An Interview with Cardiologist Dr. Michael Twyman, MD

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Three tests to help identify your risk level for heart disease, strokes, and heart attacks.

Dr. Michael Twyman is a Board-Certified Cardiologist who has now become a preventive Cardiologist, a specialist who tests you and helps you learn and understand how to avoid getting heart disease.

Today Dr. Twyman is going to explain three new tests that he offers to his patients to help decrease the risk of heart disease, stroke, and to avoid heart attacks

The first test is the Cardiac Calcium Scan that Dr Maupin has ordered for her high-risk patients for over 10 years.  It is a low dose radiation CT scan of your heart. It only takes about ten minutes.  It measures the plaque on the vessels of your heart.  When there is plaque it narrows the arteries and looks white on the CT scan.  Your score is based on how much calcium has collected on the arteries, which indicates how much plaque you have.   If your vessels are clear, your score on this test is zero or close to it, which means you are not at risk for a heart attack. If your score is 400 or above, you are in immediate danger. This test is used to determine your risk or even if you need a procedure right away.  As physicians, this is a better test than a stress test to see if you are forming plaque and therefore is a better predictor. This particular test is cheap, easy, and low radiation, so we go to this first to evaluate high risk patients.

This is a great test to determine if someone needs to take a statin or not.  Just because you have high cholesterol doesn’t mean it is a risk for heart disease.  If it doesn’t form plaque, then you don’t need a statin.

The second test that Dr Twyman does is the CIMP but what is the CIMP? It is a test that measures your carotid arteries for blockage. If you have blockage, then your arteries are narrowed with plaque and you are at risk for an embolus, or a blockage that causes a stroke.  To decide if you need treatment, or even surgery, Dr. T needs to know just how blocked your carotid arteries are. CIMP measures blood flow and size and thickness of the carotid arteries with ultrasound.  The thicker the walls of the carotid arteries are, the more inflammation and plaque you have built up and the higher risk you are for a stroke.

If you have an abnormal CIMP scan you will also have an abnormal calcium scan.  We can treat you with supplements and medication to melt away the plaque and open up the arteries.  Your plaque buildup can be reversed. This is one of the things that a preventive cardiologist tries to accomplish once they have adequate information to determine your level of risk and then they are able to formulate a plan to lower those risk factors.

Dr Twyman attempts to treat disease before it becomes irreversible and permanently damages us. Traditional cardiology training teaches us to find problems as early as possible and try to stabilize what is going on in your body so that we can avoid a stroke heart attack or heart attack and heart failure.

The third test that Dr. Twyman utilizes is the Endothelial Test to measure the thickness of the lining of your arteries.  This test measures how well your arteries expand when needed and can evaluate the endothelial lining of the arteries which tells him the functional health of your arteries…how well they work to adapt to your activity level. This is a test that can act as an early warning system and gives a patient several years grace period to change his or her diet exercise and nutrition to reverse the process.  Dr Twyman guides people to through the process.

Dr. Twyman talks us through these three tests and explains what he is looking for, how long it will last, and why these results are important in learning how to protect your heart and your blood flow in ways that will help you avoid heart disease as you age.

Suggestions are offered for those who are found to be at risk (whatever the measured risk factors are,) for how to change their diet and life- style and to determine whether or not some hormone replacement such as testosterone would be the best next step to take.

Finally, Dr. Twyman discuss his expertise in understanding circadian rhythms, especially meal scheduling and light exposure along with optimization of sleep patterns. These are relevant in helping your body avoid negative consequences that you can experience due to a confused or atypical schedule. This can be caused if you are a shift worker working nights, or if you are a pilot or someone who flies across time zones and cannot regulate their diet and sleep patterns because of the impact of their job. Sleep, diet, and light are critical to your health. Keeping regulated as much as possible can help your health more than we have understood.

Our concerns are always about helping you live healthier and longer more functional lives. We are deeply appreciative of Dr. Twyman for sharing his expertise with us this week.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.

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