that's not the cause of heart attacks. . . . but eventually that became clear that it has to be something to do with the heart and the brain, not the blood vessels. --Dr. Tom Cowan
Diabetics have more heart attacks but less plaque.
9:25. The story was they walked up Mount Tamalpais or Mount Monadinock with their wife. They felt a little funny, they had a little chest pain. The wife said you have to go to the cardiologist. They go to the cardiologist. He does a test and he says "You are 94% blocked. If you block anymore, you're going to have a heart attack." And I thought to myself if all the blood to your heart goes through these three arteries and you're 94% blocked, that means you have 6% blood flow to your heart how did you walk up Mount Tam? And you mean if you block from 6% to 4% or 3%, that's going to kill you? 6% is 0% effectively. You don't have any blood flow to your heart, so it doesn't matter if you block any more because you're already at zero or close. So that was weird.
So then I did the thing which you would think all doctors would do, but as far as I know I'm the only one who has done it, which is I said, "Okay, there must be studies that look at people who die of heart attacks and they do an autopsy on them, and they see how many of them have a blockage in the blood vessel leading to the part of their heart that had the heart attack." Right? If somebody says your sink is leaking, you go to call a plumber. He looks at the pipe leading to your sink, and says "Nope, it's not blocked. It's good. It's not the pipe." What I found was that when they started this heart attack theory, called the thrombosis theory that the cardiologists didn't believe it. They said, no, it's got nothing to do with the blockages. There's a robust blood flow through secondary collateral vessels. It's got nothing to do with blockages. So I looked, and it turns out that there were a bunch of studies from the 1940s and '50s, '60s looking at the percentage of people who died of a heart attack. So these are the worst of the worst, right? They had a heart attack and they died. Not everybody dies. The highest number I found was 78% and the lowest number was 18% had a blockage which means that somewhere between 22% and 82% had no blockage in the area of the blood vessel leading to the part of the heart that had the attack. So why did they die, like what happened to them? Now even if you have 78% that doesn't mean that was there before the heart attack because then I read a book called the edopathogenesis of coronary artery disease or coronary heart disease by a pathologist name Giorgio Baraldi. You can look up the book, and he studied people who died of heart attacks for 40 years with autopsies. And he said, " 41% of them have a blocked artery leading to the part of the heart that died, and of those 41%, half of the blockages clearly came after the heart attack not before." In other words, there was damage to the heart, like a dam there's damage to the river and you get backflow and build up of the debris in the river coming into the dam. So we're talking 18% of the people had any blockage before the heart attack of the people who died and had an autopsy. So that made me, being the reasonable person that I maybe, say, "that's not the cause of heart attacks." Now at the time I didn't know what it was which is fine you don't have to know what's true in order to know what's not true. That is a fundamental principle of logic, rational thinking, and supposedly science, even though most doctors have never heard of it. But you don't know if somebody says, "Oh, I had video at a 7-Eleven, somebody was shot and killed and it was a man between 18 and 60 wearing jeans. So you're under arrest." You say well I wasn't there I was in Singapore, not Boston, and I have proof and you prove that you weren't there, etc. And the guy says, "Until you prove to me who killed, tell me who killed the guy, you're under arrest." Like that's ridiculous, right? Nobody would say that. All you have to prove is that you weren't there. And so we've proven that that's not the cause of heart attacks. Now again, I didn't know what was, but eventually that became clear that it has to be something to do with the heart and the brain, not the blood vessels. So it turns out that what happens is there's an imbalance in the energy generation in the heart and the heart goes what's called glycolytic which means it builds up acid just like if your muscle exceeds it's capacity like your leg you build up lactic acid and you get a cramp. Why doesn't your leg have an attack? Because your leg stops, and you flush the lactic acid out and then you go on your way. Same thing happens in your heart. Your heart isn't efficiently burning fuel, and so it uses accessory pathways to ferment, which means lactic acid, which causes cramps which we call angina. The difference with your heart and your brain compared to the spleen and your liver and your foot is your heart and the brain can't stop. So they keep going. They build up more acid that causes a breakdown of the tissue, which is what we call a heart attack, and then the debris builds up up river, which is why you get plaque build up upstream. And all of the changes you see with every heart attack is accompanied by a drop in the pH, acidity, and it's come because there's damage to the organ. Now that can come from a lot of reasons
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