Heart Health, Reimagined with Dr. Mona Shah, MD

What Women With A Family History of Heart Disease Are Never Told at Their Cardiology Appointment

If you’re a woman with a family history of heart disease, there is information your cardiology appointment was never designed to give you. You've been told your numbers look fine. But if you have a family history of heart disease, that answer might not mean what you think it means. Noting a family history and actually measuring what it points to are two completely different things. Most cardiology appointments do the first. Almost none do the second. In this episode, I'm going to break down what your family history is actually pointing at, why the standard workup falls short for women, how menopause changes your cardiac risk picture, and exactly which three tests to ask for before your next appointment. ⏱️ TIMESTAMPS  0:00 What Women With A Family History of Heart Disease Are Never Told at Their Cardiology Appointment  2:29 What I found when I tested myself (a cardiologist with elevated Lp(a))  4:23 Why cardiac benchmarks weren't built for women  5:47 How menopause accelerates cardiovascular risk  7:47 The 2024 study: what happens when LDL, Lp(a), and hsCRP are all elevated  9:47 Three tests and one question to bring to your next appointment ❓ QUESTIONS ANSWERED Q: What is lipoprotein(a) and why does it matter if you have a family history of heart disease?  A: Lp(a) is a genetically inherited particle that drives plaque formation in the arteries, independent of diet or exercise. It requires a separate blood test not included on a standard lipid panel, and a family history of early heart disease is one of the strongest signals that it may be elevated in you. Q: How does menopause affect heart disease risk in women with a family history?  A: Estrogen protects the arteries by reducing inflammation and slowing plaque formation. When it drops at menopause, that protection lifts, and for women with elevated Lp(a) or other genetic risk running in the background, risk that looked manageable at 45 can look meaningfully different at 55. Q: What three blood tests should women with a family history of heart disease ask for?  A: Ask for Lp(a), ApoB (not just LDL), and high-sensitivity CRP. Research shows that when all three are elevated together, lifetime cardiovascular risk is 163% higher, yet none of the three are included on a standard lipid panel. 📱 RESOURCES  Website: www.drmonashah.com  IG: https://www.instagram.com/drmonashahmd/  Blog: https://drmonashah.wordpress.com/ Youtube: https://www.youtube.com/@DrMonaShahMD 🔔 Subscribe for weekly content on what preventive cardiology actually looks like, including the tests, labs, and conversations most cardiologists never start. ABOUT DR. MONA SHAH:  Dr. Mona Shah is a triple board-certified cardiologist in cardiology, holistic medicine, and coronary CT. After 20 years inside conventional cardiology, she left to build a practice that does what the standard system rarely does: look inside the artery wall before something goes wrong. She uses advanced imaging, including coronary CTA with AI analysis, to give patients a real picture of their cardiac risk. She specializes in patients with a family history of heart disease, elevated ApoB or Lp(a), and anyone who has been told they're fine but still isn't sure. #HeartDisease #PreventiveCardiology #CoronaryCTA #HeartAttackPrevention #HolisticCardiologist

Reactive Cardiologist vs. Preventive Cardiologist: Most People See the Wrong One

You left cardiology with a clean stress test and a pat on the back. Something in you still didn't believe it. That feeling was right. You were asking a preventive question and getting a reactive answer. Most people have no idea that mismatch is even happening to them. In this episode, I'm going to walk you through what each type of cardiologist actually does, where each approach breaks down, and how to know which one you need right now. ⏱️ TIMESTAMPS  0:00 Reactive Cardiologist vs. Preventive Cardiologist: Most People See the Wrong One 2:12 Why 50% of people have a first heart attack with no prior warning at all  3:32 What a preventive cardiologist looks for before any symptoms appear  4:47 The real limit of preventive cardiology and who it works for  5:57 The variable that decides which approach you need: timing  6:32 How to know if you are still in the preventive window right now  10:19 How to find a preventive cardiologist and what to say at the first visit ❓ QUESTIONS ANSWERED Q: What is the difference between a reactive and a preventive cardiologist?  A: A reactive cardiologist responds to symptoms and acute events using tools like stress tests, stents, and bypasses. A preventive cardiologist looks for problems before symptoms develop, using advanced imaging and lipid markers like ApoB and Lp(a) to find and address risk while there is still time to change it. Q: Can you have a heart attack even after a normal stress test?  A: Yes. A normal stress test only confirms that a severe blockage is not present at that moment. It cannot detect soft plaque quietly building inside your arteries, and 50% of first-time heart attacks arrive with no prior warning at all. Q: How do I find a preventive cardiologist?  A: Look for a practice focused on early detection, coronary CT angiography with AI plaque imaging, and advanced lipid testing including ApoB and Lp(a). If the practice only runs standard annual panels and stress tests, that is a reactive practice, not a preventive one. Keep looking. 📱 RESOURCES  Website: www.drmonashah.com  IG: https://www.instagram.com/drmonashahmd/  Blog: https://drmonashah.wordpress.com/ Youtube: https://www.youtube.com/@DrMonaShahMD 🔔 Subscribe for weekly content on what preventive cardiology actually looks like, including the tests, labs, and conversations most cardiologists never start. ABOUT DR. MONA SHAH:  Dr. Mona Shah is a triple board-certified cardiologist in cardiology, holistic medicine, and coronary CT. After 20 years inside conventional cardiology, she left to build a practice that does what the standard system rarely does: look inside the artery wall before something goes wrong. She uses advanced imaging, including coronary CTA with AI analysis, to give patients a real picture of their cardiac risk. She specializes in patients with a family history of heart disease, elevated ApoB or Lp(a), and anyone who has been told they're fine but still isn't sure. #HeartDisease #PreventiveCardiology #CoronaryCTA #HeartAttackPrevention #HolisticCardiologist

The Two Cholesterol Numbers Your Doctor Isn't Checking

Your doctor ran your standard lipid panel and told you your cholesterol is fine. Somewhere online, someone told you cholesterol doesn't cause heart disease anyway. Both of them are pointing at the same wrong number, and because of it, most people have never had the two tests that would actually tell them their real cardiovascular risk. These tests are not experimental. They are available at most labs. And most doctors are still not ordering them. In this episode, I'm going to show you why LDL misleads cardiovascular risk, what ApoB and Lp(a) actually measure, and the exact words to say at your next appointment to get these tests added to your workup. ⏱️ TIMESTAMPS  0:00 The Two Cholesterol Numbers Your Doctor Isn't Checking 1:19 How LDL became the default and where the model breaks down  2:12 How plaque forms: particles enter the artery wall, not cholesterol  2:54 The 1972 formula problem: why your LDL can make you feel safer than you are  3:27 Why the "cholesterol doesn't matter" influencer argument is dangerous  5:00 The two numbers that actually measure your cardiovascular risk  6:08 ApoB: a direct count of every particle capable of entering your artery wall  6:55 Lipoprotein(a): the genetic risk factor that does not change with diet or exercise  8:41 Exactly what to say at your next appointment to get these tests ordered ❓ QUESTIONS ANSWERED Q: Can you have normal LDL and still be at high risk for a heart attack?  A: Yes. ApoB measures the actual number of atherogenic particles hitting your artery wall. Two people can have identical LDL with completely different ApoB levels. One is low risk. The other is actively building plaque right now. LDL cannot tell you which one you are. Q: What is Lipoprotein(a) and should I check it?  A: Lp(a) is a genetically determined risk factor for plaque formation that does not respond to diet, exercise, or most medications. If it is elevated and nobody has told you, you are managing a cardiac risk you do not know you have. It only needs to be checked once in your life, but you do need to check it. 📱 RESOURCES  Website: www.drmonashah.com  IG: https://www.instagram.com/drmonashahmd/  Blog: https://drmonashah.wordpress.com/ Youtube: https://www.youtube.com/channel/UC2h_A-ydXfBqP1j_IWdOBlw/ 🔔 Subscribe for weekly content on what preventive cardiology actually looks like, including the tests, labs, and conversations most cardiologists never start. ABOUT DR. MONA SHAH:  Dr. Mona Shah is a triple board-certified cardiologist in cardiology, holistic medicine, and coronary CT. After 20 years inside conventional cardiology, she left to build a practice that does what the standard system rarely does: look inside the artery wall before something goes wrong. She uses advanced imaging, including coronary CTA with AI analysis, to give patients a real picture of their cardiac risk. She specializes in patients with a family history of heart disease, elevated ApoB or Lp(a), and anyone who has been told they're fine but still isn't sure. #HeartDisease #PreventiveCardiology #CoronaryCTA #HeartAttackPrevention #HolisticCardiologist

After 20 Years in Cardiology, I Stopped Trusting Stress Tests

Your stress test came back normal. Your doctor said you're fine. Fifty percent of people who have their first heart attack had no idea they had heart disease, and many of them passed a stress test in the months before.  A stress test only tells you whether your most severe blockages are already restricting blood flow. It cannot find the softer, smaller deposits that are far more likely to rupture. A normal result is not a clean bill of health for your arteries. In this episode, I'm going to show you what a stress test can and cannot find, why I stopped ordering them the same way after 20 years, and exactly what questions are worth asking at your next cardiac appointment. ⏱️ TIMESTAMPS 0:00 - Why Stress Tests Miss the Most Dangerous Cardiac Risk 1:05 - What a Stress Test Actually Measures (And What It Doesn't) 2:00 - Why Even a Low Calcium Score Can Leave You at Risk 4:01 - Soft Plaque: The Silent Threat No Standard Test Can Find 4:47 - The Pattern I Couldn't Ignore After 20 Years in Cardiology 5:39 - What Every Patient Who Slipped Through Had in Common 6:44 - What I Now Believe About Heart Attack Risk 7:44 - Patient Story: No Symptoms. Normal Test. Significant Plaque. 9:00 - Three Questions to Ask Your Doctor Right Now 9:52 - Your Action Steps Before Your Next Appointment ❓ QUESTIONS ANSWERED Q: Can you have heart disease if your stress test came back normal? A: Yes. A stress test only detects blockages that are 60 to 70 percent or greater. The deposits most likely to rupture and cause a heart attack are smaller and softer, and don't restrict blood flow enough to trigger a result. A normal stress test means no severe blockage was detected, not that your arteries are clear. Q: What is soft plaque and why is it more dangerous than calcified plaque? A: Soft plaque sits inside the artery wall, produces no symptoms, and won't appear on a stress test or basic calcium score. When it ruptures, it triggers a sudden clot. Most heart attacks are caused by soft plaque in people who had no prior warning signs and looked fine on standard tests. Q: What test can actually detect soft plaque in the arteries? A: A coronary CTA with AI imaging looks directly inside the artery wall and identifies both soft and hard plaque before symptoms develop. It provides a far more complete picture of your real cardiac risk than a treadmill test or a standard lipid panel. 📱 RESOURCES Youtube: https://www.youtube.com/@DrMonaShahMD Website: www.drmonashah.com IG: https://www.instagram.com/drmonashahmd/ Blog: https://drmonashah.wordpress.com/ 🔔 Subscribe to this podcast for weekly content on what preventive cardiology actually looks like, including the tests, labs, and conversations most cardiologists never start. ABOUT DR. MONA SHAH: Dr. Mona Shah is a triple board-certified cardiologist in cardiology, holistic medicine, and coronary CT. After 20 years inside conventional cardiology, she left to build a practice that does what the standard system rarely does: look inside the artery wall before something goes wrong. She uses advanced imaging, including coronary CTA with AI analysis, to give patients a real picture of their cardiac risk. She specializes in patients with a family history of heart disease, elevated ApoB or Lp(a), and anyone who has been told they're fine but still isn't sure. #HeartDisease #StressTest #PreventiveCardiology #CoronaryCTA #HeartAttackPrevention

What Health-Conscious People Get Wrong About Protecting Their Heart.

You work out. You watch what you eat. Your last physical came back clean. And somewhere along the way, you stopped worrying about your heart. But a healthy lifestyle and healthy arteries are not the same thing.  For a specific group of patients doing everything right, plaque builds quietly inside the artery wall while every standard test says there is nothing to see. This episode is for those people. In this episode, I'm going to show you why living healthy doesn't guarantee clean arteries, what your standard labs are actually measuring versus what they miss, and two specific tests to request before your next appointment. ⏱️ TIMESTAMPS 0:00 - The Patients Who Scare Me Most (And Why) 1:17 - What a Healthy Lifestyle Actually Protects (And What It Misses) 2:53 - Soft Plaque: The Threat Building in People Who Feel Fine 3:57 - Why Your Labs Were Never Designed to Detect This 5:04 - How to Know If You're One of These Patients 5:56 - My Personal Story: I Found Plaque in My Own Arteries 6:21 - The One Scan That Looks Directly Inside the Artery Wall 7:34 - Two Tests to Request Before Your Next Appointment ❓ QUESTIONS ANSWERED Q: Can you have plaque building in your arteries even if you eat well and exercise? a: Yes. A healthy lifestyle reduces the rate of plaque accumulation but doesn't stop it entirely, especially in people with genetic risk factors like elevated Lp(a). Plaque can form quietly in the artery wall while every standard lab marker looks normal and every external measure of health looks fine. Q: What is Lp(a) and why does it matter for heart disease risk? A: Lp(a) is a genetic marker that drives plaque formation regardless of diet or exercise habits. Most standard lipid panels don't include it. Elevated Lp(a) is one of the strongest independent predictors of cardiovascular risk, and the majority of people who have it have never been tested. Q: What is a coronary CTA and how does it differ from a stress test? A: A coronary CTA with AI imaging scans directly inside the coronary artery wall and can identify both soft and hard plaque before symptoms appear. A stress test only detects whether blood flow is already restricted by a severe blockage. These are different questions with very different answers about your actual risk. 📱 RESOURCES Youtube: https://www.youtube.com/@DrMonaShahMD Website: www.drmonashah.com IG: https://www.instagram.com/drmonashahmd/ Blog: https://drmonashah.wordpress.com/ 🔔 Subscribe to this podcast for weekly content on what preventive cardiology actually looks like, including the tests, labs, and conversations most cardiologists never start. ABOUT DR. MONA SHAH: Dr. Mona Shah is a triple board-certified cardiologist in cardiology, holistic medicine, and coronary CT. After 20 years inside conventional cardiology, she left to build a practice that does what the standard system rarely does: look inside the artery wall before something goes wrong. She uses advanced imaging, including coronary CTA with AI analysis, to give patients a real picture of their cardiac risk. She specializes in patients with a family history of heart disease, elevated ApoB or Lp(a), and anyone who has been told they're fine but still isn't sure. #HeartDisease #PreventiveCardiology #CoronaryCTA #HeartAttackPrevention #HolisticCardiologist