood cannot flow as well as it should. When the plaque's hard, outer shell cracks (plaque rupture), platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes "starved" for oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage. This is called a myocardial infarction (MI), or heart attack.

Metabolic Syndrome
Metabolic syndrome is a group of health problems that include too much fat around the waist, elevated blood pressure, high triglycerides, elevated blood sugar, and low HDL cholesterol. Together, this group of health problems increases your risk of heart attack, stroke, and diabetes. Metabolic syndrome is caused by an unhealthy lifestyle that includes eating too many calories, being inactive, and gaining weight, particularly around your waist.

Plaque
Atherosclerotic plaque is a waxy substance formed inside the arteries that supply blood to your heart. This substance, called plaque, is made of cholesterol, fatty compounds, calcium, and a blood-clotting material called fibrin. Doctors have found that there are two kinds of plaque: hard (calcified) and soft.

Most people know about hard plaque and how it can cause a heart attack. If hard plaque builds up in the arteries that supply blood to your heart, the blood flow slows or stops. This decreases the amount of oxygen that gets to the heart, which can lead to a heart attack.

But doctors have now found that even though some heart attacks are caused by hard plaque, most heart attacks are caused by soft or vulnerable plaque. A vulnerable plaque is an inflamed part of an artery that can burst. This can lead to the formation of a blood clot, which can lead to heart attack.

In fact, vulnerable plaque may be buried inside the artery wall and may not always bulge out and block the blood flow through the artery. This is why researchers began to look at how inflammation affects the arteries, and if inflammation could lead to a heart attack. What they found was that inflammation leads to the development of "soft" or vulnerable plaque. They also found that vulnerable plaque was more than just debris that clogs an artery, but that it contained different cell types that enhance blood clotting.

Patients with this kind of plaque may not feel symptoms. In the early stages of the process, the change in blood flow may not be detected with standard testing, but researchers are looking at special scanning techniques that may highlight the presence of vulnerable plaque.

Stroke
A stroke occurs when a blood vessel in the brain is blocked or bursts. Without blood and the oxygen it carries, part of the brain starts to die. The part of the body controlled by the damaged area of the brain can't work properly.

Brain damage can begin within minutes, so it is important to know the symptoms of stroke and act fast. Quick treatment can help limit damage to the brain and increase the chance of a full recovery.

Transient Ischemic Attack (TIA)
A TIA is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage. TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. The symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes. The average is about a minute. Unlike stroke, when a TIA is over, there's no injury to the brain. Recognizing and treating TIAs can reduce your risk of a major stroke.

Risk Factors

Cardiovascular Risk Factors
The major risk factors are well-established. A family history of heart disease is one risk factor. Other risk factors can be controlled. Of these, the main ones are high blood pressure, high cholesterol, diabetes, obesity, smoking, and a sedentary lifestyle. Stress is also believed to raise the risk, and exertion and excitement can act as triggers for an attack.

Men 45 and older and women 55 years and older are at increased risk of heart attack. High levels of estrogen are thought to protect premenopausal women fairly well from heart attack, but the risk increases significantly after menopause.

Cholesterol
Cholesterol is a waxy, fat-like substance made in the liver and found in certain foods, such as food from animals, like dairy products (whole milk and cheese), eggs and meat. The body needs some cholesterol in order to function properly. Its cell walls, or membranes, need cholesterol in order to produce hormones, vitamin D and the bile acids that help to digest fat. But the body needs only a small amount of cholesterol to meet its needs. When too much is present, health problems such as coronary heart disease may develop.

  • Low density lipoproteins (LDL): LDL, also called "bad" cholesterol, can cause buildup of plaque on the walls of arteries. The more LDL there is in the blood, the greater the risk of heart disease.
  • High density lipoproteins (HDL): HDL, also called "good" cholesterol, helps the body get rid of bad cholesterol in the blood. The higher the level of HDL cholesterol, the better. If your levels of HDL are low, your risk of heart disease increases.
  • Triglycerides: Triglycerides are another type of fat that is carried in the blood by very low density lipoproteins. Excess calories, alcohol or sugar in the body are converted into triglycerides and stored in fat cells throughout the body.


Diabetes
About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke.

Diabetes is a disorder of metabolism--the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced (insulin resistance).

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and ethnicity. About 80 percent of people with type 2 diabetes are overweight.

Family History
Cardiovascular disease can run in families -- if you have a family history of heart disease, you may be at greater risk for heart attack, stroke, and other heart problems. The closer the relative, the greater your heart disease risk. If you have a "first-degree relative" -- that's a mother, father, sister, or brother (or even a son or daughter) who had heart disease at an early age (male relative younger than 55, female relative younger than 65), that increases your risk of developing heart disease. The more family members who have had early heart disease, the greater your risk of developing heart disease.

High Blood Pressure or Hypertension
Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and it contributes to hardening of the arteries or atherosclerosis and the development of heart failure. There are several categories of blood pressure, including:

  • Normal: Less than 120/80
  • Prehypertension: 120-139/80-89
  • Stage 1 hypertension: 140-159/90-99
  • Stage 2 hypertension: 160 and above/100 and above


Smoking
About 30 percent of all deaths from heart disease in the U.S. are directly related to cigarette smoking. Smoking is a major cause of atherosclerosis. Among other things, the nicotine present in smoke causes:

  • Decreased oxygen to the heart.
  • Increased blood pressure and heart rate.
  • Decrease in the good HDL cholesterol.
  • Increase in blood clotting.
  • Damage to cells that line coronary arteries and other blood vessels, triggering atherosclerosis and heart disease.

Diagnostic Tests

Abdominal Ultrasound
An abdominal ultrasound uses reflected sound waves to produce a picture of the organs and other structures in the upper abdomen. It is often used to detect, measure, or monitor an aneurysm in the aorta. An aneurysm may cause a large, pulsing lump in the abdomen. No radiation is involved.

Carotid Ultrasound
The carotid arteries in the neck can be easily viewed with a risk-free ultrasound test. Atherosclerosis in these arteries suggests a higher risk for heart attacks and strokes. This is because atherosclerosis occurs throughout the body. The ultrasound helps doctors evaluate blood flow and can show blocked or reduced blood flow through narrowing in the major arteries of the neck. No radiation is involved.

CT Coronary Scan
Coronary computed tomography angiography (CTA) is a noninvasive heart imaging test currently undergoing rapid development and evaluation. High-resolution, three-dimensional pictures of the moving heart and great vessels are produced during a coronary CTA to determine if either fatty or calcium deposits (plaques) have built up in the coronary arteries.

Before the test, an iodine-containing contrast dye is injected into an IV in the patient's arm to improve the quality of the images. A medication that slows or stabilizes the patient's heart rate may also be given through the IV to improve the imaging results.During the test, which usually takes about 10 minutes, X-rays pass through the body and are picked up by special detectors in the scanner.

This kind of scan can also be used to study all parts of the body and is referred to as a whole body scan.

CT Cardiac Scan
Computed tomography, commonly known as a CT scan, combines multiple X-ray images with the aid of a computer to produce cross-sectional views of the body. Cardiac CT is a heart-imaging test that uses CT technology with or without intravenous (IV) contrast (dye) to visualize the heart anatomy, coronary circulation, and great vessels (which include the aorta, pulmonary veins, and arteries). From the CT cardiac scan a calcium score can be derived. That score is another useful indicator for determining risk.

Echocardiogram
An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen. Echo can be used as part of a stress test and with an electrocardiogram (EKG) to help your doctor learn more about your heart. No radiation is involved.

Stress Echo
During this test, an echocardiogram is done both before and after your heart is stressed either by having you exercise or by injecting a medicine that makes your heart beat harder and faster. A stress echocardiogram is usually done to find out if you might have decreased blood flow to your heart. No radiation is involved.


Adapted from the WebMD, American Heart Association, Texas Heart Institute