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Oh hey, it's the woman on the swamp tour who won't stop screaming. Yeeha, Ali Ward, and we are here with your heart in your ears. Cardiology, let's consider this episode of one on one. It's a very basic intro to a really huge discipline. And this is a guest I have waited months and months and months to interview.
It all started. I got a note from a list named Matthew Evan Taylor who said, not only was this person a top cardiologist in the country, but he also has a great radio voice and also was his dad. I did a little research and quickly realized no other cardiologist would do me and this guest. We chatted months back over the phone, and he wanted to time the episode so that it hit in February to encompass both American Heart Month and Black History Month. But he's super busy.
He had a conference to go to November, and then he was going to the Super Bowl in February. Turns out he didn't just have a conference to go to. He was being awarded the Clinical Research Prize at the American Heart Association's Scientific Sessions in twenty twenty four. Owned the Super Bowl tickets, you know. He was there as the director of Player Engagement and Education and a co investigator into the Football Player's Health Study at Harvard University.
He was at workin He is a professor and a director at the Cardiovascular Research Institute at the Moorhouse School of Medicine in Atlanta. He did his undergrad at Princeton, his doctorate from Harvard Medical School, and has been named the American Heart Association's Physician of the Year. This man's schedule, like some of our arteries, is packed wall to wall with huge responsibilities, but he is gracious and generous and we were able to nab him for about an hour
this past Saturday morning. I was terrified to take up too much of his time because I already loved him so much. And we turned this episode around in just a few days. He showed up on video and a shirt and tie, all smiles. He let me ask him so many questions. But first, before we get into it, thanking about on the patrons who submitted their questions before we recorded. Thanks to all the folks in ologies merch
from ologiesmerch dot com. Thanking about on the listeners leaving reviews which helped the show so much, such as this recent review from Amy and Arlington, who wrote, you learn new stuff each time, you come away amazed by all the smart and good people in the world, something we all need nowadays. Thank you, Amy and Arlington and everyone who has ever left a review. I have read them all. Okay,
let's get to the heart of the matter. Cardiology comes from the Greek for heart easy, and we covered as much as we could in the time that we had. So Yeah, consider this a one oh one, A primer.
Get pumped for valves, tubes, beats, electrical shocks, Gray's anatomy glossaries, heavy metal hearts, The effects of long term stress on the heart, What those blood pressure numbers mean, how to read an EKG, what to do with an emergency cardiac disease symptoms, what your heart wants you to eat, how to decipher your cholesterol numbers, and why you would want to trust me it's fun, The worst heart art out there, and why a wedding ring goes on that finger with researcher, Professor, physician,
Heart Hero and your new favorite cardiologist, doctor Herman Taylor. This one is going to come up on Tuesday, so this is going to be a quick turnaround.
Yeah, okay, all right, Yeah, let's get to it.
Okay, he him, Yes, okay, Herman Taylor. Now you're a cardiologist. How long have you been a cardiologist?
I've been a cardiologist really since nineteen ninety, which now I guess is what thirty five years? Is that? Right?
Yeah?
Yes, quite a long time.
Now, what was it that drove you into cardiology when you were in med school, when you were on this path to becoming a doctor. When did that passion start for you?
Well, let's see, originally I was I guess just very interested in science. The thing that got me going actually was believe it or not, And this dates me a bit. The Space program got me first interested in science in general, and I gravitated through a period where I wanted to be an oceanographer. You may not be familiar with the undersea world of Jacquesustau.
We would like to know more about this serpent who ages ago it turned from land to the ocean of his origin to prey on the tiny bottom dwen hours.
But if you go back in the archives, I'm sure you could find that I found that really inspirational. But as time went by, I got more interested in physics, as it turns out, which led me actually to cardiovascular physiology. The way it was taught back then, there was a heavy emphasis on himodynamics and flows and fluids as sort of one of the primary things you had to master if you wanted to understand what was going on with
the circulation with the heart. In college, while I was still vacillating a little bit about what I was going to do after college, I had the opportunity to go to Cornelli University's School of Medicine for a research fellowship, and part of that experience was teaching cardiovascular physiology, and that's sort of where things everything came together for me in terms of my interest in the heart and the circulation.
And that combined with sort of seeing through the opportunity of this summer research fellowship, seeing clinical scenarios that showed that marginalized populations had a particularly bad time with cardiovascular disease. All that sort of piqued my interest, got my passions
going and pointed in the direction of cardiology. After spending some time on a faculty in Birmingham, my hometown, teaching cardiology, seeing patients, etc. And really having a wonderful experience being in my hometown treating people who were maybe colleagues and friends and coworkers of my parents and friends, and I got inspired by the idea of studying a large population
of African Americans looking specifically at cardiovascar risk. There had been a study and still actually still is, a study called the Framingham Heart Study, which looked at a long term took a long term view of cardiovascular health and a population in the Northeast that happened to be almost entirely white. In fact, even more specifically, mostly it was either Italian Irish or Irish Italian in terms of its heritage.
So this study, founded just after World War Two, focused on the long term heart health of over five thousand residents of Framington, Massachusetts, and it's ongoing. It's in its third generation of volunteer subjects and among many discoveries chronicled in thousands of published papers were findings about cigarette smoke and heart disease, psychosocial factors, and genetic or inherited risk factors.
That study has been tremendous in its contrabans, but there was a major omission. You know, that's a very small slice of the human family when you talk about people whose heritage is traced principally to Western Europe. Mankind, womankind is much broader than that, and there were some special challenges in the black population that weren't adequately being met.
So the world of research was really looking for a way to fill that gap, and we came together with the idea of the Jackson Heart Study to do that. So it was a particularly fun time of my career.
And the Jackson Heart Study, started twenty five years ago, looked at the cardiac health of again over five thousand participants. But this time in Jackson, Mississippi. And another reason why we waited until February for this episode at doctor Taylor's suggestion for a Black History Month is that Black history
factors into what care patients receive. And one twenty twenty study laying out a lot of info was published in the Journal of Hypertension titled discrimination and Hypertension risk among African Americans. In the Jackson Heart Study, you mentioned that there are certain circumstances that put heart health at risk. More, what is genetic versus? What is lifestyle? What is access to medical care? What factors are really affecting any person?
Well, there's so many, and it's a combination, a convergence of a lot of different dimensions. Let's say, so the genetic certainly, you know, family history and things that run in families are important. There are some very specific things like abnormalities and cholesterol metabolism, tendencies towards high blood pressure. Those things can run in families. But so can things like eating habits which are not genetic in any serious way.
If there is a family tradition of eating a quote Southern diet or what people might consider a soul food diet, or some other diet that has a propund difference of certain types of foods, seasoning that carries certain electrolyzed that might not be good taken in overabundance, a tendency to fry foods which causes chemical changes in foods that may not be ideal, et cetera.
So cardiac disease may involve a straight up DNA predisposition like familial hypercholesterolmia, which is cosmetis genetic link on how your body recycles LDL or bad cholesterol, and it might require meds no matter how you change your habits. And of course, heart health is affected by geographic and lifestyle factors like how walkable your neighborhood is, or diet in
your culture. And actually, if you want a great Black History Month episode on cuisine, doctor Psyche Williams Forsen is a food historian who we interviewed for a Black American Magnrology episode. But yeah, some heart conditions are just wired into yourselves.
Those types of things can run in families. Then you have cultural and societal exposures that may be quite material in terms of whether a person develops high blood pressure, diabetes, et cetera, or heart disease, itself, and these can relate to things that induce stress in the population, whether it's the stress of city life or the stress of you know, let's let's call it discriminatory practices, or limited access to care,
or limited access to good food. Those things too, can all come together to create an ecosystem that's very unfavorable for your heart. And some people face those things day in and day out, and they accumulate over time and can lead to some fairly serious sequella.
Yeah, I didn't know what that work meant. Sequella, Yes, sequella, Okay, I got it.
Maybe I should pick another word. Things that happen in contant, So that's or, you know, in sequence, I guess, but you.
Know, I'm not sure. I don't take you as someone who spends a lot of time scrolling on social media, because you've got a lot of important things to do. But there was this viral video that went around of this heart.
So it is a one piece.
Piece, so it was a model of a heart that they were teaching in anatomy and it almost was spiral the muscle. They almost stretched it out like unrolling a map or something. Is that how a heart is constructed?
Wow? Well, I haven't seen the video, okay, but what is true is that the heart in the embryo, the heart starts out as a straight tube right of cells, and as gestation goes forward, that tube begins to fold up, twist on itself, and fuse. And what you wind up having is this four chambered marvel of a muscle. Muscle is maybe too simple a description of what it is, because it has electrical properties, it has contractile properties, and
even a sort of a mind of its own. I mean, it can beat on outside of your body, powered by its own spontaneous electrical impulses. They've left to its totally through its own devices, as long as it had oxygen and nutrients.
So when you see people in medical dramas, hopefully not in real life unless you're a healthcare worker, in which case, thank you so much, they may be using what's called an AED and this is an automated external defibrillator, and it's called automatic because it detects and then it analyzes the patient's heart rhythm and then it delivers an electrical shock to reset the cardiac arrhythmia, which a rhythmic so
it's out of sync heart beats. So if a person has a cardiac arrest and they have no pulse, no heart, they're not breathing. The protocol is typically to administer CPR if you know how to do it, and then if there's an AED nearby, use that next. And I cannot stress enough that first aid training is going to do a better job than me. I'm my podcast host and
I'm just search engining how to save a life. And then I'm trying to tell you in like seventeen seconds now, if a heart can beat with electrical charge and oxygen. Is that what happens in heart transplants?
I don't know.
I've never had one. But our guest, doctor Tom Bulk in the Mycology episode, did have a heart transplant, and we discussed it in his episode, which we'll link for you, during which he pointed me toward this felted box on his desk. It looked like a Kleenex box, but it contained a fluid filled plastic bag with the heart he was born with. It was sliced up like thick roast beef. Now, how do those transplants work well? In brief, a donor heart is removed, usually from a patient who has experienced
brain death. But is a live via intubation, and one that support is withdrawn and the patient passes. The heart is removed and it's taken on ice to wherever the recipient is hopefully close by. They only have a couple hours on ice. Now, the recipient is prepped and while the surgeons replace their heart, a cardiopulmonary bypass machine circulates and oxygenates their blood while the recipient's heart is getting
taken out. Now, typically the donor heart would be transplanted, not beating, and then restarted, but thrillingly, weirdly and surreally. As described in this twenty to twenty three paper first inhuman beating heart transplant, doctor Joseph Wu and his team at Stanford were able to restart a donor heart, keep it warm with blood and beating as it was being implanted into its new recipient. Trust me, we could do a thirteen episode series just on this topic. But those
are some basics, back to even basic or basics. How did you build your heart in the first place? How'd you do it?
So? Yeah, it starts out as a two. It twists and bols and fuses in just the right way, and you get again this four chamber structure that we know as the heart.
What are those four chambers doing? If you had to break it down to someone who is obviously not a cardiologist, the ventricles, the chambers, what's doing what?
Okay, so there are four chambers. There's a left heart, if you will, in a right heart. Each side of the heart, let's go with that terminology has sort of an atrium, just like the atrium to a building. The four you end up building, and that atrium is the first chamber, and it receives blood and then loads the sort of more business in the stronger, more thickly muscle chamber called the ventricle. The right atrium takes all of the venus blood. All the blood has been say used,
let's call it. It's been out to the body, has dropped off its nutrients and its oxygen, has participated in cholesterol transport, has taken immune cells to where they need to go, and all the various functions of blood that comes back with a lot of the oxygen and nutrients depleted for another round to pick up essentially more oxygen by being pumped through the lung. So there's a special part of the heart that's devoted entirely to making sure that fresh blood with a fresh supply of oxygen is
supplied to the body. The first stop after first coming into that right atrium going through a valve which is a one way door. Now that valve is called the tricuspid valve for those who want detail. But coming through that valve, leaving the atrium, it goes into the right ventricle.
Which is downstairs from the right entry or atrium.
That strong ventrals then pumps it up to the lungs where it goes through this amazing network of blood vessels and down to where the blood vessels are so thin they come right up next to the little sacs that have air oxygen alvil and they're so close that the oxygen can just diffuse across into the blood. And then after the blood gets refreshed from people like to talk about blue blood and bright red blood, it turns much more closer than this bright red type of blood.
So once again the spent blood enters the right atrium via the vena cava as venus blood heads to the ventricle and then to the lungs via the pulmonary arteries where it fills up on oxygen, and then it heads back to the heart's left atrium via the pulmonary veins. Okay, so you got fresh blood back to the heart for distribution.
All of that then drains from the lungs into now the left atrium, okay, which is the first chamber after the blood has been refreshed. Once there, that atrium squeezes and pushes loads the true business end of the heart, the left ventricle. This is the most powerful part of the heart. This is the thickest muscle in the heart.
Why because it has to then generate enough pressure to push blood through the body to every cubic millimeter or even smaller portion of tissue throughout the heart and every organ to again supply oxygen and nutrients, and then allow after it all is used, for the whole thing to
circle back again to the heart. The heart does this through it's estimated thousands of miles if you could, if you could stretch all of these vessels out into end, they'd be several thousand for an individual person, which is kind of hard to conceive.
Several thousand.
Well, when you consider that the blood vessels go from the big obvious vessels down to tiny microscopic capillaries that allow again, the diffusion of nutrients and oxygen into every part of tissues and organs throughout the body. You can imagine that. Yeah, if it was possible that it would make for a very very long highway of blood vessels.
Okay, So the atrium is on top, the ventricles are on the bottom, and the left side is tasked with shooting blood out to your whole body like an Olympic shot putter, but just throwing buckets of blood as far as it can. And that beefy left side is why our heart is kind of left leaning in our chest. Now, as for a wedding ring on the left ring finger, what's the deal with that so called vina and which is the blood plumbing that leads from the heart straight
to that one wedding ring finger digit? Friends, it's flim flam. All the veins and the arteries go back and forth to the heart and wedding rings. Over time, they've been worn on either hand. Some were even worn on the thumb when the fashion was like blingier and bulkier one hundreds of years ago. So no, you do not have a vein or an artery that goes straight from your heart to your wedding ring. It's cute though. Now if you're like, I must know more about this history, you
can see the nineteen seventeen book. Well, I'm going to take a breath here. It's titled Rings for the Finger from the Earliest known times to the present, with full descriptions of the origin, early making materials, the archaeology, history for affection, for love, for engagement, for wedding, commemorative morning, et cetera. That's the whole title. I find that et cetera at the end to be like the funniest thing I've ever read, because it's the longest title of the book,
maybe in the universe. Anyway, onward, I need you to know also that atrium, you know how it means entry hall for the heart. Ventricle derives from the Latin for little belly, So that's a little belly of your heart. More on guts in your hearts later in the episode. Now, remember how in the recent surgical Anchiology episode with doctor s Sheila Blumberg about veins and arteries, we learned that venous blood is on its return trip to the heart.
It's darker in color, it's low in oxygen from delivering it all over your body. While arterial blood it's fresh from the lungs, it's brighter, and it's fueled up with O two on the way to your body. If you don't remember that, that's okay, because I just told you so. Obviously, the speed and pressure that that fluid is pumping through your body is important when it comes to blood pressure. When it comes to heart health too, we always hear, like,
my blood pressure, it's good or bad. What does blood pressure have to do with your heart health?
Well, it has so much to do with it. One, the pressure you need to keep blood actually flowing to the heart itself. Just like every other tissue in the body, the blood has arteries that feed itself, that pump blood through to the heart muscle or that what's called the mio cardium.
Okay, so a quick terminology breakdown here. Myo muscle card heart eum means the tissue and idis means inflammation. So myocardium is the muscle tissue of the heart, and myocarditis is inflammation of the muscle tissue of the heart. But yeah, the myocardium, the heart muscle is the pump and in fluid dynamics or chemo dynamics, you need to keep things moving.
Maybe in order to do that, there's a certain head of pressure that's needed in the heart, but it can't be too much. If it's too much, then what can happen, and is those arteries that are so vital to the heart survival become damaged the lining inside of them called the endothelium. That then lining that allows for the exchange of oxygen and nutrients and so forth, is so very important.
If it becomes damaged and starts to dysfunction, that allows all sorts of badness, like cholesterol accumulation, the formation of what we call fatty streaks, which are just it's like a giant oil slick on a road where you have cholesterol gathering breaking through the barrier that should be intact. That cholesterol event is being consumed by cells from the body that are designed to protect the body against invaders.
They're called leukocytes aka white blood cells. Those macrophagias that gobble up the LDL or the bad cholesterol, they help convert it to foam cells. Don't worry. Don't worry about that. So these macrophasis, doctor Taylor explains.
But they come in, they gorge themselves on the cholesterol, they break down and form debris. It causes inflammation, and there's this cascade of events that then leads to the body trying to contain it by forming a plaque over the top, a very fragile covering over this whole mess, right, and that contains the damage for a while, and it could be years. This whole process can take years in development.
In fact, we see some of these changes I'm describing, and the autopsies of soldiers who are eighteen nineteen years old, you can see the very beginnings of this process. Anyway, that type of damage can be initiated by pressures that are too high. That then sets up a situation where that plaque could erode or rupture.
And remember that plaque is like spackle over a.
Moldy wallposing all of that garbage to the blood passing by, which sort of sees it as this disruption in the artery and then sends all sorts of things to fix this break in the artery.
Platelets, which you remember from high school biology, are mainly intended to stop you from bleeding, right. They form a clot to close a cut you may have or bruise. But in this case, the platelets which are like, think of these tiny pieces of velcrow. They come to the site where all of this has happened, and they stick to each other as well as sticking to the site.
So we covered this a little in the surgical angiology episode. But atherosclerosis or hardening of the arteries is kind of under the umbrella of coronary artery disease, and high blood pressure can stress out the arteries and it damages cells and it invites more plaque to build up. So what is high blood pressure exactly? Well, the top number of your blood pressure is your systolic blood pressure, and that is how much force is pushing against your artery walls
when the heart contracts, like how stiff is the garden house. Now, the bottom number of your blood pressure is the diastolic blood pressure, and that's how much pressure is in the arteries or the hose between the beats. So the top number is usually what's under scrutiny for your heart health
because again that's the higher pressure. It's when it contracts and pumps out blood, and numbers above one thirty over eighty will kind of raise your cardiologist eyebrows because something over one thirty over eighty could cause some plaque in your arteries to break off. Okay, then what would happen?
And then this process can go on as a cascade out of control and ultimately calls a blockage in that artery which could lead to a heart attack. Oh that's not good. Now I've abbreviated a whole lot of processes just to somewhat dramatize the idea that blood pressure is one of those things that damages the artery that leads to a cascade of events that could be quite quite bad for you. And that's mechanical injury to the wall.
Now you can also have a chemical injury to the wall from things like cigarette smoke and all of the toxins that are in the cigarette smoke, other inflammatory processes that might be tied to obesity, diabetes, even things like stress can be injurious and set up this cascade of problems that can lead to damage to the vital inside of the arteries. It's important to know that having blood pressure out of control can damage the heart of self.
It can damage it another way. By the way, if you imagine this heart and your heart beats about what one hundred thousand times a day, one hundred thousand times a day silently. It's carrying out its function over and over. Its repair have been steady activity. That's a lot of weightlifting. If you have pressure inside the system higher than it should be, then your muscle is working harder than it should and that strain causes the muscle to grow. Just like if you did a whole lot of curls with
a weight, you'd expect your biceps to grow. Then that muscle grows bigger than it was originally intended to grow, and that can lead to other problems in terms of the function of that ventricle. To put it, simply to overwork the heart for any long period of time under the strain of high blood pressure can lead to failure of the pump. Actually two types of failure, one failure being that the heart can begin to sag and be weak and ineffect and the pump is sort of worn out.
Another type of failure is that the heart gets so thick that it doesn't relax in between beats. Oh that non relaxation then produces symptoms that are very much like the heart failure. When the heart is baggy and weak and so one we call help ref one we call help HEEF as an acronym for heart failure with preserved ejection fraction and heart failure with a reduced ejection fraction. And the injection fraction is simply a measure of how much blood the pump pumps out with each beat.
So when that left ventricle is either too big or too baggy and it goes to squeeze out blood, it may only squirt like a dribble, you know, like below fifty percent of what's in there instead of a normal seventy percent. Does the heart ever take in more than a pupping? Does it ever get behind, like taking in too much and not able to pump it out fast enough or vice versa.
Yes, And that happens in a number of ways. I just talked about the heart failure of the really thick heart where it's not relaxing like it should, and what happens is that the pressures go up inside the heart and that pressure backs into the lungs. It manifests as shortness of breath, fatigue, other things that can happen with a heart that's gotten too.
Big, and that's congestive heart failure, which again can occur if the heart muscle is too weak to pump a out of blood when it contracts, which would be a systolic issue, or if it's too thick and therefore that left ventricle or the left little belly is too small to fill up properly between beats, which would be distolic.
And the classic picture of that can look like swollen legs, swollen liver and sort of the origin of all of the organs that otherwise normally let blood flow right back up to the heart.
And where does stress factor into all of this? If you're freaking out over any various amount of things that say, your job or your home life, or you just have a lot of stress in your life.
This is the year twenty twenty five, what.
Is that doing to your heart? Like beat by beat, day by day.
Well, stress and the hormones related to stress, like adrenaline, just as one that everybody is somewhat familiar with. Those things can cause blood pressure to go up, can cause arteries to constrict, and cause the heart rate to increase. Those things increase the stress on the system.
And adrenaline has a very good reason for doing this. It's raising your blood pressure so blood can rush where it needs to be to run away or to stay and kick someone's ass.
Inflammation that can be tied to all of those processes not only help raise the blood pressure directly, but they can be again injurious to the blood vessels and weaken them in important ways. So, for instance, take the stress of perceived discrimination as just one example, and this applies to discrimination based on race, on appearance, and other things.
And this is true across many marginalized populations such as Native communities, women, LGBTQ, folks, people of lower socioeconomic status,
trauma survivors, and more. And you can see the twenty ten paper the Impact of Social Determinants on Cardiovascular Disease First Start, or the twenty twenty four study LGBTQ plus Cardiovascular Health Equity, the twenty twenty study Cardiovascular Health in American Indians and Alaska Natives, or doctor Taylor's recent paper Cardiovascular Risk and Resilience among Black Adults, Rationale and Design of the Morehouse Emory Center for Health Equity Study, or
his twenty sixteen paper Percive discrimination is associated with health behaviors among African Americans in the Jackson Heart Study.
It's clear that from the Jackson Heart Study and other studies, that having the perception that you're being discriminated against can actually raise your blood pressure and lead to a chronic, sustained elevation in your blood pressure, which can lead to some of the things we've already talked about. Stress can
come in many ways. So there's the emotional stress. There's a stress sometimes of environmental toxins if you will, you know, inhaled exhaust from living your highways, other aspects of the environment that can add to systemic inflammation, add to a stressful day emotionally, all of these things can again converge and really cause the cardiovascar system cause of difficulties. I mean, the system is so sensitive to the environment, and sometimes
that's a positive thing. So it's very curious to note that if you listen to a certain type of music, if you listen to slow, soothing music, your heart tends to slow towards the beat of the music.
Wow.
If you listen to a lot of agitated type music, you know it's stimulating. I have one example of this from early in my practice where this came into play in a very dramatic way. I was doing a residency and rotating through western North Carolina through Appalachia, and a woman came in in the middle of the night with a massive heart attack. And part of the things that we do in those situations is not only all of the fancy drugs, but it's very important to keep the
heart rate down. The faster the heart beats, the more oxygen it requires. And you don't want a heart that's undergoing a fresh to be overworking like that. And this woman, we could not get her heart rate down. We were even using medications, the standard medications to help bring it down, and it was resistant to that. Her husband was watching us as we were paying a lot of attention to the monitor in terms of how fast the heart was going, and he said, Doc, do you mind if I sing
to her? And of course we looked at each other and it was the middle of the night. We're into ICU, and I said, uh, you know, we've tried everything else. I would yeah, I would invite that. So the guy goes to his car, gets adulcimer, this beautiful mountain stringed instrument, comes back to the ICU and starts singing this beautiful bluegrass melody to her. The first thing you saw was
the calm that came over her face. Oh the next thing you saw was a monitor showing us that our heart rate was steadily coming down to where it should be.
Wow.
It was one of the most impressive and beautiful moments earlier in my career. But the heart is that type of organ. It is very responsive to things in the environment that could be used for good, although sometimes the environment can be hostile and be hard on the heart.
The proof is in the studies such as the effects of music on the cardiovascular system and cardiovascular health, and the abstract of that study states that the greatest benefit on health is visible with classical music and meditation music, whereas heavy metal music or techno are not only ineffective but possibly dangerous and can lead distress and or life
threatening arrhythmias. But I needed to know what metal was chosen for these studies, and according to the twenty fourteen and paper, acute auditory stimulation with different styles of music influences cardiac autonomic regulation in men. The researchers shows Heavy Metal Universe by German power metal band Gamma Ray. Let's take a quick lesson. Okay, that's probably good. Can you explain what signs to look for for having cardiac issues?
I feel like there's a lot of maybe misinformation or fragmented information about how to spot heart issues, what symptoms you might be having, what should people look for?
Okay, well, there are many forms of our disease, of course, but the one that kills most people, and we'll go straight to things that kill you. I'm ready. The one that kills most people is course heart attack, and unfortunately, a huge segment of heart disease deaths manifest as the very first symptom of heart disease. It was often said when I was in training that when it comes to death from heart disease, often the first symptom is the last.
And what was meant by that, of course, is that a lot of people have no suspicion that they have heart disease, even though you know. Often in retrospect they said, well I should have known. So this question of how do you know or what should trigger you to thinking about heart disease, it's a big question. Heart disease kills more Americans than any other cause.
Really, what about globally? I mean America. We're not known for our walkable cities or our bike friendly roads, or a commitment to conservative portions. We love hot dogs and pie. Surely globally there must be bigger threats across the whole world. Wait, okay. According to World Life Expectancy Statistics, the number one cause of death globally in twenty nineteen with eighteen point six million deaths worldwide, what was cardiovascular disease?
Leading diagnosis within the heart disease category is heart attack or mild cardial infarction. That just means a mild cardia
means cardiac muscle, and infarction means death. So a death of a portion of the beating heart muscle is what a heart attack is, and it's caused by that series of events where you get a usually on acute blockage in an artery that is supposed to supply the heart muscle with an ever fresh supply of blood full of oxygen and nutrients, and when that it gets interrupted by traumbas that shuts down and things south of the blockage then are exposed to death.
So a clot or thrombosis is really sadly common, and about twenty five percent of deaths worldwide are due to this because they can get into the lungs as an embolism or a clot can cause a stroke or of course, a heart attack, how does it lead to a heart attack? So a big enough clot in a blood tube means that the heart gets starved of oxygen that's known as hypoxia and other nutrients it needs, and that starved heart muscle is in coagulative necrosis, which is a great name
for a fashion line sold a hot topic. But what becomes of that dead heart tissue is a scar that functionally doesn't contribute much. It's just like a hot mess of a HouseGuest who is a drain on your home and your vibe. And this dead muscle or an infarction can look kind of drained and pale yellowish. Imagine like a steak is your heart with a rubbery, pale spot.
That would be the infarction. Now, in the event of a heart attack, CPR keeps the blood circulating because you're manually pumping the heart, and this is done to keep oxygen supplying your body's tissues, including the heart, to prevent sell death. A defibrillator, however, can give the electrical stimulus to restart the heart so that it beats again on its own. And remember that aed the automated external defibrillator
that we talked about. So if if you're ever feeling like you don't know how to help in this topsy turvy world, you don't know where to start, consider maybe a first aid glass, because you never know when a stranger's life could just depend on a course that you took at the community center.
While I'm on this, I should also say that it's particularly important that we stress that the leading cause of death for women is heart disease. The leading cause perhaps of medical angst in a lot of women is cancer, specifically breast cancer. Yeah, and that is a very important, very important disease on the sort of on the landscape
of things that threaten women's health. But if I were to tell you that one in thirty nine women will succumb to breast cancer, I would counter I would further tell you to be aware that one in three women will succumb to heart disease.
Wow, oh my gosh.
So it's important to know that. And one of the distressing things in reacent publication of American Heart Association is that women were more aware of the threat of heart disease in two thousand and nine than they were in twenty nineteen. Why is that, I'm not entirely. Sure, Yeah, but it was particularly true among younger women who seemed somehow to have become either less worried or less informed about that particular threat.
Now, breast cancer advocacy and visibility has done so much for awareness and promoting screenings, And if you're in any of the countries that have designated October as Breast cancer Awareness Month, you've likely been exposed to pink ribbons and balloons and campaigns. We released a Surgical Oncology episode in October twenty eighteen and we talked about those campaigns. But did you even know that February is Heart Month in the US and also in Canada, the UK, and the Philippines, Australia,
New Zealand. Now globally, World Heart Day is September twenty ninth, But as the leading cause of death in the world, it flies under the radar more than I would expect. We're not as scared and thus preventative about it as many cardiologists would like, Especially for people assigned female at birth.
They largely viewed cancer in particular breast cancer as the leading threat to their lives, so it's important and for men, the rates of death from part disease are even higher. So should every woman run out and get a calcium coronary CT to look for coronary calcium today? No, I don't think that's where I want to go with this. I think, first of all, it's important that people know their numbers. We like to say that is know some
basic things about your physiology. Right now, you need to know what your blood pressure is from a fairly recent reading. If you have no idea, then you should go and get it checked. And as some specifics about how to get a checked.
So ask your doctor or nurse or healthcare provider to check it and note those numbers. Get your cholesterol checked. Even hit that blood pressure machine at the back of the pharmacy, which is not just for board kids stuck waiting for their parents to get a prescription. Are you a dentist save a life and take blood pressure readings when people come in for their six month cleanings and checkups. If you're like, why would a dentist do that? I
thought the same thing. My dentist, doctor Peter Sharon in LA, takes my blood pressure every time I come in, and at first I was like, why are we doing this, doc? We're here from a chompers, and he explained many people don't see medical doctors until there's a problem, and he was like, people are in here regularly, let's do it. And he's helped catch cardiovascular disease in earlier stages for his patients. Doctor Sharon, that fucking rocks other dentists think about it.
You should know what your cholesterol profile looks like, what your LDL and HDL numbers in particular look like. There are some other categories of cholesterol that might even be more important to know, but at least knowing your LDL and HDL is important.
Just some crib notes. LDL it stands for low density lipoprotein, and it's the bad cholesterol. It's the main source of blockages in the arteries. Now. HDL, high density lipoprotein, is the good cholesterol which helps get rid of bad LDL cholesterol. In general, if you're over twenty years old, you're gonna want total cholesterol under two hundred with that LDL the bad stuff under one hundred and HDL the good stuff over sixty or above is best. Mine. Last time I
checked it, my total it's one ninety eight. So I'm really riding the line here and later doctor Taylor will tell me and you what to do about it.
You need to know what your blood sugar or something called your hemoglobin A one C is critically important for all of us, particularly those of us and families that have high rates of diabetes or heart disease. And you need to have an idea about your your weight or BMI or waste circumference. Having some idea about those numbers gives you an idea about how much of the dangerous type of fat you may be carrying around your waist, around your viscera, and that which is the more toxic
form of weight distribution. Those are the first things. Oh, and I should add to that quickly. Those are the sort of numbers, the measure numbers, and a certain set of behaviors also that are concerning that with these numbers together can pose a real threat for early on set coronary disease and other types of heart disease. Those behaviors are ready exercise or the lack thereof. And you're eating habits, what types of foods you like and what quantities I
see exercise, eating sleep? Let me see it again, right right? You know? I mean when I was coming up through medicine in particular. You know, people thought it was really cool to say, you know, I'll stay up all night and I'll do this, and i'll do that, and I'll learn from every patient that comes in the door. I'm gonna be the best doctor ever. Was you know, I'll sleep when I'm dead kind of right. Not a good philosophy,
Not a good philosophy at all. And of course smoking or vaping, those things things are again, as I've said a couple of times, one of those chemical insults to the endothelium that can start a whole cascade of problems.
We chat about vaping risks to your arteries in the recent Surgical and Geology episode. We also discuss gardening or smoking the ganja and how that can affect your heart. And we also have episodes on sleeping and dreaming and circadian rhythms, which is going to scare your ass into pajamas pretty quick.
So okay, so there's the cluster of things that if there are any aberrations, if you are let's call it nod goppli it with what we like to say is a healthy lifestyle, then you begin to put yourself at an increased need to surveil yourself in terms of whether or not there are issues related to your health. Now, I didn't talk about genetics. Genetics can be very very important.
You know, if you have a history of someone in your family, particular first order relative, you know, father, am, the sister, brother that died early, say a woman who died before age sixty five or a man who died before age fifty five of heart related problems, then you yourself will probably be at enhanced risk. It need to be a little more vigilant than the next person about your heart. And certainly if you're having symptoms, then you know that sort of raises the anti if you're having
you know, some of the classic heart related symptoms. Let's go again with heart attack or angina, which comes from my angina being pain. Pectoris is the whole name angina pectorus being chest pain. That of course is a significant red flag.
So angina means pain. I didn't know that. I also thought it was pronounced angina this whole time. Alas, now we know why Gray's anatomy is always shouting these medical words like myocardi infection and pectoral anchinnout because this is the stuff we actually die from.
And if you're having discomfort in your chest, particularly on exertion or instances of high emotion, those things need to be paid attention to and may require specific evaluation if you are in the throes of an actual heart attack. Okay, we're getting really sort of deep into the disease process now. But if you're having classically and elephants sitting on your chest, shortness of bread, coal sweats, pain radiating down your arm, and obviously something is quite wrong, and you need to
dial nine to one one. Don't drive, don't have someone drive you, don't get on the subway. Call nine to one one, because the care is coming to you to be initiated right away, not when you arrive at a hospital, even if it's three blocks away. Okay, that description I gave you is classic and derived almost entirely from the male population, so it needs to be amended and amended in everyone's mind to be inclusive of other manifestations that
are perhaps a little more frequent among women. Now. Women can have any of those classic symptoms, but they have a higher preponderance of what we have historically called atypical presentations. They may be typical for women, but they were atypical. According to the old textbooks, that can be more of a deep fatigue, a deep sense of indigestion, other symptoms above the waste that are just distinctly unusual and lasting
fifteen twenty minutes. Those things also have been shown to be manifestations of significant blockages that lead to heart attacks in women. Now, you will also get indigestion sometimes, right that's going to happen. You will also maybe have fleeting,
you know, symptoms that concern you that won't be your heart. However, if you are you know, it's Saturday morning, you know, and you're at the soccer match, and you're having this unmistakable, undeniable deep again and some of our patients used to say, this misery in the chest or you know, even in the stomach. It's just it's not it's not going away. It's insistent. You may need to dial nine to one one. Run the risk of being embarrassed quote unquote that it
was just indigestion. I say run that risk because some people will delay or deny or say I don't want to cause people a lot of trouble. I certainly don't want the embarrassment of that ambulance coming up here to my son's soccer match. How dramatic is that? Right? But unfortunately, you know, I've had patients die of what they thought was indigestion when in fact it was a heart attack in the making. So I'm not trying to scare people.
What i want to do is sort of elevate alertness to the manifestations of a significant health problem that might not fit the Hollywood description of what you saw, you know, in the movie, right.
So you don't have to clutch your chest and scream I'm having a heart attack. To be having a heart attack, and it doesn't just involve pain down your left arm.
Some real world, non Hollywood symptoms of a cardiac emergency can be chest pain or discomfort, pain or discomfort in the jaw, neck or back, pain or discomfort in the arms, either arms or shoulders, shortness of breath, feeling very tired, light headed or faint, even nausea or vomiting, and ladies and those assigned female at birth you may have additional or different red flags, including anxiety, pain in the back
or arm, upset stomach, and brushing off. These cardiac symptoms could lead to your family donating all your clothes to goodwill and starting a GoFundMe to buy your casket. Not to freak you out. Let's just be real so.
That alertness may save lives. And I myself always had respect for the person who came in and we found you know, the Ekg's normal, the blood work is normal, everything's beautiful, and you can go home. I don't mind seeing, you know, a whole bunch of people like that over the course of the day. If that means that people are paying attention, and it might be that we may save someone who otherwise may have dismissed their symptoms.
Can I ask you just a couple of questions from listeners? Sure, go ahead, Okay, great? And each week we send money
from our heart to an organization chosen by theologist. And this week doct Herman Taylor suggested the Center for Black Agency and Resilience CEBAR, which was recently founded to trumpet the indisputable tradition of black resilience and agency, challenging the narrative that emphasizes vulnerability, and as the founder and president, doctor Taylor aims to increase knowledge about the Black community's interpersonal relationships which provide joy and resilience via a multidisciplinary
research project. So a donation will go to cbar dot org, which is linked in the show notes. And thanks to sponsors of the show for helping us do that.
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Okay, your questions. Doctor Taylor is a very, very busy man, so we didn't even get to scratch the surface because cardiology is a huge field and this is just one episode, but we got to ask a few great ones from patrons via Patreon dot com slash ologies onward, let's hear him. We had so many great questions. Genna Congdon wanted to know.
Hey, so my question is regarding EKG tracings in the wild. You see them on logos, on people's tattooes, kind of everywhere, and very often they're really inaccurate and pretty funny if you know what you're looking at. My husband and I both work in healthcare and we play a little game of pointing out these really wrong EKG tracings and trying to diagnose them. Do you notice when you see really wacky EKG lines and try to make up in your head what they could be if they were in real life.
I have seen one that just didn't make any sense and was so inaccurate on the side of an ambulance. So let me know if you played this game too.
Oh all the time? Yeah, you know, it's in logos. It's where you know, the critical parts of the waveforms are missing that would either not exist in nature or be totally alarming. You know, they tend to be a little bit idealized. So yeah, but we're okay, well in terms of not getting too upset about that. Actually, we kind of like the attention that people are thinking about their hearts in that way.
And if you're like, hey, yes, but you have no idea what Jenna or doctor Taylor talking about. Congratulations you are Alley Ward. Come along as I figure out what those waves mean. Okay, So a normal EKG or ECG an electric cardiogram, is when they adorn you with all those wired stickers that look like they have little denim rivets or small robot nipples on them, and they pick up electrical activity that looks like a line with some wiggles and a spike, and it repeats over and over
if you are not dead. And this is called a sinus wave because the sinus node is a part of the heart that works as a pacemaker and it's keeping
things on beat. So on an EKG, there's a little bump above the baseline, followed by that big spike which then comes down dips a little below the baseline, and then another bump like the first one, but a little bigger, very very simply, that first small bump is a pe wave and that represents the electrical activity in the atria to atriums and the big spike or QRS complex is what that big spike is called, is the ventrical electrical activity.
And then the third bump a little bigger than that pea wave is called a tea wave, and that's when the heart is at rest. And if these rhythms are off, then that could indicate an issue under the hood. Buddy, we got something going on. And an irregular beat is called an arrhythmia. An aphib or atrial fibrillation is an irregular and some psy chaotic heart rhythm that needs to be monitored to make sure that it doesn't cause blood clots or stroke. Down the line, Now, how many beats
a minute should you have? What's the good tempo you want to shoot for, So sixty to one hundred is in the healthy range, but consistently over one hundred is what's known as techycardia, which means fast heart. And if you're in good cardiovascular shape, you might have a lower resting heart rate because you're myocardia is strong enough where a heart beat blasts enough blood out so it can
kind of slow down the pace it's breezing along. Conversely, a weaker heart has to kind of frantically beat faster to get blood to where it needs to go. Now back to the tissues and the issues of the heart. How is the heart electrified? What is happening here? Asked Azam's partner Ali Andy Pepper zach ever Ate first time question ask Ur Smelanie Abbott and jack Lyn Costa Rive
the tiger Earl of Gramigan and Tiger. Udi Sigawa Young wanted to know are there really similar cells to brains and guts in the heart?
Well, yeah, in a matter of speaking in particular, one let's start with the brain. You know, the heart has a nervous system of sorts. In that I mentioned that if it was removed from the body of a human or another species, if you will, it would continue beating. And it beats because of that electrical system. It has its own Paine pacemaker. It generates its own electricity that the muscle responds to. The muscle is what we call an excitable tissue. If you shock it, it jumps. If
it had stopped for whatever reason, it will beat. After the shop. There are cells that we say they spontaneously depolarized, and that is there's a flux of ions across the membranes of the cells. You know, potassium and sodium of flowing and calcium of flowing in a certain way that the change in the electrical potential across the membrane causes a discharge to occur from this pastemaker. I'm tried not to go two different technicalities, and I hope I have
a lot of people. But because of that property, the heart has its own pastmaker and the rest of the heart responds. The pacemaker is way up in that right atrium we talked about earlier, but there's a network of fibers that carry each impulse through the rest of the heart as well as the heart. Muscle itself can carry the impulse even without those fibers, but it does have a sort of nervous system. Cardiac muscle is different from
skeletal muscle is perhaps in some ways. It has some similarities to smooth muscle and other parts of the body, but the milcarding is special. It has a ton of mitochondria, those energy producing cells. It has that spontaneous depolarization property, and it is woven in a special way that allows the type of contraction with each beat that propels the blood forward.
And that depolarization which creates the humps and the spike of a sinus wave on the eg. That's this wave of electrical depolarization, and it triggers the cardiac muscle to contract and as for the heart and the gut alliance, A study just came out a month or so ago titled Unlocking the Gut Cardiac Axis a Paradigm Shift in Cardiovascular Health, and it notes that an imbalance in your gut microbiome can trigger an immune response, and that inflammation
can affect the lighting of your arteries and it can lead to plaque build up, and we all know now that plack build up can cause all kinds of problems for the heart. Also, you have a vagus nerve that runs from your brain to your gut, and it can regulate heart rate and arrhythmias, which is another reason to just respect your wonderful bod, eat your vegetables, go for a walk if you can. Now. Congestive heart failure is that one of the bigger risks for people? And how
is heart failure? How is that different than a heart attack? Is that more insidious?
Yeah? Great question. Heart failure can be thought of as sort of a final common pathway for a lot of different problems. Okay, let's start with it. A quick description of heart failure. Let's go with the classic heart failure, the congestive heart failure as you referred to it, the heart wears out right, it gets big and baggy, and it's not a very good pump That ejection fraction should normally, each time the heart beats, it should pump out about
sixty percent of what's in it. Right, the ejection fraction can go down to twenty percent or less.
So operating at about a third of what it should be, congesting the heart like a traffic congestion, which is frustrating. Also in this case low key lethal.
That's heart failure of a sort. Now, how does that happen? A big heart attack? In the wake of that, you can develop heart failure. A valve breaks down and leaks severely. Because valves are normally supposed to be a one way door that keeps blood flowing through the heart in one direction. That breaks down, congestion can happen. The heart gets big and weak. Uncontrolled high blood pressure, as we talked about earlier, that can lead to heart failure. Viral infections can lead
to certain viral infections. Alcohol excess can poison the muscle and lead to congestive heart failure, and there are other causes. Even uncontrolled thyroid disease can lead to heart failure.
Just as I note we've got a recent thyroid episode. You know who wants to hear it? Your thyroid so cute?
It tends to be a fairly gradual onset process, taking years and multiple insults to finally get to that stage. It is a deeply it's a challenging problem. If today someone was diagnosed with congestive heart failure, their five year survival would probably be roughly equivalent to the five year survival of receiving a diagnosis of colorectal cancer the same day,
right wow. However, we have developed multiple approaches to the treatment of heart failure that are promising, and the specific type of heart failure matters in terms of how we approach it. The specifics of those therapeutic approaches are best discussed with your physician. And I want to just I want to leave a note of hope because of these
therapeutic advances, things are getting better all the time. And even today I was reviewing a paper that looked at engineered heart muscle that was grown from stem cells that actually was proven to improve the contractile function of the left ventricle to a significant degree. And there are all sorts of other new advancements that are being made so there's a lot of hope in the area.
And when it comes to what you eat yourself, a lot of people Raya, Anastasia Press Don Smallchek. Raya asked the relationship between high sugar intake and heart health assuming one eats otherwise while asking for a quote, friend Anastasia wants to know what you think of plant based diets, and Don asked, our cheerios actually good for your heart.
Diet was also in the minds of patrons Mims, Isabella Bartleson, Rya, Anastasia press Ronnie Rob Morgan, Ali Is Tired, Karen h Ron, Wendy Foreman, and Stacy Pinkwetts, who asked, am I going to live to be five hundred? Because I eat oatmeal with flax seed meal every day. When it comes to what you eat your diet, what does doctor Hermann Taylor recommend?
Let me tell you what I recommend. No, I have to say, and this is kudos to my wife. We are really beginning to move as much as we can, as deliberately as we can, to more and more of a plant based which doesn't eliminate consumption of certain meats, especially fish. Our ideal is a Mediterranean style diet right where there's plenty of fiber, plenty of vegetables and fruits, olive oil. It doesn't totally restrict other types of meat, but I mean, it doesn't eliminate it, but it does
restrict it. And we try not to overdo the sodium. We stay away from processed meats as much as possible because there's all sorts of badness there, but I strongly
recommend leaning towards plant based types of food. There's also something called the DASH diet which was designed specifically to help lower blood pressure, and it too is characterized by high number of feedings of vegetables and fruits, as well as high amounts of fiber, potassium, low fat, high calcium foods like the yogurt, and an assortment of sort of dietary alterations that actually have been shown to lower blood pressure by some eleven points in certain populations, which is
as much as some drugs.
And the DASH diet side note stands for dietary approaches to stop hypertension, and it recommends eating vegetables, fruits, and whole grains, including fat free or low fat dairy products, fish, poultry, beans, nuts, and vegetable oils and limiting foods that are high in saturated fat like fatty meats, full fat dairy products, tropical oils like coconut palm kernel palm oil, and limiting sugar
sweetened beverages and sweets. And the Dash Diet Eating Plant says it's important to choose foods that are low insaturated and transfats and rich in potassium, calcium, magnesium, fiber, and protein, and also lower in sodium, since excess sodium, usually from processed foods, makes your body retain water to dilute that sodium, which raises your blood volume and it leads to higher
than healthy blood pressure. Now, for folks with low blood pressure or low blood volume, say if you have pots, if your doctor says to go hogwild on the sodium for other reasons, obviously listen to them. But in general, we eat way more sodium than we evolve to do. Now, what if you're on a road trip or you were
bad at cooking. The American Heart Association says that good convenience store DASH diet snacks include parts skim string, cheese, boiled eggs, unsalted nuts, greek yogurt, and whole foods which are not cheetos, but they will keep you alive. Now, when it comes to hydration and eating produce, sometimes you're like, the world sucks. I need a treat. So what I like to do is pretend that I'm in a post apocalyptic world like Mad Max style, and that water is
something that people start wars over. So if anyone gives me like free water, like at a restaurant, I like to pretend it's the score of a lifetime. My fridge dispenses clean, filtered water. I would be a fool to pass up sixty four ounces or more that a day fruits and vegetables. What if I mouthed off of the government and I got shipped to Mars, but I escaped the prison pod and I found a stash of salads in oranges until I could build a ship to go home.
That's elaborate, but you can just like pretend you're lost at sea or something, and then you see water and vegetables and you're like, what a slag, gotta have them.
There's help out there. Dash diet Mediterranean diet, those are sort of two at the top of my list. And eat plants every chance you get.
Do you ever experience any eyepain when you see headlines about carnivore diets, like do you roll your eyes so hard that they hurt?
That's a very good question. They are not my favorite. And now this is a controversial area for some but yeah, we're omnivores, right, So some meat's okay. But I think historically meat was more of a condiment than it was a central part of the meal. And I think that is sort of a model of where we need to go in terms of inching more and more towards vegetable sources of protein and all the other great things the vegetables do. I think we should keep pushing towards that.
You know, saturated fats are much more cholesterol genic than eating cholesterol. You know, eating a piece of steak will produce a lot more issues in terms of cholesterol than eating an egg. Right, So I would say that, yeah, I don't really dig the conif.
I figured it was something along those lines. So that's helpful in terms of what to put in your mouth. But how about lasen up your sneakers or dipping into some water aerobics, maybe rollerblading without a shirt. Patrons, Matt Tacato, Anthony Richard's, Beth and Greer Kyla c Marathon or Curtis Takahashi, samwiz at a Cappello gool next door and Haley Blonzo first time question ask are they all asked about the
effects of exercise on the heart? And Haley, I'm happy to accompany you in your ears on any walks you take. I know a lot of ologites. You're here to learn about weird stuff while you're out on strolls. I salute you. Way to go, but is it ever too late to start that? And very very last question from listeners Brendan and Ashley first on question asker ask can getting into shape your regular cardio later in life undo some of the potential heart damage of being obese or sedentary previously?
They say, I was overweight my whole life until last year when I started running and eating better and lost eighty five pounds. Is it ever too late to get to help out your heart?
Never too early, never too late. Okay, I'm so proud of her. That is fantastic. That's cause for celebration. Your heart is celebrating. Let me tell you, when you take off even a loss of five percent of total body fat is felt by the heart in terms of that strain of pumping through those thousands of miles of arteries, capillaries and so forth critically important to your heart health.
You have done yourself a tremendous favor. I would say to you, congratulations, and I wish I had more patience like you.
Oh, that's such great news. So that's inspiring. It's never too late to do something good for your heart. Now, what about what about you? What's the hardest part of your job and the part you love the most.
Well, In recent years I migrated much more heavily towards research, But I will tell you that the hardest part of my job, if I look over the span of my career, was seeing people when it was too late. Was the heart attack or the cardiac arrest we could not reverse, you know, walking from that bedside and telling the family
was yes, those were the hardest moments. What I have loved the most clinically is I guess kind of the opposite of coming out of the calf lab and telling a family who was worried about chest pain in their loved ones that the arteries were clear. While we may not have the answer to the chest pain today, what we know is that the most dangerous thing that it could be appears not to be on the table, and we can now move methodically through the other less lethal possibilities.
Those were good moments, I think. Finally, I think realizing that for some populations where we hear a lot of important work which I've been proud to contribute to on the disparities that those populations, like African Americans, like other marginalized populations historically, that there's a lot of bad news.
There's a lot of news about foreshortened lives or higher rates of heart disease, hypertension and so forth, important to document, important to heighten our awareness that we need to have public health and other approaches that target some of these really troubling statistics that simultaneous with the sort of bad news, that there's a lot of reason to be excited about
the resilience of these populations. There was a time in American history about one hundred years ago where the extinction of African Americans was predicted based on statistics at that time and the circumstances of the fallback on reconstruction and other things that were aimed at helping the black population
that was newly freed. Despite all that travail. There are incredible stories of health and longevity and call it joy among the population that has had to confront such important obstacles, and that resilience, I think really points to another aspect of human existence, if you will, that points to how it is so humanly possible to overcome so many of
these challenges. And I'm very, very proud of those resilient African Americans and others who are living life long and well and thriving and flourishing despite some of the challenges that they face historically and present day. So I think that resilience that I see evidence of all the time is something that gives me a lot of happiness and joy.
Well, your work is amazing, and I think Matthew for suggesting.
You, I'll deal with him later.
We're now friends online.
I do have to just say, Matthew's my oldest son. I'm so proud of him out at UC Berkeley and the frontier that he's opening up in music I think is exciting and everybody should pay attention to what happens next with Matthew.
Evan Taylor, you know I need to have him on for a music episode now.
You gotta do that.
You've gotta do this multi generational. Taylor's well, thank you so so much. I'll let you get back to your Saturday. I really great, so ask caring people your cardiac curiosities, because you only live once, and you will live better and longer if you listen to him. I cannot thank doctor Herman Taylor enough for his time to do this episode and for highlighting February as Heart Month and as
Black History Month. And it's just another among millions of examples of how much diversity matters and science because discovery is all about what questions we're asking, and you need a variety of experience and perspectives to identify and tackle problems and find solutions. Thank you again, doctor Taylor for all of your work. Thank you to his son, doctor Matthew Evan Taylor, who's an associate Professor of composition at UC Berkeley's Department of Music, Doctor Taylor. Doctor Matthew Evan
Taylor that is will release his first LP soon. It's called Life Returns and it was recorded live at the Metropolitan Museum of Art in twenty twenty two. You can find out more about that and follow Matthew on Instagram at Matthew event Taylor. Now we are at Ologies on Instagram and Blue Sky. I'm at Ali Ward on both. We have shorter, kid safe and classroom friendly versions of Ologies. Wherever you get podcasts, just look for them in their own feed. We have new green artwork via Portland artist
Bunny Dutch. Also, Ologies Merch is available at ologiesmerch dot com, and if you would like to be a patron of the show and submit questions before we record, you can find us at patreon dot com slash Ologies. It costs one dollar a month to join. That is the entrance fee into our heart Now. Aaron Talbert admins Theologies podcast Facebook group. Aveline Malick makes our pro transcripts. Kelly ar Dwyer does the website. Noelle Dilworth is keeping us on
beat as scheduling producer. Susan Hale is managing director, and the Blood supplying all of our organs and also did additional research and producing for this episode. Thank you, Susan. Our assistant editor and Atria for raw audio is jakecha and left Ventricle. Helping us pump these out every Tuesday. Is Mercedes Maitland, our lead editor of Maitland Audio. Nick Thorburn Pace made the theme music and if you stick around untill the end, I burden you with a secret
about my life and some behind the scenes on this episode. Okay, so we were recording with doctor Taylor. It was going great. He was amazing. The mic that we sent him was working wonderfully. For some reason, the interface that I use to record kept popping up with a notice saying that his end wasn't recording, no fault of his own. I have no idea what was going on with the website that was supposed to be recording us, And in fact I went to go look at the files, the files
were not there. They did not record. Thankfully, Mercedes found a backup copy somewhere in a folder that had to be downloaded and pieced together, so all of the audio survived. But it was like, if this is just not recording, I don't even know. I'm going to disappear. I'm going to go into a witness protection or something. I'm going to change my name. I'm going to wear wake the
rest of my life. This is too embarrassing. I honestly started crying when she told me that she was able to get a backup of the files, I shed tears. I was so thrilled. Anyway, Think of your heart like a shelter pet who deserves nothing but the best in life, and take care of it as you would a stray guinea pig or a surrendered collie. You deserve it. Okay,
Bye bye hackadermatology, homology, r doo, zoology, lithology, zonology, meteorology, paratology, ethology, zeriology, elinology. Honey, you have such a big heart.
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That's the kind of smoothness you feel.
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