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Ask Dr. Gott 11/30

Heart testing not needed for young, healthy people

DEAR DR. GOTT: My husband, 50, recently died of an apparent heart attack. I say apparent because an autopsy was never performed even though the hospital nurse told us one would be done. He was a long-distance runner who collapsed 2 miles into a 13-mile run, with no witnesses.
    Shouldn't we all, starting about age 40, have stress tests, EKGs and blood tests for homocysteine, C-reactive protein and cholesterol every five to 10 years?
    If these tests were routine, couldn't we prevent many prime-of-life heart attacks be they due to arrhythmia, cholesterol, valve problems, etc.?
    DEAR READER: Cardiac problems in relatively young and well-conditioned athletes are usually caused by arrhythmias, irregular and/or rapid pulse rates that compromise cardiac efficiency and can lend to cardiac arrest. There are no consistently abnormal lab findings, such as you suggest, to winnow out those patients with potential heart problems. Nor is there anything to be gained by performing long lists of expensive tests — most of which are for problems untreatable except by lessening blood-cholesterol levels, anyway.
    When a loved family member suddenly and unexpectedly dies of cardiac causes — and we have yet to know whether your husband died of heart-related complications — the event is shocking, to say the least.
    I wish that an autopsy had been performed. This would have been far superior to an "apparent heart attack" as a final diagnosis.
    I recommend that you share your concerns and unresolved issues with your family physician, who may wish to comment further on your husband's premature death, obtain further testing of family members and provide therapy as needed. However, once again, I do not advise extensive investigations in otherwise healthy family members — except for routine annual testing.
    The tragedy you experienced was probably unavoidable, given the information you supplied, but I understand your concerns and needs.

    DEAR DR. GOTT: Since sugar is out of your diet, does that rule out all fruit, certain fruits, etc., or is natural sugar permissible?
    DEAR READER: In the interests of simplicity, fruit sugars are allowed in my diet, in moderation.
    To give you related information, I am sending you a copy of my Health Report "Strategy for Losing Weight: An Introduction to the No Flour, No Sugar Diet". Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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