Latest / Heart Health, Reimagined with Dr. Mona Shah, MD / Heart Doctor Reveals Frightening Results From Own Heart Scan

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Heart Doctor Reveals Frightening Results From Own Heart Scan · Heart Health, Reimagined with Dr. Mona Shah, MD

• 0:00
  SPEAKER_00: If you just got a result that scared you, maybe a scan, maybe a lab number, and maybe a doctor who mentioned plaque and moved on, you now have a list of things you have been told to start, stop, take, or avoid.
• 0:14
  SPEAKER_00: And you still have no idea which one to do first.
• 0:17
  SPEAKER_00: I've treated thousands of patients through exactly this decision.
• 0:21
  SPEAKER_00: I also made it myself.
• 0:23
  SPEAKER_00: And what I know from both sides of it is which move changes everything that comes after, and which ones just keep you busy.
• 0:32
  SPEAKER_00: I'm going to walk you through exactly what I did in the order I did it and why each step set up the next one.
• 0:38
  SPEAKER_00: By the end of this, you will have a starting point.
• 0:41
  SPEAKER_00: When people find out they have plaque, the first thing most of them do is overhaul their diet.
• 0:47
  SPEAKER_00: And honestly, it makes complete sense.
• 0:49
  SPEAKER_00: Diet is what you can control right now.
• 0:52
  SPEAKER_00: It feels like you're doing something.
• 0:54
  SPEAKER_00: Your doctor probably told you to cut saturated fat.
• 0:57
  SPEAKER_00: The internet has 17 more opinions about what to eat.
• 1:00
  SPEAKER_00: So you pick a direction and you start.
• 1:02
  SPEAKER_00: Diet absolutely affects cardiovascular risk.
• 1:06
  SPEAKER_00: That is not even a question.
• 1:08
  SPEAKER_00: And the research on certain dietary patterns, lowering inflammation, improving lipid profiles, and slowing plaque progression is real.
• 1:17
  SPEAKER_00: The instinct to improve your diet is a good one.
• 1:20
  SPEAKER_00: I would simply want more information before deciding exactly what changes to make.
• 1:26
  SPEAKER_00: Here's where it breaks down.
• 1:28
  SPEAKER_00: When you don't know what kind of plaque you have, or why it formed, or which one of your specific risk factors is driving it, and it could be multiple, you are making diet changes in the dark.
• 1:40
  SPEAKER_00: You might be addressing a problem you don't have.
• 1:43
  SPEAKER_00: You might be ignoring the one that is actually moving the fastest.
• 1:47
  SPEAKER_00: If I started treating my plaque before I even understood what was driving it, I could spend six months overhauling my entire life to do the right things for the wrong problem.
• 1:57
  SPEAKER_00: And what makes the right first move so hard to find is that nobody tells you what it is actually supposed to do.
• 2:04
  SPEAKER_00: The diet overhaul feels like the answer because it feels like an action, something you're doing.
• 2:10
  SPEAKER_00: The real first move feels like a step backward, but it's not.
• 2:14
  SPEAKER_00: And the second thing most people try when the diet overhaul doesn't feel like enough is just as premature.
• 2:21
  SPEAKER_00: The other place most people go immediately is supplements.
• 2:25
  SPEAKER_00: Omega-3s, aged garlic, coQ10, red yeast rice, all real, all supported by evidence.
• 2:32
  SPEAKER_00: If your doctor is more aggressive, maybe they put you straight on a statin.
• 2:37
  SPEAKER_00: And again, I understand why.
• 2:39
  SPEAKER_00: You want to see a number move.
• 2:40
  SPEAKER_00: You want proof that you are doing something.
• 2:43
  SPEAKER_00: The problem with going straight to treatment is that plaque is not one thing.
• 2:48
  SPEAKER_00: Soft plaque and hard plaque behave completely differently.
• 2:52
  SPEAKER_00: They respond to different interventions.
• 2:54
  SPEAKER_00: The specific markers driving your plaque, whether that's elevated LPA, lipoprotein A, whether it's elevated insulin resistance, high sensitivity CRP, chronic inflammation, or something else entirely, also determine which approach actually produces a result in your arteries.
• 3:12
  SPEAKER_00: Treating before you know your full picture is like putting out a fire before you know what kind of fire it even is.
• 3:20
  SPEAKER_00: I would not start a single supplement or change a single medication until I knew exactly what kind of plaque I had and exactly which markers were building it.
• 3:29
  SPEAKER_00: When you know your plaque type and you know which kind of specific risk factors is most active, the path from here to better is clear.
• 3:38
  SPEAKER_00: You stop choosing between 17 options and you start following a specific approach, even if it's multifactorial.
• 3:45
  SPEAKER_00: Now let me give you a few questions that tell you whether you have already had enough of that picture or whether you are still missing pieces you don't even know about yet.
• 3:55
  SPEAKER_00: Before you start anything, ask yourself these four questions honestly.
• 3:59
  SPEAKER_00: Has anyone classified your plaque as soft, hard, or mixed?
• 4:03
  SPEAKER_00: Not just you have some plaque.
• 4:05
  SPEAKER_00: Has anyone ever told you the type?
• 4:07
  SPEAKER_00: Do you know which specific marker is driving your plaque?
• 4:10
  SPEAKER_00: Is it your LPA?
• 4:11
  SPEAKER_00: Is it your APOB?
• 4:12
  SPEAKER_00: Is it your chronic inflammation?
• 4:14
  SPEAKER_00: Is it insulin resistant?
• 4:16
  SPEAKER_00: Or is it all of them?
• 4:17
  SPEAKER_00: Or do you just know your total cholesterol and your LDL?
• 4:20
  SPEAKER_00: Has anyone told you how much plaque you have, where it is, and whether it has changed since your last scan?
• 4:27
  SPEAKER_00: Or do you have one data point and no baseline to compare it?
• 4:31
  SPEAKER_00: Do you know your HSCRP, that marker of inflammation, your APOB, your insulin resistance score?
• 4:38
  SPEAKER_00: Or are you working only from a standard lipid panel?
• 4:41
  SPEAKER_00: If you can answer yes to these questions, you have enough of the picture to start making real decisions.
• 4:47
  SPEAKER_00: You can move to treatment with actual targets.
• 4:50
  SPEAKER_00: If you're missing one of these or more of these answers, you're in the group that needs a picture before the plan.
• 4:57
  SPEAKER_00: And that group is usually unfortunately the majority.
• 4:59
  SPEAKER_00: Most people who find out they have plaque don't have any of the other information because nobody went back to fill it in.
• 5:06
  SPEAKER_00: The person this matters most for looks like this.
• 5:09
  SPEAKER_00: You eat well, you exercise, you're not overweight, you have a family history that made you proactive, you got a scan, you got a result, and you left that appointment with a number and no roadmap.
• 5:21
  SPEAKER_00: Your doctor said, watch your diet and get labs and come back in a year.
• 5:26
  SPEAKER_00: You've been trying to figure out what to actually do ever since.
• 5:30
  SPEAKER_00: That is the person who needs a full picture before a single treatment decision gets made.
• 5:36
  SPEAKER_00: So here's a single move I would make before anything else.
• 5:40
  SPEAKER_00: The one I would not skip no matter what.
• 5:42
  SPEAKER_00: But first, if this is the kind of thinking you have been looking for from a cardiologist, subscribe.
• 5:48
  SPEAKER_00: Every week I put out something on what preventive cardiology actually looks like when you go deeper than the standard workup.
• 5:55
  SPEAKER_00: Hit subscribe and you will not miss it.
• 5:57
  SPEAKER_00: Before I took a new supplement to treat my plaque, before I adjusted a single thing about my diet, I would consider getting a clearly AI coronary CTA scan.
• 6:10
  SPEAKER_00: Of course, decision has to be discussed with your provider and make sure you're a good candidate for it.
• 6:17
  SPEAKER_00: But if you can, I highly recommend it.
• 6:20
  SPEAKER_00: And I would get a full advanced lipid panel and lab panel that included APOB, lipoprotein A, high sensitivity CRP, and an insulin resistant score, as well as homocysteine.
• 6:33
  SPEAKER_00: That combination tells you things that nothing else can tell you at the same time.
• 6:39
  SPEAKER_00: The scan tells you exactly what is inside your artery walls right now, the type of plaque, the location, how much, and where is it in risk, high risk, stable risk, or unstable.
• 6:52
  SPEAKER_00: The labs tell you which biological process is driving it.
• 6:56
  SPEAKER_00: Is it one or multiple?
• 6:58
  SPEAKER_00: Once you have all of that information, you're not guessing anymore.
• 7:02
  SPEAKER_00: And you have a target of what to reach your goals.
• 7:06
  SPEAKER_00: Every intervention you try after that is aimed at a specific target.
• 7:10
  SPEAKER_00: This is called precision medicine.
• 7:13
  SPEAKER_00: Everyone's not the same.
• 7:14
  SPEAKER_00: This is personal.
• 7:16
  SPEAKER_00: I'm vegetarian, I'm at a healthy weight, I exercise.
• 7:19
  SPEAKER_00: When I got my own clearly scan and show soft plaque, it was minimal, but it was present.
• 7:25
  SPEAKER_00: And the reason was not my diet, it was elevated LPA and the hormonal shift that comes with menopause.
• 7:31
  SPEAKER_00: If I had skipped the scan and gone straight to treating my cholesterol, I would have been optimizing for the wrong driver.
• 7:37
  SPEAKER_00: The LPA would have kept doing its job quietly while I felt like I was handling it.
• 7:42
  SPEAKER_00: The scan and the labs together told me which fight I was actually in.
• 7:47
  SPEAKER_00: If I were you, I would stop making treatment decisions before you have a scan that classifies your plaque and a lab panel that tells you which marker is driving it.
• 7:57
  SPEAKER_00: Get the Clearly AI coronary CTA if you possibly can.
• 8:01
  SPEAKER_00: If you can't, at least get a regular coronary CTA without the Clearly, because that will at least tell you something about your plaque, whether it's soft or hard.
• 8:13
  SPEAKER_00: The Clearly AI just tells you way more in detail.
• 8:16
  SPEAKER_00: See if it's offered in your area.
• 8:18
  SPEAKER_00: This, of course, needs to be discussed with your provider in a shared decision-making conversation to make sure it is an appropriate test for where you are right now.
• 8:27
  SPEAKER_00: Request the advanced panel, APOB, LPA, high sensitivity CRP, fasting insulin, homocysteine.
• 8:37
  SPEAKER_00: Write those names down.
• 8:38
  SPEAKER_00: Bring them to your appointment.
• 8:40
  SPEAKER_00: Those two pieces together become your actual treatment map.
• 8:43
  SPEAKER_00: Here's the first thing to do tonight to start that process before you even pick up the phone.
• 8:48
  SPEAKER_00: A clearly AI scan and a full advanced panel are not decisions you make in the exam room.
• 8:54
  SPEAKER_00: They are decisions you prepare for.
• 8:56
  SPEAKER_00: When you walk into that appointment already knowing what to ask for and why, the conversation is completely different.
• 9:03
  SPEAKER_00: You're not waiting to be told what to do.
• 9:05
  SPEAKER_00: You are directing the workup.
• 9:07
  SPEAKER_00: Think about how a good architect works before a renovation.
• 9:10
  SPEAKER_00: They don't start tearing out walls on day one.
• 9:12
  SPEAKER_00: They do a structural assessment first.
• 9:14
  SPEAKER_00: They find out exactly what is load-bearing, what can be moved, and what will cause a collapse if you touch it wrong.
• 9:22
  SPEAKER_00: The assessment is not the delay.
• 9:23
  SPEAKER_00: The assessment is the reason the renovation works.
• 9:26
  SPEAKER_00: Skipping straight to treatment before you have your full picture is tearing out walls without a structural report.
• 9:33
  SPEAKER_00: When you walk into that appointment with these specific questions, you stop being a patient who gets managed and you start being someone who gets a real answer and taking hold of your own health care and being an advocate for yourself.
• 9:47
  SPEAKER_00: The difference between those two outcomes usually comes down to who came in prepared and who didn't.
• 9:53
  SPEAKER_00: Step one, write down whether you have ever had a scan that classified your plaque type, soft, hard, or mixed.
• 10:01
  SPEAKER_00: If the answer is no, ask about a coronary CTA and ask if clearly AI plaque analysis is in your area.
• 10:10
  SPEAKER_00: Step two, write down whether anyone has ever tested your APOB, your lipoprotein A, your HSCRP, your fasting insulin, and even your homocysteine level.
• 10:22
  SPEAKER_00: If any of those are blank, circle them.
• 10:25
  SPEAKER_00: Those are your specific requests for the next appointment.
• 10:29
  SPEAKER_00: Step three, call your doctor's office tomorrow and ask for the earliest available appointment.
• 10:34
  SPEAKER_00: Tell them you want to discuss advanced cardiac imaging and an expanded lipid panel.
• 10:39
  SPEAKER_00: That exact phrase.
• 10:41
  SPEAKER_00: Write it down tonight so you say it correctly when someone answers.
• 10:45
  SPEAKER_00: I found plaque in my own arteries.
• 10:47
  SPEAKER_00: I know what that moment feels like.
• 10:50
  SPEAKER_00: And the single biggest advantage I had was I knew exactly which question to answer first.
• 10:56
  SPEAKER_00: You now have the same advantage.
• 10:58
  SPEAKER_00: Get the picture before you start the plan.
• 11:00
  SPEAKER_00: That is where your sequence starts.
• 11:02
  SPEAKER_00: If you have not seen the video where I talk more in depth about the two types of cardiologists, check out that video next.
• 11:09
  SPEAKER_00: It'll open your eyes to what's possible for your heart health.