Fast Chat: Changing Your Heart

Dr. Arthur Agatston's first book, "The South Beach Diet," was a best seller that turned into a national phenomenon. Now the cardiologist is back with "The South Beach Heart Program," which aims to reduce heart attacks and strokes. He spoke with Julie Scelfo.

It turns out that view is completely wrong. Instead, plaque develops like a little pimple in the vessel wall, but instead of filling with pus, it fills with cholesterol. Blood flow remains normal until the plaque "pimple" ruptures. The healing process includes a blood clot, and if the clot is big enough, that's what blocks the artery.

The cosmetic-surgery approach to coronary arteries--making them look nice with balloons and stents--doesn't really work. That's going after the wrong plaque, the kind that has already ruptured and is no longer a threat. Instead, it's the soft plaque pimples that are little ticking time bombs, because they blow up and cause a sudden blockage. We're spending billions of dollars going after the wrong plaque.

A better diagnosis of who's harboring these little ticking time bombs, and then treating aggressively with diet and exercise changes and medication. Noninvasive imaging like heart scans will generally show plaque years before you have a heart attack or stroke.