Age Gracefully

Welcome to Age Gracefully – where aging is something to celebrate!
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Age Gracefully

How to Prevent a Heart Attack

March 12, 2026 • Mark and Veronica • Season 1 • Episode 3

0:00 | 9:08

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A heart attack often doesn’t start with a dramatic warning sign. It starts quietly, with plaque building in the coronary arteries, until one day a vulnerable plaque ruptures, a clot forms, and blood flow stops. That’s why we focus on a question that matters to anyone who wants true heart attack prevention: how do you detect dangerous coronary artery disease before symptoms show up?

We dig into the risk factors everyone knows like high cholesterol, high blood pressure, smoking, diabetes, and family history and also the bigger reality that there are many more drivers of atherosclerosis than most people ever hear about. Then we explain what actually causes a heart attack at the artery level, and why common tools like the cardiac stress test can miss earlier disease. We also talk candidly about the limitations of stress testing for women, where false positives can turn the results into more confusion than clarity.

From there, we shift to the future of preventive cardiology: coronary CT angiogram screening paired with artificial intelligence plaque analysis. We explain how AI tools such as Clearly can differentiate stable versus unstable soft plaque, quantify total plaque burden across the coronary arteries, and report stenosis with much higher precision. We also name other platforms in this space such as HeartFlow, Elucid, and Caristo and discuss how measuring perivascular inflammation may add another layer to cardiovascular risk assessment. Finally, we share why we pair imaging with an advanced lipid panel and inflammatory biomarkers like ApoB, lipoprotein(a), and hs-CRP, plus a quick look at the Luna trial that uses AI imaging to track plaque changes over time.

If you want a clearer, more personalized view of your heart health, hit play, then subscribe, share this with someone you love, and leave a review with your biggest heart screening question.

Longevity Personalized offers Coronary CT with AI plaque analysis. Be sure your scan is interpreted by a board certified cardiologist with training in Cardiac CT scanning. Visit longevitypersonalized.com to learn more and to schedule your scan.

Age Gracefully exists to provide you with cutting edge science related to healthy aging in a relaxed, easy going, educational, conversational format.

This information is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional before making any changes to your health regimen or starting any new treatment. Do not disregard or delay seeking medical advice based on something you hear in this podcast. Your health is personal, and the information provided here may not be suitable for everyone. You have the power to shape your health and well-being.

SPEAKER_00 0:52

Welcome to Longevity Personalized. I'm Veronica Gordon. I'm a life coach, and I'm here with Dr. Mark Gordon, a board-certified cardiologist. Welcome, Dr. Gordon.

SPEAKER_01 1:01

Thanks, Veronica. It's a pleasure to be here.

SPEAKER_00 1:03

And today we're here to talk about how to prevent a heart attack.

SPEAKER_01 1:07

So we're excited to share with you guys some information about some new technology that can actually help you prevent a heart attack.

SPEAKER_00 1:14

So who's at risk?

SPEAKER_01 1:16

Well, the typical risk factors that everybody talks about are high cholesterol, high blood pressure, smoking, diabetes, and family history of heart disease. But there's an additional 25 or so further risk factors that people really don't talk about.

SPEAKER_00 1:31

So what causes a heart attack?

SPEAKER_01 1:34

When a person's having a heart attack, a plaque in one of their coronary arteries ruptures. And the body tries to heal that by forming a blood clot. As the blood clot grows,

Welcome And The Big Promise

SPEAKER_01 1:44

it eventually plugs up the entire artery so that the blood flow downstream stops. The heart muscle then past the blockage dies.

SPEAKER_00 1:53

So what can we do to prevent a heart attack?

SPEAKER_01 1:56

Well, to look for signs of heart disease in the past, people have typically done stress tests. But stress tests are notoriously inaccurate. They have an accuracy

Heart Attack Risks And Causes

SPEAKER_01 2:06

of about 70 to 75%. But that's only to detect a blockage of at least 70%. So if you have any narrowing, any plaque in your arteries up to that point, a stress test won't detect it. And for women, it's even worse. You might as well flip a coin. A woman having a stress test has a 50-50 chance of having what we call a false positive, meaning the stress test is abnormal, but they do not have any significant coronary artery disease. So stress testing is really the past. And this new type of testing, which we're going to discuss, is the future of preventive cardiology.

SPEAKER_00 2:45

So what other tests are available?

Why Stress Tests Miss Disease

SPEAKER_01 2:48

Well, the coronary CT angiogram has been around for about 20 years now, and the technology has improved with better scanners and so forth. But recently there's been a new breakthrough. There's a new technology, it's artificial intelligence, that can actually analyze a coronary CT angiogram, and with a very, very high degree of precision and accuracy, it can tell you precisely what your risk is.

SPEAKER_00 3:12

So he's talking about Clearly, so tell us about Clearly.

SPEAKER_01 3:15

So Clearly is an artificial intelligence program we've been using here with our clients for about three years. And it looks at the CT angiogram data and it differentiates the plaque between the soft stable and the soft unstable plaque. So if you've got one of those plaques that's ready to rupture, like for a heart attack, we can detect that with this particular scan. And it also gives you the

CT Angiograms Meet AI Plaque Analysis

SPEAKER_01 3:40

total amount of plaque in all of your coronary arteries, so it's something that you can follow over time, get another scan a year or so later, see if you're laying down more plaque or if you're having a regression of plaque or what's going on. Additionally, it's been shown that the coronary CT angiogram with AI analysis can give you a precise percentage of stenosis or narrowing. As opposed to a coronary CT angiogram, that will give you a range, like for example, 50 to 75%, whereby the AI technology will tell you it's 67.5% narrowed. So a much higher degree of certainty with regard to the severity of narrowing, the total amount of plaque, whether the plaque is stable or unstable or calcified. It's just been such a great technology for us to be able to do all of those things and give our patients a very, very precise risk assessment. It's important to mention that there are other companies that have similar AI technologies for coronary CT angiograms. These include heart flow, alucid, and choristo. And one of the things that choristo does that the other ones don't is it measures perivascular inflammation surrounding the coronary arteries, which can be something that leads to further rapid progression of atherosclerosis.

SPEAKER_00 5:00

And what age would you recommend getting the clearly?

SPEAKER_01 5:03

I recommend everybody gets a clearly scan. It should be a screening test just like mammograms for breast cancer or colonoscopies for colon cancer. And if you've got significant risk factors, you should probably get one early in your 20s or 30s. But if not, then perhaps 40 would be a good age to consider having one done.

SPEAKER_00 5:21

Amazing. So if you're listening clearly, you should get your clearly. So how does how does

Other AI Options And Inflammation

SPEAKER_00 5:27

a person order their test?

SPEAKER_01 5:28

Well, below this video, there's a link to our website, and that takes you to our Clearly page where you can get more information. And you can additionally go ahead and order your scan there if you'd like to proceed. I'd like to emphasize that it's important to get lab tests done as well. And the one lab screening test that we recommend is an advanced lipid panel that looks at not only the standard lipid profile

When To Get A Scan

SPEAKER_01 5:52

of LDL, total cholesterol, HDL, and triglycerides, but looks at LDL particle number, particle size, APOB, lipoprotein A, inflammatory biomarkers such as HSCRP, LPPLA2, and myeloperoxidase. This combined with a coronary CT angiogram with AI plaque analysis is your best way to know your true cardiovascular risk for the future. I believe that everyone should have a CT

How To Order And What Labs

SPEAKER_01 6:20

angiogram with AI plaque analysis done at some age, depending upon your other risk factors and your family history. So go ahead, check it out, do your due diligence, but consider getting a coronary CT angiogram with AI plaque analysis. It could change your life, it could save your life. One other thing I'd like to mention before we close is that we're participating in a study called the Luna study to look at regression of atherosclerosis, and we're using coronary CT angiograms with AI technology for the plaque analysis to determine the amount of plaque at the beginning, in the middle, and at the end of the study, and to quantitate it very precisely. If you'd like to get additional information about this study, it's called the Luna trial, looking at lumbarkinase, natokinase, and tricaprin as agents to help potentially cause regression of atherosclerosis. To get more information, go to our podcast, Season 1, Episode 2, to get a more complete description of the study.

SPEAKER_00 7:23

Well, we appreciate you joining us until the next time.

People on this episode

Mark Gordon, Longevity Cardiologist

Co-host

Veronica Davis Gordon, Longevity Coach

Co-host