Speaker 1: Virgin Media broadband is smooth. How smooth you ask, Well,
Speaker 1: Imagine you're a big old war.
Speaker 2: Russ and rather than lumbering around a glacier avoiding polar bears,
Speaker 2: you're on a lake, driving a speedboat three thousand kilos
Speaker 2: of mollusk, munching magnificence, feeling the wind in your whiskers
Speaker 2: and the sun on your big blubbery face. That's the
Speaker 2: kind of smoothness you feel. With ninety nine point nine
Speaker 2: percent broadband reliability available nationwide Virgin Media, it's playtime subject
Speaker 2: to location availability.
Speaker 3: Teasin, he's apply for broadland reliability see Virgin Media dot
Speaker 3: I E Forward slash proof.
Speaker 4: Oh hey, it's the woman on the swamp tour who
Speaker 4: won't stop screaming. Yeeha, Ali Ward, and we are here
Speaker 4: with your heart in your ears. Cardiology, let's consider this
Speaker 4: episode of one on one. It's a very basic intro
Speaker 4: to a really huge discipline. And this is a guest
Speaker 4: I have waited months and months and months to interview.
Speaker 4: It all started. I got a note from a list
Speaker 4: named Matthew Evan Taylor who said, not only was this
Speaker 4: person a top cardiologist in the country, but he also
Speaker 4: has a great radio voice and also was his dad.
Speaker 4: I did a little research and quickly realized no other
Speaker 4: cardiologist would do me and this guest. We chatted months
Speaker 4: back over the phone, and he wanted to time the
Speaker 4: episode so that it hit in February to encompass both
Speaker 4: American Heart Month and Black History Month. But he's super busy.
Speaker 4: He had a conference to go to November, and then
Speaker 4: he was going to the Super Bowl in February. Turns
Speaker 4: out he didn't just have a conference to go to.
Speaker 4: He was being awarded the Clinical Research Prize at the
Speaker 4: American Heart Association's Scientific Sessions in twenty twenty four. Owned
Speaker 4: the Super Bowl tickets, you know. He was there as
Speaker 4: the director of Player Engagement and Education and a co
Speaker 4: investigator into the Football Player's Health Study at Harvard University.
Speaker 4: He was at workin He is a professor and a
Speaker 4: director at the Cardiovascular Research Institute at the Moorhouse School
Speaker 4: of Medicine in Atlanta. He did his undergrad at Princeton,
Speaker 4: his doctorate from Harvard Medical School, and has been named
Speaker 4: the American Heart Association's Physician of the Year. This man's schedule,
Speaker 4: like some of our arteries, is packed wall to wall
Speaker 4: with huge responsibilities, but he is gracious and generous and
Speaker 4: we were able to nab him for about an hour
Speaker 4: this past Saturday morning. I was terrified to take up
Speaker 4: too much of his time because I already loved him
Speaker 4: so much. And we turned this episode around in just
Speaker 4: a few days. He showed up on video and a
Speaker 4: shirt and tie, all smiles. He let me ask him
Speaker 4: so many questions. But first, before we get into it,
Speaker 4: thanking about on the patrons who submitted their questions before
Speaker 4: we recorded. Thanks to all the folks in ologies merch
Speaker 4: from ologiesmerch dot com. Thanking about on the listeners leaving
Speaker 4: reviews which helped the show so much, such as this
Speaker 4: recent review from Amy and Arlington, who wrote, you learn
Speaker 4: new stuff each time, you come away amazed by all
Speaker 4: the smart and good people in the world, something we
Speaker 4: all need nowadays. Thank you, Amy and Arlington and everyone
Speaker 4: who has ever left a review. I have read them all. Okay,
Speaker 4: let's get to the heart of the matter. Cardiology comes
Speaker 4: from the Greek for heart easy, and we covered as
Speaker 4: much as we could in the time that we had.
Speaker 4: So Yeah, consider this a one oh one, A primer.
Speaker 4: Get pumped for valves, tubes, beats, electrical shocks, Gray's anatomy glossaries,
Speaker 4: heavy metal hearts, The effects of long term stress on
Speaker 4: the heart, What those blood pressure numbers mean, how to
Speaker 4: read an EKG, what to do with an emergency cardiac
Speaker 4: disease symptoms, what your heart wants you to eat, how
Speaker 4: to decipher your cholesterol numbers, and why you would want
Speaker 4: to trust me it's fun, The worst heart art out there,
Speaker 4: and why a wedding ring goes on that finger with researcher, Professor, physician,
Speaker 4: Heart Hero and your new favorite cardiologist, doctor Herman Taylor.
Speaker 4: This one is going to come up on Tuesday, so
Speaker 4: this is going to be a quick turnaround.
Speaker 5: Yeah, okay, all right, Yeah, let's get to it.
Speaker 4: Okay, he him, Yes, okay, Herman Taylor. Now you're a cardiologist.
Speaker 4: How long have you been a cardiologist?
Speaker 5: I've been a cardiologist really since nineteen ninety, which now
Speaker 5: I guess is what thirty five years? Is that? Right?
Speaker 1: Yeah?
Speaker 5: Yes, quite a long time.
Speaker 4: Now, what was it that drove you into cardiology when
Speaker 4: you were in med school, when you were on this
Speaker 4: path to becoming a doctor. When did that passion start
Speaker 4: for you?
Speaker 5: Well, let's see, originally I was I guess just very
Speaker 5: interested in science. The thing that got me going actually
Speaker 5: was believe it or not, And this dates me a bit.
Speaker 5: The Space program got me first interested in science in general,
Speaker 5: and I gravitated through a period where I wanted to
Speaker 5: be an oceanographer. You may not be familiar with the
Speaker 5: undersea world of Jacquesustau.
Speaker 3: We would like to know more about this serpent who
Speaker 3: ages ago it turned from land to the ocean of
Speaker 3: his origin to prey on the tiny bottom dwen hours.
Speaker 5: But if you go back in the archives, I'm sure
Speaker 5: you could find that I found that really inspirational. But
Speaker 5: as time went by, I got more interested in physics,
Speaker 5: as it turns out, which led me actually to cardiovascular physiology.
Speaker 5: The way it was taught back then, there was a
Speaker 5: heavy emphasis on himodynamics and flows and fluids as sort
Speaker 5: of one of the primary things you had to master
Speaker 5: if you wanted to understand what was going on with
Speaker 5: the circulation with the heart. In college, while I was
Speaker 5: still vacillating a little bit about what I was going
Speaker 5: to do after college, I had the opportunity to go
Speaker 5: to Cornelli University's School of Medicine for a research fellowship,
Speaker 5: and part of that experience was teaching cardiovascular physiology, and
Speaker 5: that's sort of where things everything came together for me
Speaker 5: in terms of my interest in the heart and the circulation.
Speaker 5: And that combined with sort of seeing through the opportunity
Speaker 5: of this summer research fellowship, seeing clinical scenarios that showed
Speaker 5: that marginalized populations had a particularly bad time with cardiovascular disease.
Speaker 5: All that sort of piqued my interest, got my passions
Speaker 5: going and pointed in the direction of cardiology. After spending
Speaker 5: some time on a faculty in Birmingham, my hometown, teaching cardiology,
Speaker 5: seeing patients, etc. And really having a wonderful experience being
Speaker 5: in my hometown treating people who were maybe colleagues and
Speaker 5: friends and coworkers of my parents and friends, and I
Speaker 5: got inspired by the idea of studying a large population
Speaker 5: of African Americans looking specifically at cardiovascar risk. There had
Speaker 5: been a study and still actually still is, a study
Speaker 5: called the Framingham Heart Study, which looked at a long
Speaker 5: term took a long term view of cardiovascular health and
Speaker 5: a population in the Northeast that happened to be almost
Speaker 5: entirely white. In fact, even more specifically, mostly it was
Speaker 5: either Italian Irish or Irish Italian in terms of its heritage.
Speaker 4: So this study, founded just after World War Two, focused
Speaker 4: on the long term heart health of over five thousand
Speaker 4: residents of Framington, Massachusetts, and it's ongoing. It's in its
Speaker 4: third generation of volunteer subjects and among many discoveries chronicled
Speaker 4: in thousands of published papers were findings about cigarette smoke
Speaker 4: and heart disease, psychosocial factors, and genetic or inherited risk factors.
Speaker 5: That study has been tremendous in its contrabans, but there
Speaker 5: was a major omission. You know, that's a very small
Speaker 5: slice of the human family when you talk about people
Speaker 5: whose heritage is traced principally to Western Europe. Mankind, womankind
Speaker 5: is much broader than that, and there were some special
Speaker 5: challenges in the black population that weren't adequately being met.
Speaker 5: So the world of research was really looking for a
Speaker 5: way to fill that gap, and we came together with
Speaker 5: the idea of the Jackson Heart Study to do that.
Speaker 5: So it was a particularly fun time of my career.
Speaker 4: And the Jackson Heart Study, started twenty five years ago,
Speaker 4: looked at the cardiac health of again over five thousand participants.
Speaker 4: But this time in Jackson, Mississippi. And another reason why
Speaker 4: we waited until February for this episode at doctor Taylor's
Speaker 4: suggestion for a Black History Month is that Black history
Speaker 4: factors into what care patients receive. And one twenty twenty
Speaker 4: study laying out a lot of info was published in
Speaker 4: the Journal of Hypertension titled discrimination and Hypertension risk among
Speaker 4: African Americans. In the Jackson Heart Study, you mentioned that
Speaker 4: there are certain circumstances that put heart health at risk. More,
Speaker 4: what is genetic versus? What is lifestyle? What is access
Speaker 4: to medical care? What factors are really affecting any person?
Speaker 5: Well, there's so many, and it's a combination, a convergence
Speaker 5: of a lot of different dimensions. Let's say, so the
Speaker 5: genetic certainly, you know, family history and things that run
Speaker 5: in families are important. There are some very specific things
Speaker 5: like abnormalities and cholesterol metabolism, tendencies towards high blood pressure.
Speaker 5: Those things can run in families. But so can things
Speaker 5: like eating habits which are not genetic in any serious way.
Speaker 5: If there is a family tradition of eating a quote
Speaker 5: Southern diet or what people might consider a soul food diet,
Speaker 5: or some other diet that has a propund difference of
Speaker 5: certain types of foods, seasoning that carries certain electrolyzed that
Speaker 5: might not be good taken in overabundance, a tendency to
Speaker 5: fry foods which causes chemical changes in foods that may
Speaker 5: not be ideal, et cetera.
Speaker 4: So cardiac disease may involve a straight up DNA predisposition
Speaker 4: like familial hypercholesterolmia, which is cosmetis genetic link on how
Speaker 4: your body recycles LDL or bad cholesterol, and it might
Speaker 4: require meds no matter how you change your habits. And
Speaker 4: of course, heart health is affected by geographic and lifestyle
Speaker 4: factors like how walkable your neighborhood is, or diet in
Speaker 4: your culture. And actually, if you want a great Black
Speaker 4: History Month episode on cuisine, doctor Psyche Williams Forsen is
Speaker 4: a food historian who we interviewed for a Black American
Speaker 4: Magnrology episode. But yeah, some heart conditions are just wired
Speaker 4: into yourselves.
Speaker 5: Those types of things can run in families. Then you
Speaker 5: have cultural and societal exposures that may be quite material
Speaker 5: in terms of whether a person develops high blood pressure, diabetes,
Speaker 5: et cetera, or heart disease, itself, and these can relate
Speaker 5: to things that induce stress in the population, whether it's
Speaker 5: the stress of city life or the stress of you know,
Speaker 5: let's let's call it discriminatory practices, or limited access to care,
Speaker 5: or limited access to good food. Those things too, can
Speaker 5: all come together to create an ecosystem that's very unfavorable
Speaker 5: for your heart. And some people face those things day
Speaker 5: in and day out, and they accumulate over time and
Speaker 5: can lead to some fairly serious sequella.
Speaker 4: Yeah, I didn't know what that work meant. Sequella, Yes, sequella, Okay,
Speaker 4: I got it.
Speaker 5: Maybe I should pick another word. Things that happen in contant,
Speaker 5: So that's or, you know, in sequence, I guess, but you.
Speaker 4: Know, I'm not sure. I don't take you as someone
Speaker 4: who spends a lot of time scrolling on social media,
Speaker 4: because you've got a lot of important things to do.
Speaker 4: But there was this viral video that went around of
Speaker 4: this heart.
Speaker 2: So it is a one piece.
Speaker 4: Piece, so it was a model of a heart that
Speaker 4: they were teaching in anatomy and it almost was spiral
Speaker 4: the muscle. They almost stretched it out like unrolling a
Speaker 4: map or something. Is that how a heart is constructed?
Speaker 5: Wow? Well, I haven't seen the video, okay, but what
Speaker 5: is true is that the heart in the embryo, the
Speaker 5: heart starts out as a straight tube right of cells,
Speaker 5: and as gestation goes forward, that tube begins to fold up,
Speaker 5: twist on itself, and fuse. And what you wind up
Speaker 5: having is this four chambered marvel of a muscle. Muscle
Speaker 5: is maybe too simple a description of what it is,
Speaker 5: because it has electrical properties, it has contractile properties, and
Speaker 5: even a sort of a mind of its own. I mean,
Speaker 5: it can beat on outside of your body, powered by
Speaker 5: its own spontaneous electrical impulses. They've left to its totally
Speaker 5: through its own devices, as long as it had oxygen
Speaker 5: and nutrients.
Speaker 4: So when you see people in medical dramas, hopefully not
Speaker 4: in real life unless you're a healthcare worker, in which case,
Speaker 4: thank you so much, they may be using what's called
Speaker 4: an AED and this is an automated external defibrillator, and
Speaker 4: it's called automatic because it detects and then it analyzes
Speaker 4: the patient's heart rhythm and then it delivers an electrical
Speaker 4: shock to reset the cardiac arrhythmia, which a rhythmic so
Speaker 4: it's out of sync heart beats. So if a person
Speaker 4: has a cardiac arrest and they have no pulse, no heart,
Speaker 4: they're not breathing. The protocol is typically to administer CPR
Speaker 4: if you know how to do it, and then if
Speaker 4: there's an AED nearby, use that next. And I cannot
Speaker 4: stress enough that first aid training is going to do
Speaker 4: a better job than me. I'm my podcast host and
Speaker 4: I'm just search engining how to save a life. And
Speaker 4: then I'm trying to tell you in like seventeen seconds now,
Speaker 4: if a heart can beat with electrical charge and oxygen.
Speaker 4: Is that what happens in heart transplants?
Speaker 1: I don't know.
Speaker 4: I've never had one. But our guest, doctor Tom Bulk
Speaker 4: in the Mycology episode, did have a heart transplant, and
Speaker 4: we discussed it in his episode, which we'll link for you,
Speaker 4: during which he pointed me toward this felted box on
Speaker 4: his desk. It looked like a Kleenex box, but it
Speaker 4: contained a fluid filled plastic bag with the heart he
Speaker 4: was born with. It was sliced up like thick roast beef. Now,
Speaker 4: how do those transplants work well? In brief, a donor
Speaker 4: heart is removed, usually from a patient who has experienced
Speaker 4: brain death. But is a live via intubation, and one
Speaker 4: that support is withdrawn and the patient passes. The heart
Speaker 4: is removed and it's taken on ice to wherever the
Speaker 4: recipient is hopefully close by. They only have a couple
Speaker 4: hours on ice. Now, the recipient is prepped and while
Speaker 4: the surgeons replace their heart, a cardiopulmonary bypass machine circulates
Speaker 4: and oxygenates their blood while the recipient's heart is getting
Speaker 4: taken out. Now, typically the donor heart would be transplanted,
Speaker 4: not beating, and then restarted, but thrillingly, weirdly and surreally.
Speaker 4: As described in this twenty to twenty three paper first
Speaker 4: inhuman beating heart transplant, doctor Joseph Wu and his team
Speaker 4: at Stanford were able to restart a donor heart, keep
Speaker 4: it warm with blood and beating as it was being
Speaker 4: implanted into its new recipient. Trust me, we could do
Speaker 4: a thirteen episode series just on this topic. But those
Speaker 4: are some basics, back to even basic or basics. How
Speaker 4: did you build your heart in the first place? How'd
Speaker 4: you do it?
Speaker 5: So? Yeah, it starts out as a two. It twists
Speaker 5: and bols and fuses in just the right way, and
Speaker 5: you get again this four chamber structure that we know
Speaker 5: as the heart.
Speaker 4: What are those four chambers doing? If you had to
Speaker 4: break it down to someone who is obviously not a cardiologist,
Speaker 4: the ventricles, the chambers, what's doing what?
Speaker 5: Okay, so there are four chambers. There's a left heart,
Speaker 5: if you will, in a right heart. Each side of
Speaker 5: the heart, let's go with that terminology has sort of
Speaker 5: an atrium, just like the atrium to a building. The
Speaker 5: four you end up building, and that atrium is the
Speaker 5: first chamber, and it receives blood and then loads the
Speaker 5: sort of more business in the stronger, more thickly muscle
Speaker 5: chamber called the ventricle. The right atrium takes all of
Speaker 5: the venus blood. All the blood has been say used,
Speaker 5: let's call it. It's been out to the body, has
Speaker 5: dropped off its nutrients and its oxygen, has participated in
Speaker 5: cholesterol transport, has taken immune cells to where they need
Speaker 5: to go, and all the various functions of blood that
Speaker 5: comes back with a lot of the oxygen and nutrients
Speaker 5: depleted for another round to pick up essentially more oxygen
Speaker 5: by being pumped through the lung. So there's a special
Speaker 5: part of the heart that's devoted entirely to making sure
Speaker 5: that fresh blood with a fresh supply of oxygen is
Speaker 5: supplied to the body. The first stop after first coming
Speaker 5: into that right atrium going through a valve which is
Speaker 5: a one way door. Now that valve is called the
Speaker 5: tricuspid valve for those who want detail. But coming through
Speaker 5: that valve, leaving the atrium, it goes into the right ventricle.
Speaker 4: Which is downstairs from the right entry or atrium.
Speaker 5: That strong ventrals then pumps it up to the lungs
Speaker 5: where it goes through this amazing network of blood vessels
Speaker 5: and down to where the blood vessels are so thin
Speaker 5: they come right up next to the little sacs that
Speaker 5: have air oxygen alvil and they're so close that the
Speaker 5: oxygen can just diffuse across into the blood. And then
Speaker 5: after the blood gets refreshed from people like to talk
Speaker 5: about blue blood and bright red blood, it turns much
Speaker 5: more closer than this bright red type of blood.
Speaker 4: So once again the spent blood enters the right atrium
Speaker 4: via the vena cava as venus blood heads to the
Speaker 4: ventricle and then to the lungs via the pulmonary arteries
Speaker 4: where it fills up on oxygen, and then it heads
Speaker 4: back to the heart's left atrium via the pulmonary veins. Okay,
Speaker 4: so you got fresh blood back to the heart for distribution.
Speaker 5: All of that then drains from the lungs into now
Speaker 5: the left atrium, okay, which is the first chamber after
Speaker 5: the blood has been refreshed. Once there, that atrium squeezes
Speaker 5: and pushes loads the true business end of the heart,
Speaker 5: the left ventricle. This is the most powerful part of
Speaker 5: the heart. This is the thickest muscle in the heart.
Speaker 5: Why because it has to then generate enough pressure to
Speaker 5: push blood through the body to every cubic millimeter or
Speaker 5: even smaller portion of tissue throughout the heart and every
Speaker 5: organ to again supply oxygen and nutrients, and then allow
Speaker 5: after it all is used, for the whole thing to
Speaker 5: circle back again to the heart. The heart does this
Speaker 5: through it's estimated thousands of miles if you could, if
Speaker 5: you could stretch all of these vessels out into end,
Speaker 5: they'd be several thousand for an individual person, which is
Speaker 5: kind of hard to conceive.
Speaker 4: Several thousand.
Speaker 5: Well, when you consider that the blood vessels go from
Speaker 5: the big obvious vessels down to tiny microscopic capillaries that
Speaker 5: allow again, the diffusion of nutrients and oxygen into every
Speaker 5: part of tissues and organs throughout the body. You can
Speaker 5: imagine that. Yeah, if it was possible that it would
Speaker 5: make for a very very long highway of blood vessels.
Speaker 4: Okay, So the atrium is on top, the ventricles are
Speaker 4: on the bottom, and the left side is tasked with
Speaker 4: shooting blood out to your whole body like an Olympic
Speaker 4: shot putter, but just throwing buckets of blood as far
Speaker 4: as it can. And that beefy left side is why
Speaker 4: our heart is kind of left leaning in our chest. Now,
Speaker 4: as for a wedding ring on the left ring finger,
Speaker 4: what's the deal with that so called vina and which
Speaker 4: is the blood plumbing that leads from the heart straight
Speaker 4: to that one wedding ring finger digit? Friends, it's flim flam.
Speaker 4: All the veins and the arteries go back and forth
Speaker 4: to the heart and wedding rings. Over time, they've been
Speaker 4: worn on either hand. Some were even worn on the
Speaker 4: thumb when the fashion was like blingier and bulkier one
Speaker 4: hundreds of years ago. So no, you do not have
Speaker 4: a vein or an artery that goes straight from your
Speaker 4: heart to your wedding ring. It's cute though. Now if
Speaker 4: you're like, I must know more about this history, you
Speaker 4: can see the nineteen seventeen book. Well, I'm going to
Speaker 4: take a breath here. It's titled Rings for the Finger
Speaker 4: from the Earliest known times to the present, with full
Speaker 4: descriptions of the origin, early making materials, the archaeology, history
Speaker 4: for affection, for love, for engagement, for wedding, commemorative morning,
Speaker 4: et cetera. That's the whole title. I find that et
Speaker 4: cetera at the end to be like the funniest thing
Speaker 4: I've ever read, because it's the longest title of the book,
Speaker 4: maybe in the universe. Anyway, onward, I need you to
Speaker 4: know also that atrium, you know how it means entry
Speaker 4: hall for the heart. Ventricle derives from the Latin for
Speaker 4: little belly, So that's a little belly of your heart.
Speaker 4: More on guts in your hearts later in the episode. Now,
Speaker 4: remember how in the recent surgical Anchiology episode with doctor
Speaker 4: s Sheila Blumberg about veins and arteries, we learned that
Speaker 4: venous blood is on its return trip to the heart.
Speaker 4: It's darker in color, it's low in oxygen from delivering
Speaker 4: it all over your body. While arterial blood it's fresh
Speaker 4: from the lungs, it's brighter, and it's fueled up with
Speaker 4: O two on the way to your body. If you
Speaker 4: don't remember that, that's okay, because I just told you so. Obviously,
Speaker 4: the speed and pressure that that fluid is pumping through
Speaker 4: your body is important when it comes to blood pressure.
Speaker 4: When it comes to heart health too, we always hear, like,
Speaker 4: my blood pressure, it's good or bad. What does blood
Speaker 4: pressure have to do with your heart health?
Speaker 5: Well, it has so much to do with it. One,
Speaker 5: the pressure you need to keep blood actually flowing to
Speaker 5: the heart itself. Just like every other tissue in the body,
Speaker 5: the blood has arteries that feed itself, that pump blood
Speaker 5: through to the heart muscle or that what's called the
Speaker 5: mio cardium.
Speaker 4: Okay, so a quick terminology breakdown here. Myo muscle card
Speaker 4: heart eum means the tissue and idis means inflammation. So
Speaker 4: myocardium is the muscle tissue of the heart, and myocarditis
Speaker 4: is inflammation of the muscle tissue of the heart. But yeah,
Speaker 4: the myocardium, the heart muscle is the pump and in
Speaker 4: fluid dynamics or chemo dynamics, you need to keep things moving.
Speaker 5: Maybe in order to do that, there's a certain head
Speaker 5: of pressure that's needed in the heart, but it can't
Speaker 5: be too much. If it's too much, then what can happen,
Speaker 5: and is those arteries that are so vital to the
Speaker 5: heart survival become damaged the lining inside of them called
Speaker 5: the endothelium. That then lining that allows for the exchange
Speaker 5: of oxygen and nutrients and so forth, is so very important.
Speaker 5: If it becomes damaged and starts to dysfunction, that allows
Speaker 5: all sorts of badness, like cholesterol accumulation, the formation of
Speaker 5: what we call fatty streaks, which are just it's like
Speaker 5: a giant oil slick on a road where you have
Speaker 5: cholesterol gathering breaking through the barrier that should be intact.
Speaker 5: That cholesterol event is being consumed by cells from the
Speaker 5: body that are designed to protect the body against invaders.
Speaker 4: They're called leukocytes aka white blood cells. Those macrophagias that
Speaker 4: gobble up the LDL or the bad cholesterol, they help
Speaker 4: convert it to foam cells. Don't worry. Don't worry about that.
Speaker 4: So these macrophasis, doctor Taylor explains.
Speaker 5: But they come in, they gorge themselves on the cholesterol,
Speaker 5: they break down and form debris. It causes inflammation, and
Speaker 5: there's this cascade of events that then leads to the
Speaker 5: body trying to contain it by forming a plaque over
Speaker 5: the top, a very fragile covering over this whole mess, right,
Speaker 5: and that contains the damage for a while, and it
Speaker 5: could be years. This whole process can take years in development.
Speaker 5: In fact, we see some of these changes I'm describing,
Speaker 5: and the autopsies of soldiers who are eighteen nineteen years old,
Speaker 5: you can see the very beginnings of this process. Anyway,
Speaker 5: that type of damage can be initiated by pressures that
Speaker 5: are too high. That then sets up a situation where
Speaker 5: that plaque could erode or rupture.
Speaker 4: And remember that plaque is like spackle over a.
Speaker 6: Moldy wallposing all of that garbage to the blood passing by,
Speaker 6: which sort of sees it as this disruption in the
Speaker 6: artery and then sends all sorts of things to fix
Speaker 6: this break in the artery.
Speaker 5: Platelets, which you remember from high school biology, are mainly
Speaker 5: intended to stop you from bleeding, right. They form a
Speaker 5: clot to close a cut you may have or bruise.
Speaker 5: But in this case, the platelets which are like, think
Speaker 5: of these tiny pieces of velcrow. They come to the
Speaker 5: site where all of this has happened, and they stick
Speaker 5: to each other as well as sticking to the site.
Speaker 4: So we covered this a little in the surgical angiology episode.
Speaker 4: But atherosclerosis or hardening of the arteries is kind of
Speaker 4: under the umbrella of coronary artery disease, and high blood
Speaker 4: pressure can stress out the arteries and it damages cells
Speaker 4: and it invites more plaque to build up. So what
Speaker 4: is high blood pressure exactly? Well, the top number of
Speaker 4: your blood pressure is your systolic blood pressure, and that
Speaker 4: is how much force is pushing against your artery walls
Speaker 4: when the heart contracts, like how stiff is the garden house. Now,
Speaker 4: the bottom number of your blood pressure is the diastolic
Speaker 4: blood pressure, and that's how much pressure is in the
Speaker 4: arteries or the hose between the beats. So the top
Speaker 4: number is usually what's under scrutiny for your heart health
Speaker 4: because again that's the higher pressure. It's when it contracts
Speaker 4: and pumps out blood, and numbers above one thirty over
Speaker 4: eighty will kind of raise your cardiologist eyebrows because something
Speaker 4: over one thirty over eighty could cause some plaque in
Speaker 4: your arteries to break off. Okay, then what would happen?
Speaker 5: And then this process can go on as a cascade
Speaker 5: out of control and ultimately calls a blockage in that
Speaker 5: artery which could lead to a heart attack. Oh that's
Speaker 5: not good. Now I've abbreviated a whole lot of processes
Speaker 5: just to somewhat dramatize the idea that blood pressure is
Speaker 5: one of those things that damages the artery that leads
Speaker 5: to a cascade of events that could be quite quite
Speaker 5: bad for you. And that's mechanical injury to the wall.
Speaker 5: Now you can also have a chemical injury to the
Speaker 5: wall from things like cigarette smoke and all of the
Speaker 5: toxins that are in the cigarette smoke, other inflammatory processes
Speaker 5: that might be tied to obesity, diabetes, even things like
Speaker 5: stress can be injurious and set up this cascade of
Speaker 5: problems that can lead to damage to the vital inside
Speaker 5: of the arteries. It's important to know that having blood
Speaker 5: pressure out of control can damage the heart of self.
Speaker 5: It can damage it another way. By the way, if
Speaker 5: you imagine this heart and your heart beats about what
Speaker 5: one hundred thousand times a day, one hundred thousand times
Speaker 5: a day silently. It's carrying out its function over and over.
Speaker 5: Its repair have been steady activity. That's a lot of weightlifting.
Speaker 5: If you have pressure inside the system higher than it
Speaker 5: should be, then your muscle is working harder than it
Speaker 5: should and that strain causes the muscle to grow. Just
Speaker 5: like if you did a whole lot of curls with
Speaker 5: a weight, you'd expect your biceps to grow. Then that
Speaker 5: muscle grows bigger than it was originally intended to grow,
Speaker 5: and that can lead to other problems in terms of
Speaker 5: the function of that ventricle. To put it, simply to
Speaker 5: overwork the heart for any long period of time under
Speaker 5: the strain of high blood pressure can lead to failure
Speaker 5: of the pump. Actually two types of failure, one failure
Speaker 5: being that the heart can begin to sag and be
Speaker 5: weak and ineffect and the pump is sort of worn out.
Speaker 5: Another type of failure is that the heart gets so
Speaker 5: thick that it doesn't relax in between beats. Oh that
Speaker 5: non relaxation then produces symptoms that are very much like
Speaker 5: the heart failure. When the heart is baggy and weak
Speaker 5: and so one we call help ref one we call
Speaker 5: help HEEF as an acronym for heart failure with preserved
Speaker 5: ejection fraction and heart failure with a reduced ejection fraction.
Speaker 5: And the injection fraction is simply a measure of how
Speaker 5: much blood the pump pumps out with each beat.
Speaker 4: So when that left ventricle is either too big or
Speaker 4: too baggy and it goes to squeeze out blood, it
Speaker 4: may only squirt like a dribble, you know, like below
Speaker 4: fifty percent of what's in there instead of a normal
Speaker 4: seventy percent. Does the heart ever take in more than
Speaker 4: a pupping? Does it ever get behind, like taking in
Speaker 4: too much and not able to pump it out fast
Speaker 4: enough or vice versa.
Speaker 5: Yes, And that happens in a number of ways. I
Speaker 5: just talked about the heart failure of the really thick
Speaker 5: heart where it's not relaxing like it should, and what
Speaker 5: happens is that the pressures go up inside the heart
Speaker 5: and that pressure backs into the lungs. It manifests as
Speaker 5: shortness of breath, fatigue, other things that can happen with
Speaker 5: a heart that's gotten too.
Speaker 4: Big, and that's congestive heart failure, which again can occur
Speaker 4: if the heart muscle is too weak to pump a
Speaker 4: out of blood when it contracts, which would be a
Speaker 4: systolic issue, or if it's too thick and therefore that
Speaker 4: left ventricle or the left little belly is too small
Speaker 4: to fill up properly between beats, which would be distolic.
Speaker 5: And the classic picture of that can look like swollen legs,
Speaker 5: swollen liver and sort of the origin of all of
Speaker 5: the organs that otherwise normally let blood flow right back
Speaker 5: up to the heart.
Speaker 4: And where does stress factor into all of this? If
Speaker 4: you're freaking out over any various amount of things that say,
Speaker 4: your job or your home life, or you just have
Speaker 4: a lot of stress in your life.
Speaker 5: This is the year twenty twenty five, what.
Speaker 4: Is that doing to your heart? Like beat by beat,
Speaker 4: day by day.
Speaker 5: Well, stress and the hormones related to stress, like adrenaline,
Speaker 5: just as one that everybody is somewhat familiar with. Those
Speaker 5: things can cause blood pressure to go up, can cause
Speaker 5: arteries to constrict, and cause the heart rate to increase.
Speaker 5: Those things increase the stress on the system.
Speaker 4: And adrenaline has a very good reason for doing this.
Speaker 4: It's raising your blood pressure so blood can rush where
Speaker 4: it needs to be to run away or to stay
Speaker 4: and kick someone's ass.
Speaker 5: Inflammation that can be tied to all of those processes
Speaker 5: not only help raise the blood pressure directly, but they
Speaker 5: can be again injurious to the blood vessels and weaken
Speaker 5: them in important ways. So, for instance, take the stress
Speaker 5: of perceived discrimination as just one example, and this applies
Speaker 5: to discrimination based on race, on appearance, and other things.
Speaker 4: And this is true across many marginalized populations such as
Speaker 4: Native communities, women, LGBTQ, folks, people of lower socioeconomic status,
Speaker 4: trauma survivors, and more. And you can see the twenty
Speaker 4: ten paper the Impact of Social Determinants on Cardiovascular Disease
Speaker 4: First Start, or the twenty twenty four study LGBTQ plus
Speaker 4: Cardiovascular Health Equity, the twenty twenty study Cardiovascular Health in
Speaker 4: American Indians and Alaska Natives, or doctor Taylor's recent paper
Speaker 4: Cardiovascular Risk and Resilience among Black Adults, Rationale and Design
Speaker 4: of the Morehouse Emory Center for Health Equity Study, or
Speaker 4: his twenty sixteen paper Percive discrimination is associated with health
Speaker 4: behaviors among African Americans in the Jackson Heart Study.
Speaker 5: It's clear that from the Jackson Heart Study and other studies,
Speaker 5: that having the perception that you're being discriminated against can
Speaker 5: actually raise your blood pressure and lead to a chronic,
Speaker 5: sustained elevation in your blood pressure, which can lead to
Speaker 5: some of the things we've already talked about. Stress can
Speaker 5: come in many ways. So there's the emotional stress. There's
Speaker 5: a stress sometimes of environmental toxins if you will, you know,
Speaker 5: inhaled exhaust from living your highways, other aspects of the
Speaker 5: environment that can add to systemic inflammation, add to a
Speaker 5: stressful day emotionally, all of these things can again converge
Speaker 5: and really cause the cardiovascar system cause of difficulties. I mean,
Speaker 5: the system is so sensitive to the environment, and sometimes
Speaker 5: that's a positive thing. So it's very curious to note
Speaker 5: that if you listen to a certain type of music,
Speaker 5: if you listen to slow, soothing music, your heart tends
Speaker 5: to slow towards the beat of the music.
Speaker 4: Wow.
Speaker 5: If you listen to a lot of agitated type music,
Speaker 5: you know it's stimulating. I have one example of this
Speaker 5: from early in my practice where this came into play
Speaker 5: in a very dramatic way. I was doing a residency
Speaker 5: and rotating through western North Carolina through Appalachia, and a
Speaker 5: woman came in in the middle of the night with
Speaker 5: a massive heart attack. And part of the things that
Speaker 5: we do in those situations is not only all of
Speaker 5: the fancy drugs, but it's very important to keep the
Speaker 5: heart rate down. The faster the heart beats, the more
Speaker 5: oxygen it requires. And you don't want a heart that's
Speaker 5: undergoing a fresh to be overworking like that. And this woman,
Speaker 5: we could not get her heart rate down. We were
Speaker 5: even using medications, the standard medications to help bring it down,
Speaker 5: and it was resistant to that. Her husband was watching
Speaker 5: us as we were paying a lot of attention to
Speaker 5: the monitor in terms of how fast the heart was going,
Speaker 5: and he said, Doc, do you mind if I sing
Speaker 5: to her? And of course we looked at each other
Speaker 5: and it was the middle of the night. We're into ICU,
Speaker 5: and I said, uh, you know, we've tried everything else.
Speaker 5: I would yeah, I would invite that. So the guy
Speaker 5: goes to his car, gets adulcimer, this beautiful mountain stringed instrument,
Speaker 5: comes back to the ICU and starts singing this beautiful
Speaker 5: bluegrass melody to her. The first thing you saw was
Speaker 5: the calm that came over her face. Oh the next
Speaker 5: thing you saw was a monitor showing us that our
Speaker 5: heart rate was steadily coming down to where it should be.
Speaker 4: Wow.
Speaker 5: It was one of the most impressive and beautiful moments
Speaker 5: earlier in my career. But the heart is that type
Speaker 5: of organ. It is very responsive to things in the
Speaker 5: environment that could be used for good, although sometimes the
Speaker 5: environment can be hostile and be hard on the heart.
Speaker 4: The proof is in the studies such as the effects
Speaker 4: of music on the cardiovascular system and cardiovascular health, and
Speaker 4: the abstract of that study states that the greatest benefit
Speaker 4: on health is visible with classical music and meditation music,
Speaker 4: whereas heavy metal music or techno are not only ineffective
Speaker 4: but possibly dangerous and can lead distress and or life
Speaker 4: threatening arrhythmias. But I needed to know what metal was
Speaker 4: chosen for these studies, and according to the twenty fourteen
Speaker 4: and paper, acute auditory stimulation with different styles of music
Speaker 4: influences cardiac autonomic regulation in men. The researchers shows Heavy
Speaker 4: Metal Universe by German power metal band Gamma Ray. Let's
Speaker 4: take a quick lesson. Okay, that's probably good. Can you
Speaker 4: explain what signs to look for for having cardiac issues?
Speaker 4: I feel like there's a lot of maybe misinformation or
Speaker 4: fragmented information about how to spot heart issues, what symptoms
Speaker 4: you might be having, what should people look for?
Speaker 5: Okay, well, there are many forms of our disease, of course,
Speaker 5: but the one that kills most people, and we'll go
Speaker 5: straight to things that kill you. I'm ready. The one
Speaker 5: that kills most people is course heart attack, and unfortunately,
Speaker 5: a huge segment of heart disease deaths manifest as the
Speaker 5: very first symptom of heart disease. It was often said
Speaker 5: when I was in training that when it comes to
Speaker 5: death from heart disease, often the first symptom is the last.
Speaker 5: And what was meant by that, of course, is that
Speaker 5: a lot of people have no suspicion that they have
Speaker 5: heart disease, even though you know. Often in retrospect they said,
Speaker 5: well I should have known. So this question of how
Speaker 5: do you know or what should trigger you to thinking
Speaker 5: about heart disease, it's a big question. Heart disease kills
Speaker 5: more Americans than any other cause.
Speaker 4: Really, what about globally? I mean America. We're not known
Speaker 4: for our walkable cities or our bike friendly roads, or
Speaker 4: a commitment to conservative portions. We love hot dogs and pie.
Speaker 4: Surely globally there must be bigger threats across the whole world. Wait, okay.
Speaker 4: According to World Life Expectancy Statistics, the number one cause
Speaker 4: of death globally in twenty nineteen with eighteen point six
Speaker 4: million deaths worldwide, what was cardiovascular disease?
Speaker 5: Leading diagnosis within the heart disease category is heart attack
Speaker 5: or mild cardial infarction. That just means a mild cardia
Speaker 5: means cardiac muscle, and infarction means death. So a death
Speaker 5: of a portion of the beating heart muscle is what
Speaker 5: a heart attack is, and it's caused by that series
Speaker 5: of events where you get a usually on acute blockage
Speaker 5: in an artery that is supposed to supply the heart
Speaker 5: muscle with an ever fresh supply of blood full of
Speaker 5: oxygen and nutrients, and when that it gets interrupted by
Speaker 5: traumbas that shuts down and things south of the blockage
Speaker 5: then are exposed to death.
Speaker 4: So a clot or thrombosis is really sadly common, and
Speaker 4: about twenty five percent of deaths worldwide are due to
Speaker 4: this because they can get into the lungs as an
Speaker 4: embolism or a clot can cause a stroke or of course,
Speaker 4: a heart attack, how does it lead to a heart attack?
Speaker 4: So a big enough clot in a blood tube means
Speaker 4: that the heart gets starved of oxygen that's known as
Speaker 4: hypoxia and other nutrients it needs, and that starved heart
Speaker 4: muscle is in coagulative necrosis, which is a great name
Speaker 4: for a fashion line sold a hot topic. But what
Speaker 4: becomes of that dead heart tissue is a scar that
Speaker 4: functionally doesn't contribute much. It's just like a hot mess
Speaker 4: of a HouseGuest who is a drain on your home
Speaker 4: and your vibe. And this dead muscle or an infarction
Speaker 4: can look kind of drained and pale yellowish. Imagine like
Speaker 4: a steak is your heart with a rubbery, pale spot.
Speaker 4: That would be the infarction. Now, in the event of
Speaker 4: a heart attack, CPR keeps the blood circulating because you're
Speaker 4: manually pumping the heart, and this is done to keep
Speaker 4: oxygen supplying your body's tissues, including the heart, to prevent
Speaker 4: sell death. A defibrillator, however, can give the electrical stimulus
Speaker 4: to restart the heart so that it beats again on
Speaker 4: its own. And remember that aed the automated external defibrillator
Speaker 4: that we talked about. So if if you're ever feeling
Speaker 4: like you don't know how to help in this topsy
Speaker 4: turvy world, you don't know where to start, consider maybe
Speaker 4: a first aid glass, because you never know when a
Speaker 4: stranger's life could just depend on a course that you
Speaker 4: took at the community center.
Speaker 5: While I'm on this, I should also say that it's
Speaker 5: particularly important that we stress that the leading cause of
Speaker 5: death for women is heart disease. The leading cause perhaps
Speaker 5: of medical angst in a lot of women is cancer,
Speaker 5: specifically breast cancer. Yeah, and that is a very important,
Speaker 5: very important disease on the sort of on the landscape
Speaker 5: of things that threaten women's health. But if I were
Speaker 5: to tell you that one in thirty nine women will
Speaker 5: succumb to breast cancer, I would counter I would further
Speaker 5: tell you to be aware that one in three women
Speaker 5: will succumb to heart disease.
Speaker 4: Wow, oh my gosh.
Speaker 5: So it's important to know that. And one of the
Speaker 5: distressing things in reacent publication of American Heart Association is
Speaker 5: that women were more aware of the threat of heart
Speaker 5: disease in two thousand and nine than they were in
Speaker 5: twenty nineteen. Why is that, I'm not entirely. Sure, Yeah,
Speaker 5: but it was particularly true among younger women who seemed
Speaker 5: somehow to have become either less worried or less informed
Speaker 5: about that particular threat.
Speaker 4: Now, breast cancer advocacy and visibility has done so much
Speaker 4: for awareness and promoting screenings, And if you're in any
Speaker 4: of the countries that have designated October as Breast cancer
Speaker 4: Awareness Month, you've likely been exposed to pink ribbons and
Speaker 4: balloons and campaigns. We released a Surgical Oncology episode in
Speaker 4: October twenty eighteen and we talked about those campaigns. But
Speaker 4: did you even know that February is Heart Month in
Speaker 4: the US and also in Canada, the UK, and the Philippines, Australia,
Speaker 4: New Zealand. Now globally, World Heart Day is September twenty ninth,
Speaker 4: But as the leading cause of death in the world,
Speaker 4: it flies under the radar more than I would expect.
Speaker 4: We're not as scared and thus preventative about it as
Speaker 4: many cardiologists would like, Especially for people assigned female at birth.
Speaker 5: They largely viewed cancer in particular breast cancer as the
Speaker 5: leading threat to their lives, so it's important and for men,
Speaker 5: the rates of death from part disease are even higher.
Speaker 5: So should every woman run out and get a calcium
Speaker 5: coronary CT to look for coronary calcium today? No, I
Speaker 5: don't think that's where I want to go with this.
Speaker 5: I think, first of all, it's important that people know
Speaker 5: their numbers. We like to say that is know some
Speaker 5: basic things about your physiology. Right now, you need to
Speaker 5: know what your blood pressure is from a fairly recent reading.
Speaker 5: If you have no idea, then you should go and
Speaker 5: get it checked. And as some specifics about how to
Speaker 5: get a checked.
Speaker 4: So ask your doctor or nurse or healthcare provider to
Speaker 4: check it and note those numbers. Get your cholesterol checked.
Speaker 4: Even hit that blood pressure machine at the back of
Speaker 4: the pharmacy, which is not just for board kids stuck
Speaker 4: waiting for their parents to get a prescription. Are you
Speaker 4: a dentist save a life and take blood pressure readings
Speaker 4: when people come in for their six month cleanings and checkups.
Speaker 4: If you're like, why would a dentist do that? I
Speaker 4: thought the same thing. My dentist, doctor Peter Sharon in LA,
Speaker 4: takes my blood pressure every time I come in, and
Speaker 4: at first I was like, why are we doing this, doc?
Speaker 4: We're here from a chompers, and he explained many people
Speaker 4: don't see medical doctors until there's a problem, and he
Speaker 4: was like, people are in here regularly, let's do it.
Speaker 4: And he's helped catch cardiovascular disease in earlier stages for
Speaker 4: his patients. Doctor Sharon, that fucking rocks other dentists think
Speaker 4: about it.
Speaker 5: You should know what your cholesterol profile looks like, what
Speaker 5: your LDL and HDL numbers in particular look like. There
Speaker 5: are some other categories of cholesterol that might even be
Speaker 5: more important to know, but at least knowing your LDL
Speaker 5: and HDL is important.
Speaker 4: Just some crib notes. LDL it stands for low density lipoprotein,
Speaker 4: and it's the bad cholesterol. It's the main source of
Speaker 4: blockages in the arteries. Now. HDL, high density lipoprotein, is
Speaker 4: the good cholesterol which helps get rid of bad LDL cholesterol.
Speaker 4: In general, if you're over twenty years old, you're gonna
Speaker 4: want total cholesterol under two hundred with that LDL the
Speaker 4: bad stuff under one hundred and HDL the good stuff
Speaker 4: over sixty or above is best. Mine. Last time I
Speaker 4: checked it, my total it's one ninety eight. So I'm
Speaker 4: really riding the line here and later doctor Taylor will
Speaker 4: tell me and you what to do about it.
Speaker 5: You need to know what your blood sugar or something
Speaker 5: called your hemoglobin A one C is critically important for
Speaker 5: all of us, particularly those of us and families that
Speaker 5: have high rates of diabetes or heart disease. And you
Speaker 5: need to have an idea about your your weight or
Speaker 5: BMI or waste circumference. Having some idea about those numbers
Speaker 5: gives you an idea about how much of the dangerous
Speaker 5: type of fat you may be carrying around your waist,
Speaker 5: around your viscera, and that which is the more toxic
Speaker 5: form of weight distribution. Those are the first things. Oh,
Speaker 5: and I should add to that quickly. Those are the
Speaker 5: sort of numbers, the measure numbers, and a certain set
Speaker 5: of behaviors also that are concerning that with these numbers
Speaker 5: together can pose a real threat for early on set
Speaker 5: coronary disease and other types of heart disease. Those behaviors
Speaker 5: are ready exercise or the lack thereof. And you're eating habits,
Speaker 5: what types of foods you like and what quantities I
Speaker 5: see exercise, eating sleep? Let me see it again, right right?
Speaker 5: You know? I mean when I was coming up through
Speaker 5: medicine in particular. You know, people thought it was really
Speaker 5: cool to say, you know, I'll stay up all night
Speaker 5: and I'll do this, and i'll do that, and I'll
Speaker 5: learn from every patient that comes in the door. I'm
Speaker 5: gonna be the best doctor ever. Was you know, I'll
Speaker 5: sleep when I'm dead kind of right. Not a good philosophy,
Speaker 5: Not a good philosophy at all. And of course smoking
Speaker 5: or vaping, those things things are again, as I've said
Speaker 5: a couple of times, one of those chemical insults to
Speaker 5: the endothelium that can start a whole cascade of problems.
Speaker 4: We chat about vaping risks to your arteries in the
Speaker 4: recent Surgical and Geology episode. We also discuss gardening or
Speaker 4: smoking the ganja and how that can affect your heart.
Speaker 4: And we also have episodes on sleeping and dreaming and
Speaker 4: circadian rhythms, which is going to scare your ass into
Speaker 4: pajamas pretty quick.
Speaker 5: So okay, so there's the cluster of things that if
Speaker 5: there are any aberrations, if you are let's call it
Speaker 5: nod goppli it with what we like to say is
Speaker 5: a healthy lifestyle, then you begin to put yourself at
Speaker 5: an increased need to surveil yourself in terms of whether
Speaker 5: or not there are issues related to your health. Now,
Speaker 5: I didn't talk about genetics. Genetics can be very very important.
Speaker 5: You know, if you have a history of someone in
Speaker 5: your family, particular first order relative, you know, father, am,
Speaker 5: the sister, brother that died early, say a woman who
Speaker 5: died before age sixty five or a man who died
Speaker 5: before age fifty five of heart related problems, then you
Speaker 5: yourself will probably be at enhanced risk. It need to
Speaker 5: be a little more vigilant than the next person about
Speaker 5: your heart. And certainly if you're having symptoms, then you
Speaker 5: know that sort of raises the anti if you're having
Speaker 5: you know, some of the classic heart related symptoms. Let's
Speaker 5: go again with heart attack or angina, which comes from
Speaker 5: my angina being pain. Pectoris is the whole name angina
Speaker 5: pectorus being chest pain. That of course is a significant
Speaker 5: red flag.
Speaker 4: So angina means pain. I didn't know that. I also
Speaker 4: thought it was pronounced angina this whole time. Alas, now
Speaker 4: we know why Gray's anatomy is always shouting these medical
Speaker 4: words like myocardi infection and pectoral anchinnout because this is
Speaker 4: the stuff we actually die from.
Speaker 5: And if you're having discomfort in your chest, particularly on
Speaker 5: exertion or instances of high emotion, those things need to
Speaker 5: be paid attention to and may require specific evaluation if
Speaker 5: you are in the throes of an actual heart attack. Okay,
Speaker 5: we're getting really sort of deep into the disease process now.
Speaker 5: But if you're having classically and elephants sitting on your chest,
Speaker 5: shortness of bread, coal sweats, pain radiating down your arm,
Speaker 5: and obviously something is quite wrong, and you need to
Speaker 5: dial nine to one one. Don't drive, don't have someone
Speaker 5: drive you, don't get on the subway. Call nine to
Speaker 5: one one, because the care is coming to you to
Speaker 5: be initiated right away, not when you arrive at a hospital,
Speaker 5: even if it's three blocks away. Okay, that description I
Speaker 5: gave you is classic and derived almost entirely from the
Speaker 5: male population, so it needs to be amended and amended
Speaker 5: in everyone's mind to be inclusive of other manifestations that
Speaker 5: are perhaps a little more frequent among women. Now. Women
Speaker 5: can have any of those classic symptoms, but they have
Speaker 5: a higher preponderance of what we have historically called atypical presentations.
Speaker 5: They may be typical for women, but they were atypical.
Speaker 5: According to the old textbooks, that can be more of
Speaker 5: a deep fatigue, a deep sense of indigestion, other symptoms
Speaker 5: above the waste that are just distinctly unusual and lasting
Speaker 5: fifteen twenty minutes. Those things also have been shown to
Speaker 5: be manifestations of significant blockages that lead to heart attacks
Speaker 5: in women. Now, you will also get indigestion sometimes, right
Speaker 5: that's going to happen. You will also maybe have fleeting,
Speaker 5: you know, symptoms that concern you that won't be your heart. However,
Speaker 5: if you are you know, it's Saturday morning, you know,
Speaker 5: and you're at the soccer match, and you're having this unmistakable,
Speaker 5: undeniable deep again and some of our patients used to say,
Speaker 5: this misery in the chest or you know, even in
Speaker 5: the stomach. It's just it's not it's not going away.
Speaker 5: It's insistent. You may need to dial nine to one one.
Speaker 5: Run the risk of being embarrassed quote unquote that it
Speaker 5: was just indigestion. I say run that risk because some
Speaker 5: people will delay or deny or say I don't want
Speaker 5: to cause people a lot of trouble. I certainly don't
Speaker 5: want the embarrassment of that ambulance coming up here to
Speaker 5: my son's soccer match. How dramatic is that? Right? But unfortunately,
Speaker 5: you know, I've had patients die of what they thought
Speaker 5: was indigestion when in fact it was a heart attack
Speaker 5: in the making. So I'm not trying to scare people.
Speaker 5: What i want to do is sort of elevate alertness
Speaker 5: to the manifestations of a significant health problem that might
Speaker 5: not fit the Hollywood description of what you saw, you know,
Speaker 5: in the movie, right.
Speaker 4: So you don't have to clutch your chest and scream
Speaker 4: I'm having a heart attack. To be having a heart attack,
Speaker 4: and it doesn't just involve pain down your left arm.
Speaker 4: Some real world, non Hollywood symptoms of a cardiac emergency
Speaker 4: can be chest pain or discomfort, pain or discomfort in
Speaker 4: the jaw, neck or back, pain or discomfort in the arms,
Speaker 4: either arms or shoulders, shortness of breath, feeling very tired,
Speaker 4: light headed or faint, even nausea or vomiting, and ladies
Speaker 4: and those assigned female at birth you may have additional
Speaker 4: or different red flags, including anxiety, pain in the back
Speaker 4: or arm, upset stomach, and brushing off. These cardiac symptoms
Speaker 4: could lead to your family donating all your clothes to
Speaker 4: goodwill and starting a GoFundMe to buy your casket. Not
Speaker 4: to freak you out. Let's just be real so.
Speaker 5: That alertness may save lives. And I myself always had
Speaker 5: respect for the person who came in and we found
Speaker 5: you know, the Ekg's normal, the blood work is normal,
Speaker 5: everything's beautiful, and you can go home. I don't mind seeing,
Speaker 5: you know, a whole bunch of people like that over
Speaker 5: the course of the day. If that means that people
Speaker 5: are paying attention, and it might be that we may
Speaker 5: save someone who otherwise may have dismissed their symptoms.
Speaker 4: Can I ask you just a couple of questions from listeners? Sure,
Speaker 4: go ahead, Okay, great? And each week we send money
Speaker 4: from our heart to an organization chosen by theologist. And
Speaker 4: this week doct Herman Taylor suggested the Center for Black
Speaker 4: Agency and Resilience CEBAR, which was recently founded to trumpet
Speaker 4: the indisputable tradition of black resilience and agency, challenging the
Speaker 4: narrative that emphasizes vulnerability, and as the founder and president,
Speaker 4: doctor Taylor aims to increase knowledge about the Black community's
Speaker 4: interpersonal relationships which provide joy and resilience via a multidisciplinary
Speaker 4: research project. So a donation will go to cbar dot org,
Speaker 4: which is linked in the show notes. And thanks to
Speaker 4: sponsors of the show for helping us do that.
Speaker 1: Virgin Media broadband is smooth. How smooth you ask? Well,
Speaker 1: imagine you're a big old.
Speaker 2: War rush and rather than lumbering around a glassier avoiding
Speaker 2: polar bears, you're on the lake, diving the speedboat three
Speaker 2: thousand kilos of mollusk, munching magnificence, feeling the wind in
Speaker 2: your whiskers and the sun on your big blubbery face.
Speaker 2: That's the kind of smoothness you feel. With ninety nine
Speaker 2: point nine percent broadband reliability available nationwide Virgin Media, it's
Speaker 2: playtime subject.
Speaker 3: To availability tas s he's apply for broadland reliability see
Speaker 3: virgin Media dot I E forward slash proof.
Speaker 4: Okay, your questions. Doctor Taylor is a very, very busy man,
Speaker 4: so we didn't even get to scratch the surface because
Speaker 4: cardiology is a huge field and this is just one episode,
Speaker 4: but we got to ask a few great ones from
Speaker 4: patrons via Patreon dot com slash ologies onward, let's hear him.
Speaker 4: We had so many great questions. Genna Congdon wanted to know.
Speaker 7: Hey, so my question is regarding EKG tracings in the wild.
Speaker 7: You see them on logos, on people's tattooes, kind of everywhere,
Speaker 7: and very often they're really inaccurate and pretty funny if
Speaker 7: you know what you're looking at. My husband and I
Speaker 7: both work in healthcare and we play a little game
Speaker 7: of pointing out these really wrong EKG tracings and trying
Speaker 7: to diagnose them. Do you notice when you see really
Speaker 7: wacky EKG lines and try to make up in your
Speaker 7: head what they could be if they were in real life.
Speaker 7: I have seen one that just didn't make any sense
Speaker 7: and was so inaccurate on the side of an ambulance.
Speaker 7: So let me know if you played this game too.
Speaker 5: Oh all the time? Yeah, you know, it's in logos.
Speaker 5: It's where you know, the critical parts of the waveforms
Speaker 5: are missing that would either not exist in nature or
Speaker 5: be totally alarming. You know, they tend to be a
Speaker 5: little bit idealized. So yeah, but we're okay, well in
Speaker 5: terms of not getting too upset about that. Actually, we
Speaker 5: kind of like the attention that people are thinking about
Speaker 5: their hearts in that way.
Speaker 4: And if you're like, hey, yes, but you have no
Speaker 4: idea what Jenna or doctor Taylor talking about. Congratulations you
Speaker 4: are Alley Ward. Come along as I figure out what
Speaker 4: those waves mean. Okay, So a normal EKG or ECG
Speaker 4: an electric cardiogram, is when they adorn you with all
Speaker 4: those wired stickers that look like they have little denim
Speaker 4: rivets or small robot nipples on them, and they pick
Speaker 4: up electrical activity that looks like a line with some
Speaker 4: wiggles and a spike, and it repeats over and over
Speaker 4: if you are not dead. And this is called a
Speaker 4: sinus wave because the sinus node is a part of
Speaker 4: the heart that works as a pacemaker and it's keeping
Speaker 4: things on beat. So on an EKG, there's a little
Speaker 4: bump above the baseline, followed by that big spike which
Speaker 4: then comes down dips a little below the baseline, and
Speaker 4: then another bump like the first one, but a little bigger,
Speaker 4: very very simply, that first small bump is a pe
Speaker 4: wave and that represents the electrical activity in the atria
Speaker 4: to atriums and the big spike or QRS complex is
Speaker 4: what that big spike is called, is the ventrical electrical activity.
Speaker 4: And then the third bump a little bigger than that
Speaker 4: pea wave is called a tea wave, and that's when
Speaker 4: the heart is at rest. And if these rhythms are off,
Speaker 4: then that could indicate an issue under the hood. Buddy,
Speaker 4: we got something going on. And an irregular beat is
Speaker 4: called an arrhythmia. An aphib or atrial fibrillation is an
Speaker 4: irregular and some psy chaotic heart rhythm that needs to
Speaker 4: be monitored to make sure that it doesn't cause blood
Speaker 4: clots or stroke. Down the line, Now, how many beats
Speaker 4: a minute should you have? What's the good tempo you
Speaker 4: want to shoot for, So sixty to one hundred is
Speaker 4: in the healthy range, but consistently over one hundred is
Speaker 4: what's known as techycardia, which means fast heart. And if
Speaker 4: you're in good cardiovascular shape, you might have a lower
Speaker 4: resting heart rate because you're myocardia is strong enough where
Speaker 4: a heart beat blasts enough blood out so it can
Speaker 4: kind of slow down the pace it's breezing along. Conversely,
Speaker 4: a weaker heart has to kind of frantically beat faster
Speaker 4: to get blood to where it needs to go. Now
Speaker 4: back to the tissues and the issues of the heart.
Speaker 4: How is the heart electrified? What is happening here? Asked
Speaker 4: Azam's partner Ali Andy Pepper zach ever Ate first time
Speaker 4: question ask Ur Smelanie Abbott and jack Lyn Costa Rive
Speaker 4: the tiger Earl of Gramigan and Tiger. Udi Sigawa Young
Speaker 4: wanted to know are there really similar cells to brains
Speaker 4: and guts in the heart?
Speaker 5: Well, yeah, in a matter of speaking in particular, one
Speaker 5: let's start with the brain. You know, the heart has
Speaker 5: a nervous system of sorts. In that I mentioned that
Speaker 5: if it was removed from the body of a human
Speaker 5: or another species, if you will, it would continue beating.
Speaker 5: And it beats because of that electrical system. It has
Speaker 5: its own Paine pacemaker. It generates its own electricity that
Speaker 5: the muscle responds to. The muscle is what we call
Speaker 5: an excitable tissue. If you shock it, it jumps. If
Speaker 5: it had stopped for whatever reason, it will beat. After
Speaker 5: the shop. There are cells that we say they spontaneously depolarized,
Speaker 5: and that is there's a flux of ions across the
Speaker 5: membranes of the cells. You know, potassium and sodium of
Speaker 5: flowing and calcium of flowing in a certain way that
Speaker 5: the change in the electrical potential across the membrane causes
Speaker 5: a discharge to occur from this pastemaker. I'm tried not
Speaker 5: to go two different technicalities, and I hope I have
Speaker 5: a lot of people. But because of that property, the
Speaker 5: heart has its own pastmaker and the rest of the
Speaker 5: heart responds. The pacemaker is way up in that right
Speaker 5: atrium we talked about earlier, but there's a network of
Speaker 5: fibers that carry each impulse through the rest of the
Speaker 5: heart as well as the heart. Muscle itself can carry
Speaker 5: the impulse even without those fibers, but it does have
Speaker 5: a sort of nervous system. Cardiac muscle is different from
Speaker 5: skeletal muscle is perhaps in some ways. It has some
Speaker 5: similarities to smooth muscle and other parts of the body,
Speaker 5: but the milcarding is special. It has a ton of mitochondria,
Speaker 5: those energy producing cells. It has that spontaneous depolarization property,
Speaker 5: and it is woven in a special way that allows
Speaker 5: the type of contraction with each beat that propels the
Speaker 5: blood forward.
Speaker 4: And that depolarization which creates the humps and the spike
Speaker 4: of a sinus wave on the eg. That's this wave
Speaker 4: of electrical depolarization, and it triggers the cardiac muscle to
Speaker 4: contract and as for the heart and the gut alliance,
Speaker 4: A study just came out a month or so ago
Speaker 4: titled Unlocking the Gut Cardiac Axis a Paradigm Shift in
Speaker 4: Cardiovascular Health, and it notes that an imbalance in your
Speaker 4: gut microbiome can trigger an immune response, and that inflammation
Speaker 4: can affect the lighting of your arteries and it can
Speaker 4: lead to plaque build up, and we all know now
Speaker 4: that plack build up can cause all kinds of problems
Speaker 4: for the heart. Also, you have a vagus nerve that
Speaker 4: runs from your brain to your gut, and it can
Speaker 4: regulate heart rate and arrhythmias, which is another reason to
Speaker 4: just respect your wonderful bod, eat your vegetables, go for
Speaker 4: a walk if you can. Now. Congestive heart failure is
Speaker 4: that one of the bigger risks for people? And how
Speaker 4: is heart failure? How is that different than a heart attack?
Speaker 4: Is that more insidious?
Speaker 5: Yeah? Great question. Heart failure can be thought of as
Speaker 5: sort of a final common pathway for a lot of
Speaker 5: different problems. Okay, let's start with it. A quick description
Speaker 5: of heart failure. Let's go with the classic heart failure,
Speaker 5: the congestive heart failure as you referred to it, the
Speaker 5: heart wears out right, it gets big and baggy, and
Speaker 5: it's not a very good pump That ejection fraction should normally,
Speaker 5: each time the heart beats, it should pump out about
Speaker 5: sixty percent of what's in it. Right, the ejection fraction
Speaker 5: can go down to twenty percent or less.
Speaker 4: So operating at about a third of what it should be,
Speaker 4: congesting the heart like a traffic congestion, which is frustrating.
Speaker 4: Also in this case low key lethal.
Speaker 5: That's heart failure of a sort. Now, how does that happen?
Speaker 5: A big heart attack? In the wake of that, you
Speaker 5: can develop heart failure. A valve breaks down and leaks severely.
Speaker 5: Because valves are normally supposed to be a one way
Speaker 5: door that keeps blood flowing through the heart in one direction.
Speaker 5: That breaks down, congestion can happen. The heart gets big
Speaker 5: and weak. Uncontrolled high blood pressure, as we talked about earlier,
Speaker 5: that can lead to heart failure. Viral infections can lead
Speaker 5: to certain viral infections. Alcohol excess can poison the muscle
Speaker 5: and lead to congestive heart failure, and there are other causes.
Speaker 5: Even uncontrolled thyroid disease can lead to heart failure.
Speaker 4: Just as I note we've got a recent thyroid episode.
Speaker 4: You know who wants to hear it? Your thyroid so cute?
Speaker 5: It tends to be a fairly gradual onset process, taking
Speaker 5: years and multiple insults to finally get to that stage.
Speaker 5: It is a deeply it's a challenging problem. If today
Speaker 5: someone was diagnosed with congestive heart failure, their five year
Speaker 5: survival would probably be roughly equivalent to the five year
Speaker 5: survival of receiving a diagnosis of colorectal cancer the same day,
Speaker 5: right wow. However, we have developed multiple approaches to the
Speaker 5: treatment of heart failure that are promising, and the specific
Speaker 5: type of heart failure matters in terms of how we
Speaker 5: approach it. The specifics of those therapeutic approaches are best
Speaker 5: discussed with your physician. And I want to just I
Speaker 5: want to leave a note of hope because of these
Speaker 5: therapeutic advances, things are getting better all the time. And
Speaker 5: even today I was reviewing a paper that looked at
Speaker 5: engineered heart muscle that was grown from stem cells that
Speaker 5: actually was proven to improve the contractile function of the
Speaker 5: left ventricle to a significant degree. And there are all
Speaker 5: sorts of other new advancements that are being made so
Speaker 5: there's a lot of hope in the area.
Speaker 4: And when it comes to what you eat yourself, a
Speaker 4: lot of people Raya, Anastasia Press Don Smallchek. Raya asked
Speaker 4: the relationship between high sugar intake and heart health assuming
Speaker 4: one eats otherwise while asking for a quote, friend Anastasia
Speaker 4: wants to know what you think of plant based diets,
Speaker 4: and Don asked, our cheerios actually good for your heart.
Speaker 4: Diet was also in the minds of patrons Mims, Isabella Bartleson, Rya,
Speaker 4: Anastasia press Ronnie Rob Morgan, Ali Is Tired, Karen h Ron,
Speaker 4: Wendy Foreman, and Stacy Pinkwetts, who asked, am I going
Speaker 4: to live to be five hundred? Because I eat oatmeal
Speaker 4: with flax seed meal every day. When it comes to
Speaker 4: what you eat your diet, what does doctor Hermann Taylor recommend?
Speaker 5: Let me tell you what I recommend. No, I have
Speaker 5: to say, and this is kudos to my wife. We
Speaker 5: are really beginning to move as much as we can,
Speaker 5: as deliberately as we can, to more and more of
Speaker 5: a plant based which doesn't eliminate consumption of certain meats,
Speaker 5: especially fish. Our ideal is a Mediterranean style diet right
Speaker 5: where there's plenty of fiber, plenty of vegetables and fruits,
Speaker 5: olive oil. It doesn't totally restrict other types of meat,
Speaker 5: but I mean, it doesn't eliminate it, but it does
Speaker 5: restrict it. And we try not to overdo the sodium.
Speaker 5: We stay away from processed meats as much as possible
Speaker 5: because there's all sorts of badness there, but I strongly
Speaker 5: recommend leaning towards plant based types of food. There's also
Speaker 5: something called the DASH diet which was designed specifically to
Speaker 5: help lower blood pressure, and it too is characterized by
Speaker 5: high number of feedings of vegetables and fruits, as well
Speaker 5: as high amounts of fiber, potassium, low fat, high calcium
Speaker 5: foods like the yogurt, and an assortment of sort of
Speaker 5: dietary alterations that actually have been shown to lower blood
Speaker 5: pressure by some eleven points in certain populations, which is
Speaker 5: as much as some drugs.
Speaker 4: And the DASH diet side note stands for dietary approaches
Speaker 4: to stop hypertension, and it recommends eating vegetables, fruits, and
Speaker 4: whole grains, including fat free or low fat dairy products, fish, poultry, beans, nuts,
Speaker 4: and vegetable oils and limiting foods that are high in
Speaker 4: saturated fat like fatty meats, full fat dairy products, tropical
Speaker 4: oils like coconut palm kernel palm oil, and limiting sugar
Speaker 4: sweetened beverages and sweets. And the Dash Diet Eating Plant
Speaker 4: says it's important to choose foods that are low insaturated
Speaker 4: and transfats and rich in potassium, calcium, magnesium, fiber, and protein,
Speaker 4: and also lower in sodium, since excess sodium, usually from
Speaker 4: processed foods, makes your body retain water to dilute that sodium,
Speaker 4: which raises your blood volume and it leads to higher
Speaker 4: than healthy blood pressure. Now, for folks with low blood
Speaker 4: pressure or low blood volume, say if you have pots,
Speaker 4: if your doctor says to go hogwild on the sodium
Speaker 4: for other reasons, obviously listen to them. But in general,
Speaker 4: we eat way more sodium than we evolve to do. Now,
Speaker 4: what if you're on a road trip or you were
Speaker 4: bad at cooking. The American Heart Association says that good
Speaker 4: convenience store DASH diet snacks include parts skim string, cheese,
Speaker 4: boiled eggs, unsalted nuts, greek yogurt, and whole foods which
Speaker 4: are not cheetos, but they will keep you alive. Now,
Speaker 4: when it comes to hydration and eating produce, sometimes you're like,
Speaker 4: the world sucks. I need a treat. So what I
Speaker 4: like to do is pretend that I'm in a post
Speaker 4: apocalyptic world like Mad Max style, and that water is
Speaker 4: something that people start wars over. So if anyone gives
Speaker 4: me like free water, like at a restaurant, I like
Speaker 4: to pretend it's the score of a lifetime. My fridge
Speaker 4: dispenses clean, filtered water. I would be a fool to
Speaker 4: pass up sixty four ounces or more that a day
Speaker 4: fruits and vegetables. What if I mouthed off of the
Speaker 4: government and I got shipped to Mars, but I escaped
Speaker 4: the prison pod and I found a stash of salads
Speaker 4: in oranges until I could build a ship to go home.
Speaker 4: That's elaborate, but you can just like pretend you're lost
Speaker 4: at sea or something, and then you see water and
Speaker 4: vegetables and you're like, what a slag, gotta have them.
Speaker 5: There's help out there. Dash diet Mediterranean diet, those are
Speaker 5: sort of two at the top of my list. And
Speaker 5: eat plants every chance you get.
Speaker 4: Do you ever experience any eyepain when you see headlines
Speaker 4: about carnivore diets, like do you roll your eyes so
Speaker 4: hard that they hurt?
Speaker 5: That's a very good question. They are not my favorite.
Speaker 5: And now this is a controversial area for some but yeah,
Speaker 5: we're omnivores, right, So some meat's okay. But I think
Speaker 5: historically meat was more of a condiment than it was
Speaker 5: a central part of the meal. And I think that
Speaker 5: is sort of a model of where we need to
Speaker 5: go in terms of inching more and more towards vegetable
Speaker 5: sources of protein and all the other great things the
Speaker 5: vegetables do. I think we should keep pushing towards that.
Speaker 5: You know, saturated fats are much more cholesterol genic than
Speaker 5: eating cholesterol. You know, eating a piece of steak will
Speaker 5: produce a lot more issues in terms of cholesterol than
Speaker 5: eating an egg. Right, So I would say that, yeah,
Speaker 5: I don't really dig the conif.
Speaker 4: I figured it was something along those lines. So that's
Speaker 4: helpful in terms of what to put in your mouth.
Speaker 4: But how about lasen up your sneakers or dipping into
Speaker 4: some water aerobics, maybe rollerblading without a shirt. Patrons, Matt Tacato,
Speaker 4: Anthony Richard's, Beth and Greer Kyla c Marathon or Curtis Takahashi,
Speaker 4: samwiz at a Cappello gool next door and Haley Blonzo
Speaker 4: first time question ask are they all asked about the
Speaker 4: effects of exercise on the heart? And Haley, I'm happy
Speaker 4: to accompany you in your ears on any walks you take.
Speaker 4: I know a lot of ologites. You're here to learn
Speaker 4: about weird stuff while you're out on strolls. I salute you.
Speaker 4: Way to go, but is it ever too late to
Speaker 4: start that? And very very last question from listeners Brendan
Speaker 4: and Ashley first on question asker ask can getting into
Speaker 4: shape your regular cardio later in life undo some of
Speaker 4: the potential heart damage of being obese or sedentary previously?
Speaker 4: They say, I was overweight my whole life until last
Speaker 4: year when I started running and eating better and lost
Speaker 4: eighty five pounds. Is it ever too late to get
Speaker 4: to help out your heart?
Speaker 5: Never too early, never too late. Okay, I'm so proud
Speaker 5: of her. That is fantastic. That's cause for celebration. Your
Speaker 5: heart is celebrating. Let me tell you, when you take
Speaker 5: off even a loss of five percent of total body
Speaker 5: fat is felt by the heart in terms of that
Speaker 5: strain of pumping through those thousands of miles of arteries,
Speaker 5: capillaries and so forth critically important to your heart health.
Speaker 5: You have done yourself a tremendous favor. I would say
Speaker 5: to you, congratulations, and I wish I had more patience
Speaker 5: like you.
Speaker 4: Oh, that's such great news. So that's inspiring. It's never
Speaker 4: too late to do something good for your heart. Now,
Speaker 4: what about what about you? What's the hardest part of
Speaker 4: your job and the part you love the most.
Speaker 5: Well, In recent years I migrated much more heavily towards research,
Speaker 5: But I will tell you that the hardest part of
Speaker 5: my job, if I look over the span of my career,
Speaker 5: was seeing people when it was too late. Was the
Speaker 5: heart attack or the cardiac arrest we could not reverse,
Speaker 5: you know, walking from that bedside and telling the family
Speaker 5: was yes, those were the hardest moments. What I have
Speaker 5: loved the most clinically is I guess kind of the
Speaker 5: opposite of coming out of the calf lab and telling
Speaker 5: a family who was worried about chest pain in their
Speaker 5: loved ones that the arteries were clear. While we may
Speaker 5: not have the answer to the chest pain today, what
Speaker 5: we know is that the most dangerous thing that it
Speaker 5: could be appears not to be on the table, and
Speaker 5: we can now move methodically through the other less lethal possibilities.
Speaker 5: Those were good moments, I think. Finally, I think realizing
Speaker 5: that for some populations where we hear a lot of
Speaker 5: important work which I've been proud to contribute to on
Speaker 5: the disparities that those populations, like African Americans, like other
Speaker 5: marginalized populations historically, that there's a lot of bad news.
Speaker 5: There's a lot of news about foreshortened lives or higher
Speaker 5: rates of heart disease, hypertension and so forth, important to document,
Speaker 5: important to heighten our awareness that we need to have
Speaker 5: public health and other approaches that target some of these
Speaker 5: really troubling statistics that simultaneous with the sort of bad news,
Speaker 5: that there's a lot of reason to be excited about
Speaker 5: the resilience of these populations. There was a time in
Speaker 5: American history about one hundred years ago where the extinction
Speaker 5: of African Americans was predicted based on statistics at that
Speaker 5: time and the circumstances of the fallback on reconstruction and
Speaker 5: other things that were aimed at helping the black population
Speaker 5: that was newly freed. Despite all that travail. There are
Speaker 5: incredible stories of health and longevity and call it joy
Speaker 5: among the population that has had to confront such important obstacles,
Speaker 5: and that resilience, I think really points to another aspect
Speaker 5: of human existence, if you will, that points to how
Speaker 5: it is so humanly possible to overcome so many of
Speaker 5: these challenges. And I'm very, very proud of those resilient
Speaker 5: African Americans and others who are living life long and
Speaker 5: well and thriving and flourishing despite some of the challenges
Speaker 5: that they face historically and present day. So I think
Speaker 5: that resilience that I see evidence of all the time
Speaker 5: is something that gives me a lot of happiness and joy.
Speaker 4: Well, your work is amazing, and I think Matthew for suggesting.
Speaker 5: You, I'll deal with him later.
Speaker 4: We're now friends online.
Speaker 5: I do have to just say, Matthew's my oldest son.
Speaker 5: I'm so proud of him out at UC Berkeley and
Speaker 5: the frontier that he's opening up in music I think
Speaker 5: is exciting and everybody should pay attention to what happens
Speaker 5: next with Matthew.
Speaker 4: Evan Taylor, you know I need to have him on
Speaker 4: for a music episode now.
Speaker 5: You gotta do that.
Speaker 4: You've gotta do this multi generational. Taylor's well, thank you
Speaker 4: so so much. I'll let you get back to your Saturday.
Speaker 4: I really great, so ask caring people your cardiac curiosities,
Speaker 4: because you only live once, and you will live better
Speaker 4: and longer if you listen to him. I cannot thank
Speaker 4: doctor Herman Taylor enough for his time to do this
Speaker 4: episode and for highlighting February as Heart Month and as
Speaker 4: Black History Month. And it's just another among millions of
Speaker 4: examples of how much diversity matters and science because discovery
Speaker 4: is all about what questions we're asking, and you need
Speaker 4: a variety of experience and perspectives to identify and tackle
Speaker 4: problems and find solutions. Thank you again, doctor Taylor for
Speaker 4: all of your work. Thank you to his son, doctor
Speaker 4: Matthew Evan Taylor, who's an associate Professor of composition at
Speaker 4: UC Berkeley's Department of Music, Doctor Taylor. Doctor Matthew Evan
Speaker 4: Taylor that is will release his first LP soon. It's
Speaker 4: called Life Returns and it was recorded live at the
Speaker 4: Metropolitan Museum of Art in twenty twenty two. You can
Speaker 4: find out more about that and follow Matthew on Instagram
Speaker 4: at Matthew event Taylor. Now we are at Ologies on
Speaker 4: Instagram and Blue Sky. I'm at Ali Ward on both.
Speaker 4: We have shorter, kid safe and classroom friendly versions of Ologies.
Speaker 4: Wherever you get podcasts, just look for them in their
Speaker 4: own feed. We have new green artwork via Portland artist
Speaker 4: Bunny Dutch. Also, Ologies Merch is available at ologiesmerch dot com,
Speaker 4: and if you would like to be a patron of
Speaker 4: the show and submit questions before we record, you can
Speaker 4: find us at patreon dot com slash Ologies. It costs
Speaker 4: one dollar a month to join. That is the entrance
Speaker 4: fee into our heart Now. Aaron Talbert admins Theologies podcast
Speaker 4: Facebook group. Aveline Malick makes our pro transcripts. Kelly ar
Speaker 4: Dwyer does the website. Noelle Dilworth is keeping us on
Speaker 4: beat as scheduling producer. Susan Hale is managing director, and
Speaker 4: the Blood supplying all of our organs and also did
Speaker 4: additional research and producing for this episode. Thank you, Susan.
Speaker 4: Our assistant editor and Atria for raw audio is jakecha
Speaker 4: and left Ventricle. Helping us pump these out every Tuesday.
Speaker 4: Is Mercedes Maitland, our lead editor of Maitland Audio. Nick
Speaker 4: Thorburn Pace made the theme music and if you stick
Speaker 4: around untill the end, I burden you with a secret
Speaker 4: about my life and some behind the scenes on this episode. Okay,
Speaker 4: so we were recording with doctor Taylor. It was going great.
Speaker 4: He was amazing. The mic that we sent him was
Speaker 4: working wonderfully. For some reason, the interface that I use
Speaker 4: to record kept popping up with a notice saying that
Speaker 4: his end wasn't recording, no fault of his own. I
Speaker 4: have no idea what was going on with the website
Speaker 4: that was supposed to be recording us, And in fact
Speaker 4: I went to go look at the files, the files
Speaker 4: were not there. They did not record. Thankfully, Mercedes found
Speaker 4: a backup copy somewhere in a folder that had to
Speaker 4: be downloaded and pieced together, so all of the audio survived.
Speaker 4: But it was like, if this is just not recording,
Speaker 4: I don't even know. I'm going to disappear. I'm going
Speaker 4: to go into a witness protection or something. I'm going
Speaker 4: to change my name. I'm going to wear wake the
Speaker 4: rest of my life. This is too embarrassing. I honestly
Speaker 4: started crying when she told me that she was able
Speaker 4: to get a backup of the files, I shed tears.
Speaker 4: I was so thrilled. Anyway, Think of your heart like
Speaker 4: a shelter pet who deserves nothing but the best in life,
Speaker 4: and take care of it as you would a stray
Speaker 4: guinea pig or a surrendered collie. You deserve it. Okay,
Speaker 4: Bye bye hackadermatology, homology, r doo, zoology, lithology, zonology, meteorology, paratology, ethology, zeriology, elinology. Honey,
Speaker 4: you have such a big heart.
Speaker 1: Virgin Media broadband is smooth. How smooth you ask? Well,
Speaker 1: Imagine you're a big old war Russian.
Speaker 2: And rather than lumbering around a glacier avoiding polar bears,
Speaker 2: you're on a lake driving the speedboat thousand kilos of mollusk,
Speaker 2: manching magnificence, feeling the wind in your whiskers and the sun,
Speaker 2: and you have a big lubbery face.
Speaker 1: That's the kind of smoothness you feel.
Speaker 2: With ninety nine point nine percent broadband reliability available nation
Speaker 2: wide Virgin Media, It's playtime subject to.
Speaker 3: Locational availability teasincy supply for broad end reliability see Virgin
Speaker 3: Media dot I forward slushproof get value.
Speaker 8: You can't argue with at Tesco with their amazing club
Speaker 8: card prices. Serve up something special with our finest meal
Speaker 8: deal for two starring one main, two sides and dessert
Speaker 8: for only sixteen euro. Like succulent board be approved. Rush
Speaker 8: aang the Strip loin steaks with peppercorn butter or delicious
Speaker 8: Iris Chicken Parmesana served with creamy potato Greta and her
Speaker 8: mix of rainbow root vegetables and enjoy Goozillionaire or Salder
Speaker 8: caramel cheesecake. Can't argue with that shop in store or online.
Speaker 8: Tesco Every Little Helps available in most stores. Prices vary
Speaker 8: in express