Dr. Mitchell’s Cardiac Journey

Why Preventative Cardiac Care Matters to Me – And Why It Should Matter to You

As a physician, I've spent most of my career focused on gut health. For 25+ years, I worked as a gastroenterologist specializing in SIBO, motility disorders, IBS, and other GI conditions. It was what I knew, it was what I loved, and I enjoyed helping my patients find relief. But in 2019, everything changed when I was introduced to functional medicine—and specifically, the role it plays in understanding the whole body, not just the gut.

I had never heard of functional medicine before, but one of my nurse practitioners, who was getting certified in it, convinced me to attend a week-long course at the Institute for Functional Medicine (IFM). I went into the course a bit skeptical, as this was very different from traditional gastroenterology training. The research and data they presented was fascinating, but I couldn’t believe it, and I spent the entire week fact-checking everything they said.

The Turning Point: Discovering Functional Medicine

Something happened during that week. I realized the only research literature I’d been reading was strictly related to gastroenterology. As I started looking deeper, I discovered that the evidence was there; I just hadn’t been exposed to it. For example, I couldn’t believe that as a gastroenterologist, I had never heard  of the gut microbiome or its role in health and disease.

That moment sparked a whole new journey for me. I started a partnership with Dr. Margaret Harris, a professor of nutrition at UCCS who was also trained in functional medicine, to dive into the world of the microbiome. We teamed up with grad students and registered dietitians, and we began practicing with a more holistic, team-based approach. My eyes were opened to a whole new world of medicine and a new way of looking at patients’ health.

But it wasn’t just the gut health piece that drew me in. As I dove deeper into functional medicine, I became aware of testing that is available for preventative care for heart disease. Heart disease is one of the leading causes of death worldwide, and it runs in my family. My mother had a heart attack at 62, so I knew how important it was to catch these things early—before they became life-threatening, but had never considered getting testing done for myself.

A Personal Wake-Up Call: My Heart Health Journey

I started by ordering a complete wellness blood panel including a detailed cardiac assessment. I discovered that my LDL was high, and my Lp(a) levels were really elevated. Lp(a), or lipoprotein(a), is a type of cholesterol in the blood that is genetically determined and has been linked to an increased risk of heart disease, as it can contribute to the buildup of plaque in the arteries. I was alarmed by my levels, and also fascinated as I felt like I finally had an answer that explained my family history of heart attacks at a young age. Most people wait until they have symptoms to do anything about their cardiac health but my journey was showing me that I wanted to start making changes NOW - before symptoms showed up or it was too late.

I then ordered a CT calcium score, to get more information on my risk and current condition. I had elevated calcification in my right coronary artery—the very same artery that caused my mother’s heart attack. This was another wake up call that my risk of a heart attack was likely much higher than I had imagined it would be for a healthy, active person. By this time I had also read Peter Attia’s book Outlive, and was trying to follow his recommendations for additional preventative testing. So I decided to go for even more testing and got a cardiac CTA (Computed Tomography Angiography), which is a non-invasive way of imaging your coronary arteries and can show any plaque or narrowing of the arteries. This is more detailed than the CT calcium tests, which only show calcification along the artery wall that correlates to narrowing of the arteries. My first CTA was clear, and didn’t show any narrowing, which was great news.

From there, I got my kids tested for Lp(a) as well, and found they all carry the same genetic marker. This could be scary as we now know we are all at increased risk for heart attacks. But the good news is that we have the tools, the knowledge, and the resources to make lifestyle and diet changes, take supplements, and do screenings now to prevent heart attacks later. It’s something I’m passionate about advocating for: start paying attention to your heart health, especially at a young age, because we know more now than ever before about how to prevent heart disease.

As part of my journey, I didn’t stop with just the basics. I then did an exercise stress test and a carotid ultrasound, which evaluates the heart’s structure, function and blood flow. The carotid ultrasound showed that I had an advanced vascular age of 90 years old. This was yet another wake up call, and prompted me to immediately implement strict dietary changes, exercise, supplements, and eventually even adding in a statin.

A year later I had another CTA scan, and this time found a surprising 85% occlusion in one of my arteries.  This is a very serious amount of blockage and I knew I needed to get some help. I tried to get an appointment with a cardiologist, but it was several months before I could get in to see anyone, which was really frustrating. Once I finally got in with a cardiologist, I was told that I needed to either take four medications for the rest of my life or have a heart catheterization.

I opted for the heart catheterization, and once they got in there it actually showed no narrowing after all, which was a huge relief. Apparently, the imaging from the CTA wasn’t as clear as we thought, due to the type of technology used. Luckily, now the technology is improving such as with the new Spotlight Duo Cardiac CTA by Arineta, which uses less radiation than previous machines and gets clearer images by imaging over a single heartbeat rather than multiple. If there is narrowing in the arteries, the scans can then be sent through an AI software called Cleerly AI that can actually determine what type of plaque is in the artery, which determines how high of risk it is, and can lead to better treatment. 

While I wish I had this technology my first time around, I’m grateful my journey led me to learn about this so I can recommend it to patients. I am also grateful for the peace of mind I gained from doing everything I could to check my heart health. Now I know my risk and can make changes to prevent a heart attack in the future - and do the same with my kids.

Preventing Heart Disease: It’s Never Too Early to Start

I share this story not to scare you, but to inspire action. Traditional medicine typically doesn’t order these tests, and they may not be covered by insurance, but for those who want it I believe they deserve to have the option to get data early and take preventative measures rather than waiting for symptoms to show up. Heart disease is preventable, and we can start making changes now to protect ourselves. We have access to so much more data today, and we can use that data to make meaningful changes in our lives before it’s too late.

That’s why I offer full cardiac panels, lab interpretation, and monthly vascular screenings at Gutwell. I want to provide my patients with all the data they need to make informed decisions about their health. It’s about looking at everything—getting the full picture—and using that information to improve numbers, reverse disease, and make lasting changes.

We don’t have to wait for a heart attack or a life-threatening event to start caring about our hearts. Prevention starts now. By getting regular screenings, understanding genetic risks, and making lifestyle changes, we can protect our hearts for years to come. It’s never too early to start, and it’s never too late to make a change.