Prevention vs. Intervention


Board certification for the subspecialty of interventional cardiology was introduced in 1999. Physicians who have completed their three-year cardiology fellowship must take additional training in cardiac interventions such as stent placement, angioplasty, pacemaker placement, etc.

Although he is skilled in these techniques, Dr. Shammo says he prefers not to have to use them at all.

“I think that what distinguishes my practice is our great emphasis on prevention,” he explains. “Even though I am busy interventionalist, in my mind the best practice will always be prevention, rather than intervention.” On that note, Dr. Shammo aggressively battles heart disease risk factors such as high cholesterol and high blood pressure with his patients and has been proactive in initiating cardiac rehabilitation programs that stress the importance of exercise and weight loss with the aim of giving patients not only longer, but better lives. And the message is timely. As baby boomers age, Shammo suggests that continued treatment of the symptoms of heart disease alone will not be practical, cost effective or even medically prudent.

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Successful prevention hinges on another important factor. “We also pride ourselves on early detection,” emphasizes Shammo. “We believe that early detection of heart disease, just like early detection of cancer, is paramount to changing the prognosis and outcome for many of our patients. We work very hard in that regard.”

The evolution of cardiology as a specialty, as well as the emerging technologies that support it, is helping to make Shammo’s mission easier. New imaging capabilities, including high-end CT angiography, MRI and intravascular ultrasound, enable cardiologist to evaluate both the anatomy and the function of the heart like never before.

“Thanks to these kinds of technologies, we can now diagnose heart disease before any damage is done. In our office, we perform echocardiograms  as well as nuclear stress testing procedures which help us to clearly understand the anatomy and physiology of the heart.”

Dr. Shammo predicts noninvasive diagnostic procedures will eventually replace invasive testing as the modality of choice for the diagnosis of heart disease, allowing for early, intense preventive efforts. As researchers map the human genome, identify new risk factors for heart disease such as inflammation and devise methods for repairing damaged tissue with stem cells, Dr. Shammo is hopeful that reversal may one day be a real possibility.

“Early evidence suggests that intensive therapy, in some patients, there is hope that the process can be slowed, halted or even slightly reversed. Complete reversal is still not here, but it may come.”