Questioning the Role of Arterial Plaque in Heart Attacks
Regardless of the exact number, conventional wisdom states that the coronary arteries, i.e., major blood vessels, supply all of the blood flow to the heart. If one or more of them gets blocked with plaque, a bottleneck forms that prevents blood from getting through.
The area downstream from that blockage doesn’t get any blood, and hence no oxygen or nutrients. The first indication that this is occurring is pain, which we call angina. As the problem progresses, the pain worsens, which is called unstable angina. Eventually, if left untreated, you end up with a heart attack.
The field of cardiology is primarily focused on getting rid of the plaque, whether by using stents, doing bypasses, angioplasties, lowering cholesterol (since the plaque is supposedly caused by excess cholesterol), or putting the patient on a low-fat diet.
“[Conventionally], it’s all about the plaque,” Cowan says. “My point in the book is that it’s NOT about the plaque.”
The Problem With Viewing the Heart as a Pump
Cardiologists and doctors in general are taught that the walls of the heart create pressure, which causes propulsion of the blood through the body. In essence, the heart is viewed as a pump — a pressure propulsion system caused by the muscular contraction of the ventricles.
However, your body actually contains an enormous amount of blood vessels. Most of the blood vessels in your heart and body are capillaries, which are very thin-walled, very narrow tubes.
If you were to spread these blood vessels out, they would cover three football fields. If you were to place the blood vessels end to end, in a series, they would encircle the Earth between one and three times.
“The pump theory is you have a 1-pound, somewhat thin-walled organ, and it’s going to pump [blood] around the Earth every single day for 70 years; 60 to 70 times a minute. That 1-pound, thin-walled organ can [supposedly] generate enough pressure [to do that] by squeezing …
Frankly, that’s ridiculous. But it actually gets worse than that. If you do a flow velocity diagram, it turns out that the blood is moving the fastest at the heart, both before and after the heart.
As it goes into the arterioles and then the smaller arteries, it gets to the capillaries … [where] it actually stops and does a little shimmy, or it goes very slow, depending on who you believe … The analogy is, a narrow river goes fast and when it goes out into a wetland, it goes very slow.
It has to go slow — it has to stop almost — to exchange the gasses and the food. So not only are we pushing all the way around the Earth, but halfway around our travel, we stop and then we get going again. You’re expecting that to be all from the push from behind …
It even gets worse than that because we have an outflow tube of the left ventricle called the aortic arch … which is shaped like McDonald’s arch. The blood goes from the left ventricle, out the aortic valve, through the arch, then down to the body.
The analogy here is if you stick a similarly shaped arched garden hose off your spigot outside your house, and then turn it on really hard, which recreates the pumping … you would expect the garden hose to straighten out because if you put pressure, the arch would straighten.
In fact, you can look on any angiogram and catheterization and you can see that arch actually bends in a little bit during systole, which from a pressure propulsion model makes absolutely no sense at all.”