LONGEVITY with Nathalie Niddam #405: Heart Attacks Aren't What You Think | The Plaque LIE That Changes Everything (Cardiology 2.0) With Dr. Sanjay Bhojraj
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Jan 20, 2026 Dr. Sanjay Bhojraj, a cardiologist who pivoted from emergency care to a focus on prevention, shares groundbreaking insights on heart health. He dispels the myth that most heart attacks stem from significant blockages, emphasizing the danger of soft plaques. He explains the importance of imaging techniques like the CLEERLY scan for detecting high-risk conditions. Additionally, he highlights how lifestyle choices, early screening, and understanding women's unique heart risks could drastically change cardiovascular care.
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From Cath Lab To Prevention
- Sanjay Bhojraj left interventional cardiology after burnout and repeated emergency heart attack cases.
- He now runs a diet and lifestyle program focused on prevention and getting people off medications.
Heart Attacks Often From Small, Vulnerable Plaques
- Most heart attacks come from 20–50% non-flow-limiting plaques with thin caps that rupture.
- Stress and hemodynamic forces can unroof these softer plaques and trigger acute events.
Choose CT Angio When It Will Change Care
- Use advanced coronary CT (CLEERLY) to quantify soft plaque, not just calcium score.
- Reserve CT angiography for cases where anatomy will change management because of radiation and contrast risks.
