[I am not medical doctor. I have no medical training. However, I have 7 cardiac stents so my interest in Coronary Heart Disease is not purely academic.]

Once upon a time there was homocysteine, a sulfur-based amino acid. According to WebMD, "You get it mostly from eating meat. High levels of it are linked to early development of heart disease." The question, then, was to determine whether homosysteine was a like a car's accelerator or its speedometer, that is, was lowering homocysteine like taking one's foot of the brake, or was it like trying to stop a car by grabbing onto the speedometer? Again, from WebMD, "Research has shown, however, that getting your homocysteine levels down with vitamins doesn’t reduce your chance of having heart disease." Oh, well,...

Then, there was C-reactive protein, a measure of inflammation. It was thought to be a mediator of Coronary Heart Disease and the next big thing in assessing cardiac risk. And then...nothing. It felt like CRP went from being assessed on almost everyone thought to be at risk to almost no one. Maybe it's because so many things other than heart disease can lead to high levels.

Now, we have calcium score. The higher the calcium score, the greater the risk of a serious coronary event. But what is one to make of a high calcium score? I know someone with a score of 300 who was told not to do any exercise until he was given a stress test, which he passed. (And, yes, there are may tales of those who have suffered serious events after having passed a recent stress test.) Is a calcium score a real advance or is it merely the latest in a string of false leads?

The calcium score itself is not controversial. The question is what to do with it other than a stress test or a statin if the score is high. And might it turn out to be another homosysteine or CRP?

The value of Dr, Bishop's book is its suggestion of a next step after a high calcium score--a scan with contrast to determine the location of the deposits are that are behind the high score. He provides evidence to support his recommendation. I found it compelling enough to start a conversation with my cardiologist if I had a high score, myself. (This is not an option for anyone with stents because the stents would interfere with the scans.)

Those concerned with their risk of having a coronary event, perhaps due to family history, should read this book to prepare for an intelligent conversation with their own cardiologists.

Other comments:

Others have commented on the book's use of mmol/l instead of the mg/dl used in the US. It can be confusing. However,

(Bishop) mmol/l *38.7 = mg/dl (US)

Ratios are unaffected by the choice of units.

Try to avoid the audio version alone. I like audio books, but the information and message do not lend themselves well to an audiobook.

[Disclaimer: I was given a copy of the book in exchange for my honest review. Review copies of books are permitted by Amazon. I have no problem with my review. However, I've spent too much time agonizing over how many stars to award.

5 stars: I have seen first person someone with a high calcium score who was not offered the followup suggested by Dr. Bishop. The book is well worth the price if it prevents or postpones a serious coronary event, especially if it's yours. The information is presented in a way that anyone reading the book could have an intelligent conversation with his/her cardiologist about calcium scores and what should be done with them.

4 stars: A bit pricey, although much less expensive than having an MI. The choice of mm/l with no instructions for conversion to mg/dl was a huge distraction. A fear that I might be influenced to go higher (5 instead of 4) for having received a free copy. Note: fear of unconscious bias applies to the number of stars, not to the review itself.

When I started writing this disclaimer, I knew I'd award 4 stars because "If you have to think about it..." However, after reading what I've written about my quandry...]

This book is a must for anyone who has a history of cardio problems in their family or are experiencing problems of their own. In fact, if you aren't sure, you need to read this book anyway. I learned more about my heart, various tests and results than I would ever have imagined in this short and concise book. I am not a doctor and all the details and test results seem to blur for me. In this book Dr. Warrick provides cases and outlines test results compared to what would be ideal. I can now use this book as a guide when I review my results. More importantly though is that Dr. Warrick lays out a path to using CT scans to proactively prevent heart attacks rather than just treating the disease after you have one. Ironically, after I started reading this book, I developed a (non-heart) medical issue based on traditional medical test results in which a CT scan was used to further determine whether there was an actual issue. If works for one part of the body, why not for cardio as well? This is a great read presented in a very easy to understand format. I am grateful for having had the opportunity to read this book. It is a great reference book to have on hand.

The book is clear, concise, and lays out a plan to be proactive in preventing a heart attack. It was quite easy to follow and understand. This comprehensive book will not only serve as a wake-up call for many but also save lives. I now have an interest in a CCTI where I didn't before.

The book explains the functions of the heart and how plaque is formed in the arteries and then how to detect and treat it. His primary focus, of course, is on prevention of heart disease and how you can accomplish that.

I feel much more comfortable talking to my doctor about this subject. I am much more prepared to hold an honest and informative discussion.

I also think that he didn't write to his potential reader base. Americans will not comprehend most of the notations for the lipid panel values. Might have noted American notations as well. He lost me there throughout.

Disclaimer: I was offered this book in exchange for my honest opinion of it.

It is a really remarkable achievement to prevent a heart attack long before you even get the symptoms of the heart attack. In this book we have indicators that you can use to do just that! It is a very difficult thing to not have any pain or problem of which you know, but that you may have a problem a few years down the road. This book begins to explain how you may do just that. It is a primer but the explanations are concise and with a bit of humor as well. Get the book...it will give you some things to think about.

I think this book is good for anyone with a question about whether they have a true risk of heart attack or to understand the functionality of the heart and arteries. However, to be clear, it doesn't actually teach you what your real risk is. It tells you how you can find out your real risk. It explains what the heart does, explains that risk factors such as cholesterol, blood pressure, weight/BMI, etc are not always indicative of the real risk, etc. It's a good book to learn about the true risk, and how each person is an individual. According to the book, the only way to know the true risk is to have the CT scan to evaluate the arteries. That's how you know your real risk. It makes sense.

Most doctors base risk on family history, lifestyles, and "numbers" (such as blood pressure, cholesterol, weight/BMI, etc). I have a strong family history. I have good "numbers" and a good lifestyle...so according to the doctors, I'm okay. My risk should be low. But, to assess my true risk, according to this book, I would have a CT scan to evaluate what's really going on in my arteries. I believe that would be a true indicator and could give me reassurance, or it could cause me to take steps to prevent the heart attack. Unfortunately, that CT is not covered and it's expensive here in the US---and you need a doctor who will agree to order the test and then you need to be able to pay out of pocket for it.

Overall, good information, and this could potentially have the ability to save someone from a heart attack.
Unfortunately, it's not a viable option for everyone to have that test to know their true risk.

GOOD

Last October I was in Calvary hospital, Hobart, for revision of an artificial hip. My cardiovascular system decided to play a few games with the result that I was referred to Cardiology. After a battery of tests I was informed by Mr Warrick Bishop that I was suffering from Atrial Fibrillation. This charming gentleman briefly explained what that is and prescribed a treatment regime which I am still following. He did mention that he had written a book on the subject!
Recently, after a completing a messy move to Burnie, I purchased a copy of Warrick's book and once I started reading it I couldn't put it down! It is a masterpiece of form and function approaching the topic from different perspectives and absolutely demystifying a complex subject - this is from someone who gave up biology in 2nd year of high school! Interestingly I find answers to medical situations that had arisen with my parents and with other people of a similar vintage. I cannot recommend this book highly enough. It is also available as a Kindle eBook which is great for having to hand and preserving my copy of the excellent hardback version.

This book successfully explains a complex subject in language that a normal intelligent person can understand. As a person with the condition, it has helped me understand the causes, and what contribution I myself can make to minimise the effects. It also assisted me to fully comprehend the cocktail of pharmacies proposed and implemented by my specialist doctor. The writer clarifies how each piece of the jigsaw works in combination to enable me to continue enjoying a satisfactory lifestyle, while minimising the chance of dangerous medical emergencies caused by the AF condition.

Good information and easy to understand. I have AF along with cardiomyopathy so I do see a cardiologist every six months. I do everything that i can to manage my health. This book ads valuable knowledge to my management.

An easily read guide for someone who, like me, has AF. Thanks! I have a biological science background and so much of the terminology was easily understandable . I recommend this book if you want to find out about AF.