Where do our sons learn not to go to the doctors? Does that now create a social burden?

[FarCenter]

59. Did you have his cholesterol level measured during the autopsy?

Most Heart Attack Patients' Cholesterol Levels Did Not Indicate Cardiac Risk

Jan. 13, 2009 — A new national study has shown that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event, based on current national cholesterol guidelines.

Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL).

"Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit," said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study's principal investigator.

While the risk of cardiovascular events increases substantially with LDL levels above 40–60 mg/dL, current national cholesterol guidelines consider LDL levels less than 100–130 mg/dL acceptable for many individuals. The guidelines are thus not effectively identifying the majority of individuals who will develop fatal and non-fatal cardiovascular events, according to the study's authors.

http://www.sciencedaily.com/releases/2009/01/090112130653.htm

He should have gone to the doctor with the symptoms that he had during the first attack. That is acute care, not preventive care.

An EKG during a routine physical may or may not have picked up the fact that he had a heart attack already. I'm not sure whether a stress EKG will be covered by the ACA health plans. A stress EKG is not usually part of a routine physical, although it is for a high-cost evaluation like the Princeton one.