State of the Heart

Exploring the History, Science, and Future of Cardiac Disease

By: Haider Warraich

Narrated by: Neil Shah

Length: 11 hrs and 8 mins

Publisher's summary

In State of the Heart, Dr. Haider Warraich takes readers inside the ER, inside patients' rooms, and inside the history and science of cardiac disease.

State of the Heart traces the entire arc of the heart, from the very first time it was depicted on stone tablets, to a future in which it may very well become redundant. While heart disease has been around for a while, the type of heart disease people have, why they have it, and how it’s treated is changing. Yet, the golden age of heart science is only just beginning. And with treatments of heart disease altering the very definitions of human life and death, there is no better time to look at the present and future of heart disease, the doctors and nurses who treat it, the patients and caregivers who live with it, and the stories they hold close to their chests.

More people die of heart disease than any other disease in the world and when any form of heart disease progresses, it can result in the development of heart failure. Heart failure affects millions and can affect anyone at anytime, a child recovering from a viral infection, a woman who has just given birth or a cancer patient receiving chemotherapy. Yet new technology to treat heart failure is fundamentally changing just what it means to be human. Mechanical pumps can be surgically sown into patients’ hearts and when patients with these pumps get really sick, sometimes they don’t need a doctor or a surgeon - they need a mechanic.

In State of the Heart, the journey to rid the world of heart disease is shown to be reflective of the journey of medical science at large. We are learning not only that women have as much heart disease as men, but that the type of heart disease women experience is diametrically different from that in men. We are learning that heart disease and cancer may have more in common than we could have imagined. And we are learning how human evolution itself may have led to the epidemic of heart disease. In understanding how our knowledge of the heart evolved, State of the Heart traces the twisting and turning road that science has taken - filled with potholes and blind turns - all the way back to its very origin.

©2019 Haider Warraich (P)2019 Brilliance Publishing, Inc., all rights reserved.

An absolutely wonderful book

if you are a cardiac patient, this book will enhance your relationship with your cardiologist and help you to understand your condition. An absolutely wonderful book.

Incredible reading experience

Incredibly well researched, arranged and written. Dr. Warraich has a true mastery of this topic and talent for distilling & communicating his clinical experiences.

Good information, bad organization

Reading this book I was constantly struck by 'I wonder what that is' and 'aha' moments. It also really deepened my picture on how the heart works and what modern medicine is trying to do with the heart.

That being said the information is presented in a seemingly random order. Threads are started full steam, the author has a long discussion about why HDL levels might or might matter, then abandoned. He never summarizes things at all. There is several hours of discussing back and forth over which treatments work in clinical trials and which don't and he never summarizes with: 'these are the drugs/treatments with good evidence. these are the ones with bad'. There is no coherent overarching picture of the heart presented that all the findings and later discussion tie into, just a brief anatomy lesson at the beginning.

Further the author seems more interested in peppering the book with random jabs and asides than actual advice. He says stress doesn't cause heart disease, except when it does, but again he never pauses and discusses stress as a physiological feature he just rants about how everyone else gets stress wrong. Similarly, he says 'diet and exercise good for LDL and blood pressure' but never touches on the myriad number of diet and exercise programs running around and which have better or worse outcomes.

The anecdotes were good but presented in a seemingly random way throughout the book with patient's cases often started then abandoned for the author to wander off and complain about some other thing bugging him.

The whole premise of the book: 'heart disease is getting worse' is kind of sketchy. Like yea there are more people with heart disease but 'something' is going to kill us and since it's increasingly less cancer and bacteria it would only follow that heart disease would get more prevalent. Age controlled population studies would help this claim instead of just 'people are unhealthy etc etc' but I guess he didn't need that study in a book where he talks about how studies trump vague claims. (I'm not suggesting he's wrong I'm just saying it would be nicer to see the evidence he's right and more specifically which lifestyle factors are contributing most to heart disease, is it obesity? smoking? animal products? lack of exercise?) He also spends a lot of the book talking about how people are at fault for their own heart disease then transitions to how that isn't a very useful mindset in the last two chapters. Again the whole thing is just not very well put together.

If anything this is a good book for understanding what your doctor is coming from: they are distracted, filled with tons of semi-contradictory studies with lots of patients dying on them and lots of new treatments coming online with unclear side effects and a strong belief that a lot of what they are seeing is placebo, and with the view that most of their patients won't listen to them and are at fault for their problems while still trying to emphasize. The anecdotes in the book are the most useful as they show you how patients successfully managed their doctors and what your actual options for heart disease are.

If you have heart disease and want to know more or if you just want some cool facts about the heart and state of heart research this is great, but if you want a coherent picture of how the heart works and how it breaks down and how you can change your lifestyle to mitigate and fix that, this isn't your book.