Welcome, my name is Dr. Warrick Bishop. I'm a cardiologist, an author and a keynote speaker. I'm CEO of the Healthy Heart Network. I'm all about trying to help people live as well as possible for as long as possible. Heart disease is huge in Australia. Every 20 minutes someone suffers a heart attack. Most of these could probably have been avoided if only we knew what to do. This podcast is all about helping you understand blood pressure, weight, cholesterol for better health. If you enjoy this podcast, I would be honoured for a five-star review. You can share it with your family and friends. It may well save someone you love. Dr. Warrick Bishop is a private cardiologist working in Hobart and a podcaster and a writer, author. G'day, Warrick. Good morning, Rick. How are you? Yeah, very, very well, thanks. This article sort of caught our eyes of the young basketballer, Bronnie James, suffered a cardiac arrest while training at the University of Southern California. He survived. What is a cardiac arrest? Look, that's a good question, Rick, and people often confuse heart attack with cardiac arrest. So if I can take a moment to clarify that, heart attack is what's very much a layman term, and it's not a term we use in our pathology textbooks. Most commonly, people think about a heart attack being something that strikes someone down with a heart problem. Generally, Rick, that's related to a blocked artery. So the most common thing that will cause someone to be crook very quickly with their heart is a blocked artery or coronary artery disease. And we'll often refer to that as a heart attack. Now, that heart attack could lead you to getting off to hospital. presenting to your GP with aches and pains that came and went, or that heart attack, that blocked artery can lead to irritability of the muscle, which leads on to an electrical instability. And that electrical instability or that chaotic electrical outcome is called sudden cardiac arrest. So heart attack. Generally, when an artery blocks and there's a problem giving rise to pain and symptoms, sudden cardiac arrest occurring when it goes beyond that and an electrical malfunction of the heart occurs. That leads to people collapsing immediately, literally dying on the spot and really needy of resuscitation at the time. So how do you treat them differently? Well, a heart attack, the patient will need their artery opened. That's their priority. When someone's had a sudden cardiac arrest and the heart's not pumping because of electrical chaos, they need that heart rhythm restored as an absolute priority. That's when we use defibrillators and CPR. Once we've got that rhythm back, if there is a blocked artery, then their priority becomes opening that artery. But the absolute first thing to do is re-establish. that heart beating properly. That's why we use CPR and defibrillators. You're listening to Dr. Warrick Bishop, private cardiologist working in Hobart. If you've got any heart questions, send them on through. Warrick, there's one here I'm almost reluctant to ask you from Gerard, but it's probably something people have been hearing. So he's heard that there's an increase in heart issues, including myocarditis and pericarditis during the rollout of the doses of vaccines, particularly in South Australia. It's so specific. It's strange. And with booster vaccines. What is the science in terms of heart? health related to vaccinations and heart health related to COVID? Gerard, you'd be surprised to know that you're not the only one who's been asking questions like that. We have been inundated with questions regarding the vaccine and heart health. There is documentation that particularly the Moderna more so than the Pfizer vaccine, and these are the... mRNA vaccines, not the AstraZeneca vaccine, have been linked to an increased risk of inflammation of the heart muscle and the sac around the heart. Now that's myocarditis and pericarditis respectively. Pleasingly, this occurs in young men, tends to be short-lived and is infrequently any sort of problem in the longer term. So there has been a link there. One of the problems, though, is that there's been a real, if you like, amplification of concern around this in social media with people suggesting that the vaccines cause sudden cardiac death. Well, there's a very well-respected group. out of Melbourne through the Baker IDI, who have very good data where they've tracked the incidence of sudden cardiac death for a decade or so and matched that up with the incidence of sudden cardiac death after introduction of the vaccine. And this group have been able to show us that there's been no clear or appreciable uptick in the number of people having sudden cardiac. death or sudden cardiac arrest. So yes, there's a link, but we don't think it's a catastrophic link and leading to the sort of concerns that many people are obviously worried about. Thanks for addressing that. Cardiologist Warrick Bishop there. So in terms of the younger athletes and the issue of cardiac arrest, are there signs that you can look out for so you don't end up in that situation where you're keeling over in training? Yeah, that's a really good question. Of course, one of the most important, there's a number of main things that we are concerned about. One is an electrical abnormality of the heart, which is inherent and often hereditary. So it's very important if there's a family history of sudden cardiac death that the family are aware of that and go and get checked out. It's a very simple thing to do. When the electrical activity of the heart has been altered, we call that a... channelopathy and these are passed through hereditary. So these can lead to electrolyte disturbances within the cell and therefore an irregular rhythm. The other thing is that the heart muscle can be enlarged and this is a condition called hypertrophic cardiomyopathy. You don't need to remember the name but it's a thickening of the heart muscle and this can also pass through families. Again there may be a family history that gives it away. Other than that It's very hard to detect. It is worth noting, though, that occasionally, particularly in fit athletes, a very significant percussion or hit to the chest, a sudden impact or trauma, can actually stop the heart as well. And so the whole process of actually being in sport could occasionally, very, very rarely, trigger a sudden cardiac arrest as well. Ron asks, how do you tell the difference, I love this question, Ron, between wind pain and heart pain? Between wind pain and heart pain? I guess digestion, you know. Sure. Okay. So I guess if you can't tell the difference, then you always have to err to the worst possible outcome. So my advice to people is if you're ever, ever unsure. about what something is then you've got to get it checked out so if you're unsure between is this indigestion or is this my heart then you you're really obliged to get it checked out it's a different story if you get indigestion all the time and you get that same pain over and over then you're sort of comfortable that you know what it is it responds to a quick ease or whatever it might be it's very important that if something's not right or different so you think oh this isn't quite like my indigestion pain it's a bit different That should be a flag. Conversely, Rick and Ron, what we find and what I tend to observe is if someone has had a heart-related event, for example, angina or a heart attack, they have a certain quality and nature of pain. And in the future, if that problem comes back, they tend to get the same quality and nature of pain. So often indigestion pain and cardiac pain, say to people, it's apples and bananas. And often people can discern the difference. But as an individual, if you're not sure, get it checked. Dr. Warrick Bishop, cardiologist, so many questions are coming in now, but we've got to get to headlines. But can I ask you just one thing quickly for Laura? Because I reckon she's got her husband listening. My husband's on statins preventatively because his cholesterol is high. Are there other ways he could get his cholesterol down? Laura, not at the moment. If he's... If he's high enough risk to warrant statin therapy, those drugs work incredibly well. We've got nearly three decades of solid, robust data where there's no question they do a good job. We do, excitingly, have a number of interesting alternate therapies on the horizon, but we're not going to see those broadly used for a number of years yet. Okay, brilliant stuff. Dr. Warrick Bishop, thanks so much. Thanks, Rick. Have a great day. You can get more information on his website as well, where there's a huge amount of detail there. Did you know that coronary artery disease kills one in four people? So most of us are likely to carry some risk or know someone who does. If you're interested in finding out more about how to evaluate that risk, check out. www.virtualheartcheck.com.au It will give you information about risk and what else can be done to be even more precise.
