Beating Time: Dodging the Number One Killer with Dr. Lipi Roy

Could we eliminate the number one cause of death? Neil deGrasse Tyson and co-hosts Chuck Nice and Gary O’Reilly go to medical school to learn about heart health, the impacts of COVID, and the cardiovascular disease epidemic with physician Dr. Lipi Roy.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Neil deGrasse Tyson?

  Coming up next on StarTalk Special Edition, all about heart health. What are we doing right? What are we doing wrong as a nation, as the world? Turns out cardiovascular disease is the number one killer of human beings in the world today. What can we do about it? What are the misconceptions? How does it all relate to COVID? And the vaccines given to prevent us from dying and keep us out of the hospital? How do they all relate? Coming up next on StarTalk. Welcome to StarTalk, your place in the universe where science and pop culture collide. StarTalk begins right now.

• 0:44Neil deGrasse Tyson?

  This is StarTalk Special Edition. Got with me my two favorite co-hosts in the universe. Chuck Nice, Chuck, how you doing, man? What's happening, Neil? All right, longtime co-host, comedian and actor. I got Gary O'Reilly, former soccer pro, sports commentator, and we borrow him for this because his life and heart is in soccer. But thank you, Gary, for giving of yourself to us.

• 1:09Gary O'Reilly?

  Oh, my pleasure. Thank you, Neil.

• 1:11Neil deGrasse Tyson?

  And where are you going to take us here?

• 1:13Gary O'Reilly?

  Well, recently, say earlier this year, 2023, we did an explainer about the Damar Hamlin NFL cardiac emergency that he had on field. And our audience came back with a variety of thoughts and ideas as to what they thought had happened. And it made us realize, because we had a little huddle, as you do, and you know what? We maybe don't know as much about the heart, one of the most vital organs in the body, as we think we should. It is the number one killer in the USA. And I think really, we needed someone to shed a light on that. And so we brought back.

• 1:51Gary O'Reilly?

  One of our most favorite medical doctors, Dr. Lipi Roy, M.D. So Neil, would you like to introduce our guest?

• 1:57Neil deGrasse Tyson?

  Sure, sure. Uh, Lipi Roy, always great to see you again. And we've met on several occasions, not only with StarTalk. So delighted to have you sort of shed some light. Uh, internal, uh, medical physician, public health professional with the mayor's office of criminal justice. Now, whose mayor is that?

• 2:18Speaker 02

  Uh, so Mark Jay, the New York City mayor's office of criminal justice, I believe was started during the de Blasio administration.

• 2:24Neil deGrasse Tyson?

  Gotcha, gotcha. So New York City, um, mayor's office. Um, and you're a host of a YouTube show, Health, Humor and Harmony. I love the alliteration.

• 2:33Speaker 02

  Thank you.

• 2:33Neil deGrasse Tyson?

  And you're, you're often sought after commentator, and we know why. Uh, MSNBC, NBC News and Forbes. Uh, you write for Forbes. And so, so welcome back to StarTalk.

• 2:47Speaker 02

  Thank you, Neil. I'm so happy to be here. Uh, and this is a topic that matters so deeply to me, to my people. I'm a, uh, the, the daughter of Indian immigrants. I'm wearing my red.

• 2:57Neil deGrasse Tyson?

  So, so we're, we're told that there's certain foods out there that are heart healthy. And there are heart healthy habits we can undergo, heart healthy lifestyles. And even so, issues related to our heart is the number one killer of Americans. So, so what, what are we not doing? What, what's missing? What, what? Or maybe we are doing the right things and, you know, who was it that said, eat well, stay fit and die anyway? Is this what's gonna happen regardless?

• 3:31Speaker 02

  Well, that, that is the pessimistic approach, but I, but no, it's actually, Neil, we have studies. We have data showing that if people adopted these healthier lifestyles, or in other words, reduce their risk factors for heart disease, they will live longer, at least they won't die of heart disease. And to you, to Gary's point earlier, the leading cause of death globally is cardiovascular diseases. So, so just a reminder that cardiovascular diseases includes a, a group of illnesses, including coronary artery disease, um, uh, uh, cerebrovascular diseases, um, uh, peripheral artery disease,

• 4:14Speaker 02

  which supplies the arms and the legs, rheumatic heart disease.

• 4:17Neil deGrasse Tyson?

  But you said cerebral, so your brain, so. Why would your heart be implicated

• 4:22Speaker 02

  Yeah.

• 4:22Neil deGrasse Tyson?

  by something that happens in your brain? That doesn't sound right.

• 4:25Speaker 02

  Great question. Because, because cerebrovascular diseases means that these are blood vessels supplying the brain. So the blood vessels are in, are come under the category of cardiovascular diseases.

• 4:37Neil deGrasse Tyson?

  Oh, so that's why the heart is a wide swath of ailments.

• 4:41Speaker 02

  Exactly.

• 4:42Neil deGrasse Tyson?

  As you're describing it.

• 4:43Speaker 02

  Well, I, and remember, I'm not talking about the heart. I'm talking about cardiovascular diseases. So that includes all these other.

• 4:49Neil deGrasse Tyson?

  So cardio is heart vascular is your, your circulatory veins, veins and things. So to what combined, I guess, so a stroke would be cardiovascular, is that right?

• 4:58Speaker 02

  It's exactly right. So, so a cerebrovascular disease includes most commonly the stroke, strokes.

• 5:04Neil deGrasse Tyson?

  Oh, got it, got it.

• 5:05Speaker 02

  And then, and cerebrovascular disease, sorry, cardiovascular disease also includes congenital heart disease. Um, and like when you're, when you're baby and I, I already mentioned rheumatic heart disease. So yeah, to the point that we were talking about earlier, it is the leading cause of death around the globe. Seventeen point nine million people died of it in 2019. Uh, and the leading cause specifically eighty-five percent are, are dying from heart attacks and strokes. So to your question, Neil, so yeah, we know what the risk factors are, or maybe people don't. Uh, but they're not really adopting all of it. I really think it's, uh, most people don't know that the leading causes are, the risk factors are, it's smoking. It's unhealthy diet.

• 5:49Speaker 02

  It's lack of physical activity. It's being overweight or obese and it's also harmful alcohol consumption. I don't think.

• 5:56Chuck Nice?

  Oh, well, that's it. I'm dead.

• 5:57Speaker 02

  Yeah.

• 5:57Chuck Nice?

  I'm dead. Well, that's it. It was nice knowing you guys.

• 6:02Neil deGrasse Tyson?

  Chuck's got three more months.

• 6:03Chuck Nice?

  It was great, yeah. I got, I got three minutes. I got, are you kidding me? I got three minutes.

• 6:08Gary O'Reilly?

  So doctor, is it, is it as simple as saying if we cure the cardiovascular disease scenarios? We are now in the situation where we can optimize our lifespan to say 150 without there being too many problems.

• 6:23Neil deGrasse Tyson?

  No, you die of something else, you know.

• 6:25Gary O'Reilly?

  Well, I know, but the doctors answer, not my fault.

• 6:28Speaker 02

  Well, but in this particular case, our Asha physicist expert is right because I hate to be cynical, I'm almost always optimistic and positive, but in this case, I mean, look, if we, if you're right, Gary, to your point, if we optimize and suppose we eliminate all risk factors for heart disease, right, and we are not dying of heart disease, look, if we are lucky enough to live till our 80s, 90s, uh, somebody, something else is gonna get us.

• 6:57Neil deGrasse Tyson?

  I, I bet no caveman died of prostate cancer.

• 7:03Chuck Nice?

  Right. Exactly.

• 7:05Neil deGrasse Tyson?

  They didn't live long enough.

• 7:07Chuck Nice?

  They only lived to 32.

• 7:08Speaker 02

  That's right.

• 7:09Chuck Nice?

  Thirty-two years old, yeah, great prostate, everything else failed.

• 7:13Neil deGrasse Tyson?

  Okay, so this, this longevity question is, uh, it's not the direct subject of this episode, but it's way more complex than just solving one disease or another.

• 7:23Speaker 02

  Right, yeah.

• 7:24Chuck Nice?

  Mm-hmm. But, but you should keep in mind that, um, you do live better. So think of all the people who are suffering from all of these different ailments, you know, the cardiovascular diseases, um, and heart disease, um, if it, if it isn't even the big giant widow maker or whatever that kills you, you're not living well.

• 7:51Speaker 02

  Yeah.

• 7:52Chuck Nice?

  You know, you're, you're, you're suffering all that time.

• 7:54Speaker 02

  Yeah, and can I, can I share a personal story? So, so I'm of Indian heritage, the heart disease is a huge epidemic amongst i- i- i- in the Indian community. My own father, um, had, was diagnosed, he had a heart attack in his late 60s, uh, you're to, it's totally atypical by Western to at standard heart rate patient, right? Lifetime non-smoker, thin, active, um, very healthy eater, but he had a strong genetic predisposition, he had a heart attack in his late 60s, and then a very, 20 years later, a common And complication is heart failure. And to your point, Chuck, your quality of life. In the last year and a half, two years of my dad's life, he was really struggling with heart failure,

• 8:37Speaker 02

  which slowed him down considerably. This is the same guy that went from India to Europe, to Canada, drove to Florida, one of the most active guys I know. He sadly succumbed to heart failure in March of this year, but.

• 8:51Neil deGrasse Tyson?

  Oh, sorry to hear that.

• 8:52Speaker 02

  Yeah, no, thank you. But I mean, but to your point, Chuck, heart diseases, if you know, it can really impact one's quality of life. But if we don't have heart disease, I just don't think that we're going to live till one fifty, Gary, because cancer, Alzheimer's, other neurologic problems, something else is gonna get us. I, I, that's my suspicion.

• 9:16Gary O'Reilly?

  Oh, no, I totally, I totally understand. And I'm, I'm just wondering, you know, just how many different ways does the heart get broken? Does the cardiovascular system tie itself in knots? And just fail to function?

• 9:28Chuck Nice?

  One of the chief ways is being a Jets fan.

• 9:31Gary O'Reilly?

  That's.

• 9:33Chuck Nice?

  Says the Eagles fan.

• 9:34Speaker 02

  We just be the Giants, right, Chuck?

• 9:36Chuck Nice?

  Yeah, well, I'm an Eagles fan, so. He doesn't care. I don't care about Giants.

• 9:43Speaker 02

  Go, go, leave, go. I don't even follow football, but I, I know that the Jets won, but yeah. Um, well, Gary, to your point, um, outside of, um, following, um, supporting the wrong sports team, there are other actual causes of, um, of ways to attack the heart. I mean, look, the most common one we think of is coronary artery disease, right? That's when the heart vessel, the vessels that supply the heart, they get clogged or blocked, right? Causing a heart attack. But there's also structural heart disease. So that means the blood, the, the, the vessel, the, the heart valves, the heart wall, the heart chambers, they're all affected. Congenital heart disease. Um, there's also arrhythmias.

• 10:26Speaker 02

  So like a VTAC, V fib, these can all cause. Um, so there's all types of, uh, of ways to attack or harm the heart.

• 10:35Neil deGrasse Tyson?

  Wow.

• 10:36Gary O'Reilly?

  We've discussed there what happens internally. How many external? Scenarios affect the cardiovascular system, the heart. I mean, is it, is it as simple to say not many or just about?

• 10:48Speaker 02

  Well, well, great question. I mean, I mean, the heart is such a fundamental organ. I mean, I love, love the heart. It's so simple. And yet, if any one thing, one aspect that goes wrong, everything shuts down. Everything slowly deteriorates. You can have something acute, right? Like a sudden cardiac arrest, but you could also have something more chronic, like the heart failure that I described. But to your point, Gary, external causes like medications, there are tons of medications or drugs. We talked about alcohol, stimulants like cocaine. These can all adversely impact the heart. So there's a lot of other external, we didn't even talk about.

• 11:27Chuck Nice?

  And what about, what about marijuana? Marijuana? Chuck's got to know the marijuana. Everybody knows cocaine is bad for your heart, but what about marijuana?

• 11:36Speaker 02

  I think, I don't know specifically Chuck, if cannabis affects the heart. Cannabis is one of those substances that affects every organ, but I'll have to get back to on that. Cannabis is.

• 11:47Chuck Nice?

  I'm gonna take that as you saying it's absolutely safe.

• 11:51Speaker 02

  That is not what I said, but go ahead.

• 11:56Chuck Nice?

  I love that you clarified, but that is not what I.

• 12:01Speaker 02

  Actually marijuana can make the heart beat faster and can actually increase blood pressure, which can actually harm the heart. So, sorry Gary. Sorry, sorry Chuck, sorry.

• 12:12Gary O'Reilly?

  Yeah.

• 12:13Speaker 02

  Maybe Gary too.

• 12:15Gary O'Reilly?

  Maybe, maybe Gary too. You never know.

• 12:18Speaker 02

  But can I just go back to alcohol? I mean, people associate alcohol with the liver, but actually alcohol can cause cardiomyopathy. It can elevate your heart blood pressure. It can really attack the heart in many ways. And it's, it's a big issue now because with COVID, alcohol consumption has gone up in women and alcohol related mortality has gone up in women. So, look, as a woman and addiction doctor, as an internal medicine and primary care doctor, this really matters to me. So, so yeah.

• 12:48Neil deGrasse Tyson?

  But that was one of the big surprises during COVID, that liquor store sales went up precipitously that entire time.

• 12:55Speaker 02

  Yeah.

• 12:56Chuck Nice?

  Because that's when they started delivering.

• 12:59Neil deGrasse Tyson?

  Yeah, so it seems. It seems like you can track the health of a country by the runs on the liquor stores. I mean, I don't mean to laugh, but just without even, without even testing the people.

• 13:13Speaker 02

  Yeah.

• 13:13Neil deGrasse Tyson?

  You can get a first cut at the health by how many cigarettes are sold, how much alcohol is purchased.

• 13:20Speaker 02

  Yeah.

• 13:20Neil deGrasse Tyson?

  Just at the point of sale, right?

• 13:22Speaker 02

  Well, it's also a har- I'm actually glad that liquor stores were open from a harm reduction lens. Because if you off, abruptly cut off a person's alcohol supply, somebody say who drinks regularly, you're gonna put them into acute withdrawal and that's a medical emergency. That means the hospitals are gonna see more, more of these patients coming in. So from a harm reduction standpoint, I'm glad that liquor stores were actually open. But you're right.

• 13:50Chuck Nice?

  You are, you are my kind of doctor.

• 13:53Speaker 02

  But to Neil's point, he's right that we did see a rise in alcohol consumption, cigarettes, all that stuff, which is a sign of increased stress, right, and stressors, which of course we saw with the pandemic.

• 14:06Neil deGrasse Tyson?

  Right. Now, what about the, you know, I think the amateur person, the uninformed person uses these terms interchangeably. But if you could detail for us, like you may have done this the last time, but I can't hear this too often. What's the difference between a heart attack, cardiac arrest and heart failure? Those are different things, right?

• 14:26Speaker 02

  Yeah, and I'm so glad you're right, Neil. I remember in med school and resident training, repetition is the key, right? You always repeat the same thing and people confuse these concepts all the time. So let's start with cardiac arrest. Very simply, it's the heart and it stops. Heart just stops. Many different reasons, but the leading cause is a heart attack. And a heart attack or myocardial infarction, the blood vessel.

• 14:55Neil deGrasse Tyson?

  I'll go with heart attack on that one.

• 14:57Speaker 02

  Yeah, yeah, it's MI, but a heart attack. So, but the leading cause of heart attack or a heart attack is when the coronary arteries or the vessels that supply the heart get blocked. There's a plaque, so that's a heart attack. Heart attack means the heart stops because the blood vessels supplying it get blocked. And then what was the third, or the heart failure?

• 15:18Neil deGrasse Tyson?

  Wait, wait, wait, wait, wait, just to be clear. The vessels are getting blocked, constraining blood flow.

• 15:25Speaker 02

  Correct.

• 15:26Neil deGrasse Tyson?

  If you're undergoing that, a person can walk around and say, I think I'm having a heart attack.

• 15:32Speaker 02

  Correct.

• 15:33Neil deGrasse Tyson?

  Whereas if they actually had a cardiac arrest, they're on the floor.

• 15:37Speaker 02

  Yeah. Almost all causes usually cardiac arrest is usually a sudden thing, right? So you're you're dropping, you're unconscious. That doesn't mean you die, but it could mean, that's what that means. Heart stops immediately. Heart attack, to your point, Neil, you're right. People almost always have symptoms indicating, because it's a slower process. It could be fast, but it could also be slower. So that means that part of the heart muscle is no longer getting nutrients, specifically oxygen, so it starts to die. And my infarction means death of that heart muscle. And that that third distinction, Neil, you about failure.

• 16:17Speaker 02

  Yeah. So that means that that's again, a general term where the heart just isn't pumping strong enough. Again, a lot of causes, the primary cause for heart failure being a coronary artery disease or a heart disease. Yeah.

• 16:35Neil deGrasse Tyson?

  And what about the the what they call AFib? You just described that.

• 16:40Speaker 02

  Yeah, yeah. So that so again, another category for what attacks the heart or a form of heart disease is really what we call arrhythmias. And one of the most common arrhythmia or a heart rhythm abnormality is atrial fibrillation or AFib. So, you know, there's different chambers of the heart, the atrium. That atrium, it starts to kind of not have a regular rhythm, but it kind of what we call fibrillation. Yeah. Well, there's a flutter and then there's a fibrillation. Different things.

• 17:15Neil deGrasse Tyson?

  Flutter is a is a formal term?

• 17:17Speaker 02

  Atrial flutter, absolutely.

• 17:18Neil deGrasse Tyson?

  Well, all right. So so if you say my heart was a flutter, you're about to die.

• 17:22Gary O'Reilly?

  Oh, look at that.

• 17:24Speaker 02

  Isn't it funny how we.

• 17:25Gary O'Reilly?

  You're a cheerful soul today, Neil. You really are in a cheerful mood, aren't you?

• 17:29Speaker 02

  We romanticize the heart in so many ways, don't we? A broken heart. A heart is a flutter. But yeah, I'll I'll wear I'll be the medical geek here and say that a flutter. Can I tell you that atrial flutter, a flutter, your heart rate? So what's the normal heart rate? Do you guys know?

• 17:47Chuck Nice?

  Well, mine is sixty-five.

• 17:50Speaker 02

  Which is in normal range. So, normal range is from sixty to a hundred. Can I tell you, patients with A flutter, their heart rate can go up to the two hundreds? It is a absolute medical emergency. They need to get.

• 18:04Chuck Nice?

  I thought that was tachycardia.

• 18:07Speaker 02

  So, tachycardia, Chuck, great, great point. Is anything above, a heart rate above a hundred? So, tachycardia, you can have like, you know, lower range, but you can have really, really fast.

• 18:16Neil deGrasse Tyson?

  Right, right. So, just to be clear, just to be a little more complete here. So, the Greek word tachys means speed or swift. And then we get tachometer from it. And tachyon's hypothetical particles that exist traveling faster than light. And now, the medical folks, you're all into the Greek and Latin words there. So, I presume it's the same root for the word.

• 18:38Chuck Nice?

  I died faster than light.

• 18:43Chuck Nice?

  Sorry, Death. I beat you, Death. Faster than light, that's right.

• 18:46Neil deGrasse Tyson?

  You can't kill me. I'll kill myself.

• 18:48Speaker 02

  I won.

• 18:50Chuck Nice?

  I outran Death.

• 18:52Neil deGrasse Tyson?

  Right, right. So, give me that word again.

• 18:54Chuck Nice?

  Tachycardia.

• 18:57Speaker 02

  Oh, tachycardia.

• 18:59Neil deGrasse Tyson?

  Tachycardia. Got it.

• 19:00Speaker 02

  Yeah.

• 19:17Neil deGrasse Tyson?

  So, Leavy, are there, are there top five misunderstood things about the heart that, that run around the public? I mean, I can say the top five things people misunderstand about space. First, they think that you can hear explosions in space because every movie. Like, I can go down. I got my list. So, what's your list?

• 19:39Speaker 02

  Yeah.

• 19:40Neil deGrasse Tyson?

  Of things that people think is true but are.

• 19:42Speaker 02

  Yeah, I'll put this under say the top five. I mean, there's so many I can share, but the top five human heart facts and or myths. Uh, first of all, let me start off with that. I'll say that most heart attacks, I don't think people know this, most heart attacks happen on a Monday morning. Um, and so why, why is that? It turns out that Mondays cause more stress than other days for most people and stress hormones are the highest in the morning. And both of these combined increase blood pressure, increase heart rate and stress hormones. They break off a piece of plaque, these are blocking the vessel and a, a, a heart attack. Uh, another

• 20:21Neil deGrasse Tyson?

  What's your Chuck? I need you to sing here. Rainy days and Mondays.

• 20:26Gary O'Reilly?

  Yeah, I just call out. There's another, there is another pop song by an Irish band called the Boomtown Rats called I Don't Like Mondays.

• 20:35Speaker 02

  Yeah, Bob Yeldoff, right, Gary?

• 20:38Gary O'Reilly?

  Thank you. Good knowledge.

• 20:40Speaker 02

  Thank you.

• 20:43Speaker 02

  My job.

• 20:45Neil deGrasse Tyson?

  Mic drop.

• 20:46Speaker 02

  Thank you. Um, another one of my favorite, uh, like top five kind of human heart facts or myths. Men and women have different heart attack symptoms. People think, oh, women have that crushing chest, chest pain. That's actually not true. Women present somewhat differently, often more kind of benign subtle things that get missed. Some nausea, some difficulty breathing, sweats. Um, so I think that's important for women to recognize that, but especially doctors, when they present in the emergency department, don't just brush your office, heartburn, or they're, they have anxiety, make, do the proper testing, get a proper history. Um, and by the way, so we already talked about a broken heart. Well, a broken heart can feel like a heart attack

• 21:29Speaker 02

  because they have a sudden intense feelings of sadness or grief, which can mimic a heart attack, uh, with symptoms with chest pain and a shortness of breath. And why is that? Because those stress hormones and the treatment for that, for a broken heart is just getting rest. Another one of my favorite myths.

• 21:48Neil deGrasse Tyson?

  Or I'm reminded, wait, wait. So Aristotle was famously, infamously declared that the source of our feelings are in our heart. So he was partially right there in this case.

• 21:58Speaker 02

  Yeah, partially, but it's, it's in the brain, but yes.

• 22:05Neil deGrasse Tyson?

  He's right, but he's not right.

• 22:07Chuck Nice?

  It's the part of your heart that's in your brain.

• 22:09Neil deGrasse Tyson?

  There you go. Chuck said it right. Chuck M D.

• 22:13Speaker 02

  Oh, man. Yeah, well, you're gonna like this myth. Um, sneezing does not stop your heart, or it doesn't make your heart skip a beat. The heart may temporarily change rhythm, but the heart only stops during a cardiac arrest. And lastly, I like, I want to share that laughing is good for the heart. Blood vessels relax when you laugh, and then at least 20% more blood going through your body. So your heart doesn't have to work as hard. So.

• 22:42Neil deGrasse Tyson?

  So someone in the middle of a heart attack, we try to bring Chuck along and tell him jokes.

• 22:46Chuck Nice?

  There you go. Well, no, that has surely killed them.

• 22:49Neil deGrasse Tyson?

  No.

• 22:53Speaker 02

  Another really kind of cool heart fact. Did you know that there's 60,000 miles of blood vessels in your heart? And if one of those blood vessels is damaged, your heart has to work even harder. And just for reference, Neil is gonna love this. The circumference of the earth is about, say, almost 25,000 miles. But you'd have to take three trips around the earth to have to equal the length of blood vessels. I thought that was kind of cool.

• 23:17Neil deGrasse Tyson?

  OK, so I once tweeted that if you take all the veins, capillaries, and arteries out of a person's body and string them end to end, that the person would die.

• 23:33Neil deGrasse Tyson?

  That was my connotation.

• 23:35Speaker 02

  Oh, my God.

• 23:35Chuck Nice?

  Oh, wow.

• 23:38Speaker 02

  That's just what we are.

• 23:43Neil deGrasse Tyson?

  So Gary, are you still thinking about COVID here? What's up?

• 23:46Gary O'Reilly?

  Yeah, if we think back, Doctor, to that period that's just recent, lots of different things entered into our mind space as to what could be happening, what was happening, what this could do and what that could do.

• 24:01Neil deGrasse Tyson?

  The causes and effects of things was very.

• 24:02Gary O'Reilly?

  Yes, and there was very little. You know what? These are the facts. So was it an external thing? Was it an internal thing? Was COVID going to give us a heart attack? Was the vaccine going to do some damage that we couldn't tell? You know, because no one had been there yet. What are the actual facts going forward as we know now? That were real and not fantasy of some conspiracy?

• 24:24Neil deGrasse Tyson?

  So we're trying to unpack the COVID virus, that our physiological reaction to the COVID virus? And the vaccine and our reaction to the vaccines, right?

• 24:35Gary O'Reilly?

  Yeah.

• 24:35Speaker 02

  Yeah. So really great question, Gary. So let me try to unpack this. So let's, let's go back to early 2020, if not even late 2019, when we're starting to learn about this SARS-CoV-2. This novel coronavirus. So remember.

• 24:52Neil deGrasse Tyson?

  What makes it novel? What, where does that word come from?

• 24:55Speaker 02

  It means, honestly, Neil, the medical scientific community had never seen this particular virus before. We've seen the first SARS coronavirus that caused SARS, but, but we've never seen this version and.

• 25:11Neil deGrasse Tyson?

  That's what novel means. It's new on the scene.

• 25:12Speaker 02

  Exactly. That's exactly what that means. And what we discovered day by day as the, remember, we didn't even call it COVID in the beginning. We called it the coronavirus, right? We learned slowly but surely, this is not your typical respiratory virus. It, it, it was attacking all these different organ systems compared to say the common cold virus or influenza virus. These viruses strictly cause respiratory symptoms. And to your point, Gary, we soon discovered that SARS-CoV-2, it, it attacked the brain. It causes neurologic symptoms, caused GI symptoms, and it caused cardiovascular or heart symptoms.

• 25:54Speaker 02

  People were getting myocarditis, cardiomyopathies, all these heart problems, clots. And we're still trying to understand why, but we, studies now are, are suggesting and indicating that SARS-CoV-2 and COVID-19, it's not even so much an infection as it really is like an immunologic problem. And to your point, Gary, unfortunately, back when Damar Hamlin, the NFL player, underwent a cardiac arrest. He's thankfully alive, but I, when I posted a video about his cardiac arrest and he was making the different explanations, why it happened.

• 26:31Speaker 02

  So many people responded and thought incorrectly that the SARS, the COVID vaccine booster caused his cardiac arrest. And let me just say, the studies are very clear that COVID-19 or the SARS-CoV-2 virus has been shown to cause cardiac problems, but not the vaccines. This is a reminder that vaccines, they're medications that are designed for all people, and so they undergo perhaps the most rigorous testing, more than any other medication. Are there some side effects? They're, yes, they're usually minor, but it is not, cardiac arrest is really not, not one of them.

• 27:16Neil deGrasse Tyson?

  Well, you mentioned something, I have to emphasize it, because I haven't heard it put so succinctly, that if I'm developing, I'm a big pharma or any kind of pharma, and I'm developing a medicine for a particular ailment, then I'm going to test it on people that have that ailment, and maybe a few others just for control. But I don't have to test it on everyone, because it's only targeting an ailment that I'm trying to see if I can cure. A vaccine, obviously, when we're reaching for herd immunity, that goes into everyone, essentially everyone, and so you would expect vaccine trials to involve manifold more people in the testing of it than any other kind of drug. Is that a fair exposition of what you just said?

• 28:00Speaker 02

  Yeah, and I'm glad you emphasized it again. In fact, I'm going to reemphasize your emphasis of what I stated. And I'm doing this, Neil, because, as you all know, the anti-vaccine movement and vaccine skepticism has really skyrocketed. It was already on the rise before COVID. It has just skyrocketed, and this is a major public health problem, because we're seeing rises, epidemics, a little in pockets of communities, of measles, of polio. And to your point, Neil, vaccines, think about childhood vaccines, vaccines that we all got as babies to prevent diphtheria, prevent, not to treat, prevent getting

• 28:41Speaker 02

  Tetanus, polio, diphtheria. Um, these were designed uh to make sure they were safe for babies so that we can then all grow up to be healthy adults. You know.

• 28:51Neil deGrasse Tyson?

  And I think I'm old enough to have had a smallpox vaccination.

• 28:55Speaker 02

  And I'm Canadian, so I got smallpox in Canada. Yeah, the sorry, the vaccine, not the disease.

• 28:59Chuck Nice?

  Right. Say, wow, I'm now going to Canada now. So Doc, dovetailing on what you just said, do vaccines actually prevent, because you just said some prevent? Or do they actually lessen symptoms and keep you out of the hospital?

• 29:14Speaker 02

  Yeah, that's a great, great way of actually structuring that that this issue of vaccines and to address the confusion that the public has. So historically, all these childhood vaccines, they were mostly designed to prevent you from getting the disease. Diphtheria, tetanus, pertussis, polio. The COVID vaccines, however, that were developed in the last couple of years, there's confusion because it doesn't necessarily prevent you from getting the disease. The COVID vaccines were designed to do three things and they do them very well. One is to reduce the severity of the disease, reduce hospitalizations, and reduce deaths.

• 29:55Speaker 02

  Unfortunately, it wasn't a message necessarily that way in the beginning by the CDC.

• 30:00Neil deGrasse Tyson?

  Not at all. We think we thought of it as a as another vaccine where then you'll never get it again.

• 30:05Speaker 02

  Yeah, that's why a lot of the pushback from the public was, well, I got the vaccine, I still got COVID. It wasn't designed to prevent you from getting COVID. It was designed to really prevent you from getting severely sick and dying, getting hospitalized and dying. So that's the decision.

• 30:19Chuck Nice?

  Same as influenza too. I mean, this is

• 30:21Speaker 02

  Yeah.

• 30:21Chuck Nice?

  The deal with influenza that many people uh say, well, I don't, I don't need it because, you know, it's, I, I, you know. And and let me tell you, you get the flu once for real.

• 30:32Speaker 02

  Yeah.

• 30:33Chuck Nice?

  I I got it once in my life for real.

• 30:35Speaker 02

  Yeah.

• 30:35Chuck Nice?

  And I've never not gotten vaccinated again.

• 30:38Speaker 02

  Can I tell you, Chuck, I just interviewed rapper Ice T because he's promoting the flu vaccine. He wants, he wants to tell his story and because, and so the flu vaccine, to your point, Chuck, would mean you'll never get the flu? No, but it's Significantly reduces your risk of getting the flu. And as somebody who rotated through the Duke ICU, I remember seeing a thirty five year old man, otherwise completely healthy guy. He was on what's called an ECMO machine, which is like a more invasive, like their ventilator. And I asked the fellow, my ICU fellow, hey, what's what's his deal? And he said, oh, he has the flu. This is a guy that nearly died from influenza. People forget that.

• 31:18Chuck Nice?

  Still thirty five thousand people a year, people.

• 31:20Speaker 02

  Yes.

• 31:20Chuck Nice?

  Still just influenza.

• 31:22Speaker 02

  Vaccines work, people, get the vaccine.

• 31:25Chuck Nice?

  And don't write, please, okay? If you don't want to do it, that's you, okay? That's you. Well, it's science. This is a science show. What we're saying is vetted information. It is empirical. It has been proved. And so when we say it, we're not telling you to do anything. We're giving you the information. That's all we're doing. So don't write and I don't want to hear about it.

• 31:52Speaker 02

  Do I need to call nine one one? Does Chuck need a doctor?

• 31:56Chuck Nice?

  You guys are getting all political. Look at you on StarTalk getting all political. It's not political. It's science. You're political. You're political.

• 32:05Gary O'Reilly?

  Okay, it's the facts. All right, good. Um, I'm glad you I'm glad you vented.

• 32:10Speaker 02

  Yes.

• 32:10Gary O'Reilly?

  And moving into thickening of ventricle walls, doctor. This is, if I'm wrong, correct me, please. Isn't this one of the side effects of getting something like COVID? Now, if that's the case, can you rehab out of that? Unlike if you got sort of hypertrophic cardiomyopathy, which thickens and it stays sick.

• 32:29Speaker 02

  Yeah.

• 32:29Gary O'Reilly?

  Does this with COVID and it thickens, it can be rehabbed out? Or is it gonna stay sick?

• 32:36Speaker 02

  Yeah, I'm glad we're talking about heart inflammation, not anger management.

• 32:41Gary O'Reilly?

  Yeah. With that in the rearview mirror, we're out.

• 32:45Speaker 02

  Yeah, Gary, thanks for clarifying. So, heart inflammation, cardiomyopathy, can it be reversed through treatment? So, the answer is actually yes. First of all, heart inflammation is rare, right? It occurs post-injury or after an infection. Mild cases don't even need treatment. So, treatment depends on the type of inflammation and the underlying cause. And the most common types are endocarditis, myocarditis, pericarditis, and the treatment would be antibiotics, steroids, antifungals, sometimes blood thinners. But yeah, most

• 33:21Gary O'Reilly?

  Wow, antifungals?

• 33:23Speaker 02

  Yeah, because the fungus can cause cardiomyopathies and heart inflammation. So, yeah, that's the good news.

• 33:31Chuck Nice?

  Now, see, I have something called left ventricular hypertrophy. So, that's a thickening of the wall.

• 33:38Speaker 02

  Yeah.

• 33:38Chuck Nice?

  But my cardiologist said that, I mean, he gave me some medication to soften my heartbeat. But he was like, I said, so how do we unthicken the wall? And he said, it's a different kind of muscle. It doesn't work that way.

• 33:52Speaker 02

  So, LV, what you're describing Chuck is LVH. We use that term very commonly, left ventricle hypertrophy. So, that's different from, say, like, HCM or hypertrophic cardiomyopathy. So, that's a different, often there's a genetic causes for that. But what you're describing Chuck is actually very common. And that's because one of the most common causes for LVH is actually hypertension or high blood pressure.

• 34:15Chuck Nice?

  That's what I have.

• 34:15Speaker 02

  Yep, yep.

• 34:16Chuck Nice?

  That's exactly what did it.

• 34:17Speaker 02

  Yep, exactly. And valve disease, particularly the aortic valve and mitral valve disease. When you get any kind of blockage or impairment of that valve, that left ventricle has to pump even harder, which is why that heart muscle gets bigger and bigger.

• 34:35Speaker 02

  The good news is that these are treatable. So, this is a reversible type of LVH, right? So, treat the high blood pressure, treat the valve, reverse the valve disease. You can actually treat and manage the LVH and reverse it.

• 34:48Chuck Nice?

  There you go. I'm not gonna die after all.

• 34:51Speaker 02

  There is hope.

• 35:07Neil deGrasse Tyson?

  Of all the people who die of heart disease, what percentage of them does it come from a congenital condition? That they just were cheating time their entire life? So for example, I'm old enough to remember the 1970s, where jogging and running became a craze, basically for the first time. There were books on it. It was a guy named Jim Fix, who was a big running enthusiast. He was interviewed everywhere. And he wrote a book, a bestselling book, and he dropped dead of a heart attack. And only then did we learn, sorry, he dropped dead of a heart attack like in his 40s or 50s, that his father had heart disease, died very young,

• 35:51Neil deGrasse Tyson?

  and maybe he cheated time at many years beyond his due date for even having died young. So I'm just asking, what percentage of that is it? And I didn't realize that congenital heart disease is as common as it sounds like it is.

• 36:11Speaker 02

  So, look, the vast majority of people who die of heart disease really die of heart attacks and strokes from preventable causes. So let's be really clear about that, okay? The vast majority, especially today, it's lifestyle modification which can prevent that or significantly reduce your risk. What you're talking about, Neil, with the congenital heart disease, it's actually pretty rare. Are there, could it be, could there be more cases of that? If we did our testing for it? Sure. But the good news is that if you're not getting diagnosed with it until much later in life, that's actually the good kind of congenital heart disease to get. Most of them, the babies that are getting it,

• 36:56Speaker 02

  and we now have in utero, cases where you can, you know, because remember, the cardiac development ends by week eight of gestation. So, and we now have great fetal technology. Imaging, so we can detect in utero if a person, if at fetus is gonna have a congenital heart defect, most congenital heart defects. So that's, it's rare, many are treatable in utero and once a baby is born. So neonatal cardiology, there's amazing cardiac surgery advancements in that regard.

• 37:31Gary O'Reilly?

  When, when you said about, you know, these genetic mutations that predispose you to cardiac events, and you say screen them, are you always looking for the same flags, or do these things change and are tricky?

• 37:48Speaker 02

  So, so there are several genes that are involved in various ways. Some can increase your risk for arrhythmias, some can increase your risk for coronary artery disease. Like I'd say in my dad's case, I'm, without doing any testing, I almost promise you, he had a strong family history and genetic history. So there's a lot of genes that are involved. I think we're finding more and more. Gene therapy is an exciting area. To be honest, it has, the field of cardiology has not really utilized gene therapy as much as, say, other fields like oncology. So, but there are exciting advancements in that area.

• 38:30Neil deGrasse Tyson?

  But just clarify, when you say gene therapy, I, I guess I don't really know what that is. Are you going in and nip tucking the gene sequence? Or are you learning about the gene defects? And then you give support?

• 38:44Speaker 02

  Yeah, yeah. So, great question. Let me clarify that. So, gene therapy, again, there's different ways. Let's use the example, Cleveland Clinic infused the first gene therapy for hypertrophic cardiomyopathy. And it's based on this myosin binding protein C3 gene mutation, which is actually the most common genetic cause of HCM. So what they're doing actually is kind of going in and replacing or repairing that gene. Again, it depends on what the genetic mutation is. Sometimes you just have to just rectify the mutation. Other times, there's no protein at all. So you just have to replace the gene. So it depends on the, on the mutation.

• 39:26Neil deGrasse Tyson?

  So that's all gene therapy?

• 39:27Speaker 02

  Correct, correct.

• 39:28Neil deGrasse Tyson?

  Interesting. And if you make that change, will their offspring? No longer be susceptible? Hmm.

• 39:35Chuck Nice?

  Do they pass the?

• 39:37Neil deGrasse Tyson?

  Do they pass that?

• 39:38Chuck Nice?

  The gene?

• 39:39Neil deGrasse Tyson?

  The edited gene?

• 39:41Speaker 02

  Couple of ways to answer that. So it depends on at what stage they've, if they've already had kids, then obviously they're going to pass on that same defective gene, right? Um, if it was done before, uh, early on, then at that point, if the gene is repaired, they'll just pass on the healthy gene. So.

• 39:59Chuck Nice?

  Oh, man. Well, we need to make gene therapy the order of the day for everything.

• 40:03Neil deGrasse Tyson?

  Everything, everything.

• 40:05Speaker 02

  It's damn expensive, Chuck, that we need a lot more research in it. Again, the field of oncology is really on top of this and other, uh, other areas. Cardiology, surprisingly, not as much. But that said, uh, there's so much research behind cardiology because it's the leading cause of death. So I think there's going to be exciting stuff coming out.

• 40:23Chuck Nice?

  So now I've, you know, um, I've seen where there are doctors that say certain medications, they use the genes to your genetic makeup to tailor certain medications to your disease. Is, is that part of gene therapy or is that just a treatment option?

• 40:44Speaker 02

  Yeah. You guys are familiar with like, um, what is it? Uh, ancestry and what's that? The one, two, three, the, uh, something 23andMe?

• 40:52Chuck Nice?

  23andMe, yeah.

• 40:53Speaker 02

  Let me just say that the true medical opinion where that's concerned, um, first of all, really don't go by those, those tests. I mean, don't, don't use that to make medical decision making. Doctors, cyber specialists, we don't really utilize that. If you are, it depends on the patient, Chuck. It depends on the, on their history and what the actual clinical indication is. We'll do appropriate genetic testing, like say for colon cancer, you know, um, Chadwick Boseman died in his 40s, which is really young to die of colon cancer. But if you have a strong family history, then yeah, or BRCA, um, you know, if you have a strong family history of like ovarian breast cancers, then yes, that will prompt us to test you for these genes. I gotta tell you.

• 41:34Neil deGrasse Tyson?

  Angelina Jolie had the BRCA gene, is that correct?

• 41:37Speaker 02

  That's exactly right, which prompted her.

• 41:39Neil deGrasse Tyson?

  She preemptively had the double mastectomy.

• 41:41Speaker 02

  Prompted her to exactly. Uh, proactively get the uh, prophylactically get the uh, double mastectomy. Because she knew based on genetic testing that she was at very high risk. Remember, her mother died of, shoot, it was either ovarian or breast cancer. So she, so, so, but I gotta tell you Chuck, genetic testing is very expensive A and B. It's mostly still unavailable. So that's why we don't, it's not like for high blood, you know, get screened for high blood pressure. That's a very simple and cheap screening technique. We just don't have that really for most conditions.

• 42:15Gary O'Reilly?

  But doctor, we're dealing with the number one killer. I mean, if this, if this number one killer were an individual, a person of interest, there'd be a manhunt and then some, right? So are we talking about financing? Are we talking about research dollars here? Because if it, we understand that the need, the need to, for it to go into oncology is most definitely there. But surely if it's number one, and it's been number one for some time now, surely this has to be dollars well spent.

• 42:43Speaker 02

  Yeah, so let me tell you, I'm really glad you brought that up. And this is where I'm gonna, I'm, I might get a little angry and frustrated with the system.

• 42:50Gary O'Reilly?

  Okay, not with you though.

• 42:51Speaker 02

  Okay.

• 42:52Neil deGrasse Tyson?

  We're getting angry.

• 42:53Speaker 02

  I'm getting anger management right now.

• 42:56Neil deGrasse Tyson?

  Chuck is the anger manager.

• 42:59Speaker 02

  We're gonna do a whole show just on anger management, man, jeez. Um, no, but my frustration lies in, to your point Gary, yes, it still remains the leading cause of death uh, in this country and globally. But here's the thing, we know how to fix it. We know how to prevent it. We don't need more research Gary, in this particular area. We know it's just not happening. And why, I'll, I'll focus on the United States. Because in this country, we don't invest in prevention. We don't invest in what we already know. We don't help the, the communities that are real, that are marginalized, that are at most risk. We are targeting those people, those communities. We aren't telling them, hey, if you just do X, Y, and Z,

• 43:44Speaker 02

  and this is how we're gonna help you do it, you're gonna live a longer and healthier life. That's where the focus needs to be.

• 43:50Neil deGrasse Tyson?

  Okay, so there needs to be a preventive care profit structure. I disagree.

• 43:55Speaker 02

  Go ahead Neil, bring it on.

• 43:57Chuck Nice?

  Oh.

• 44:01Gary O'Reilly?

  Put them up. Put them up.

• 44:03Chuck Nice?

  Okay.

• 44:03Neil deGrasse Tyson?

  I think in the future, you should be able to, I should be able to take a pill or something so that I don't have to change my habits and I still don't get heart disease.

• 44:16Speaker 02

  That's the typical Western approach, right? This country, we want a pill for everything, right?

• 44:22Neil deGrasse Tyson?

  I, I want, I wanna eat all the cholesterol I want.

• 44:26Chuck Nice?

  Yes, right.

• 44:27Neil deGrasse Tyson?

  I wanna sit on a couch. I wanna be overweight and still not die. That's the solution.

• 44:32Speaker 02

  Hey, man.

• 44:33Neil deGrasse Tyson?

  That's how I feel about it.

• 44:34Speaker 02

  Hey, man.

• 44:35Chuck Nice?

  I made a bacon and lard sandwich the other day.

• 44:39Gary O'Reilly?

  And then I went back and made another one.

• 44:41Chuck Nice?

  And then a donut and ice cream for dessert, right? Right?

• 44:44Neil deGrasse Tyson?

  Right, right, on the couch.

• 44:45Speaker 02

  Yeah. Yeah, so there's this idea of, oh, just give me a pill, doc. I, I, you know, I don't, I don't wanna lose weight. I don't wanna eat healthy. Yeah, that's a very Western mentality, right? Just.

• 44:56Neil deGrasse Tyson?

  Yeah, and I'm from the West. Yeah, like there's something wrong with the West.

• 45:01Speaker 02

  And, and guess what? Neil, this is why we're dying. This is why heart disease is killing us. Look, I just came back from Denmark and Poland at the end of summer. I was doing some speaking, some vacation. And let me tell you, they, they, they have, especially in Denmark and in the Nordic nations, they have really healthy outcomes and they live healthier lives. They are active, they live healthy. They also, not coincidentally, have universal healthcare. Um, so, yeah.

• 45:31Chuck Nice?

  All that's good, but they also don't have the most delicious food. So, come on, let's, let's just be honest. Okay? Like, you're not gonna find that, you're not gonna find that same outcome in Italy. Okay? You can go to Poland and Denmark, you're gonna, but, but, yeah.

• 45:47Speaker 02

  Well, but, but.

• 45:48Gary O'Reilly?

  I'm pretty sure they have Italian restaurants in Copenhagen.

• 45:50Speaker 02

  I'm not, I actually dined at Noma, one of the best restaurants in the world. But, but, well.

• 45:56Neil deGrasse Tyson?

  That's in Denmark. Yeah, Chuck doesn't know about that. The number one restaurant in the world right now is Denmark.

• 46:01Chuck Nice?

  Oh, they bought that ranking and yes, I did. They bought that ranking and you know it.

• 46:07Speaker 02

  Because I got invited. I was a pandemic hero. So I was invited by Noma. I was very honored. But what can I tell you, Chuck? You're right. Greece, Italy, they are known for their cuisine, but they are also known for having very active lifestyle and eating healthier ingredients. Their pizza and pasta made with much more healthier ingredients. So look, in the

• 46:28Chuck Nice?

  It's not processed, and you're right. But now, wait a bit. You just sparked this in me. One of the chief proponents of long life is community and friendship. And what you find in those two communities that you just mentioned is tight relationships where people have lifelong companions and friends. What's that do to their heart? Is that part of it?

• 46:54Speaker 02

  Absolutely. I'm so glad you mentioned that. A common essay and motto in my field of, you know, the opposite of addiction isn't sobriety, it's connection. And what have we seen in the last six months or so? U.S. Surgeon General's report, loneliness is the new epidemic. Drug overdoses skyrocketed. This is all connected because social connections have been disrupted. These connections, human beings, the most introverted human being, still needs, craves some type of connection and human interaction. All of this, believe it or not, is still heart healthy because indirectly it'll reduce your stress hormones,

• 47:33Speaker 02

  it'll normalize your blood pressure, your heart rate, which remember are all risk factors for heart disease. So

• 47:40Neil deGrasse Tyson?

  And let's not omit the fact that if you have now a close friend, they'll say, dude, you're not eating healthy.

• 47:48Neil deGrasse Tyson?

  These forces operating back on you.

• 47:50Speaker 02

  Or a friend that's saying, hey Chuck, man, you're getting a little too angry for me, right? So you're mad to say that, right?

• 47:55Neil deGrasse Tyson?

  Yeah, yeah. So Lipi, where can we find you?

• 47:59Speaker 02

  Yeah, great. People can reach me on like Twitter, at Lipi Roy, Instagram and TikTok.

• 48:04Neil deGrasse Tyson?

  Lipi, L-I-P-I, Roy.

• 48:05Speaker 02

  Correct. And then Instagram and TikTok, at Lipi Roy M.D. And I launched my new speaking company, Sitamed, that's S-I-T-A-M-E-D, LLC.com. So reach out anytime.

• 48:17Neil deGrasse Tyson?

  Wow, okay. So you're getting out there then?

• 48:20Speaker 02

  I'm trying, and of course, my YouTube health show, Health, Humor and Harmony.

• 48:25Neil deGrasse Tyson?

  Yes, yes, we heard that. And so, we like the humor part especially.

• 48:30Speaker 02

  Trust me, I know.

• 48:32Neil deGrasse Tyson?

  Delighted to have you back on StarTalk. Thanks for your time and your expertise.

• 48:36Speaker 02

  Thank you, Neil. A pleasure being here.

• 48:39Neil deGrasse Tyson?

  All right, Chuck and Gary, always good to have you guys. Always a pleasure. Thank you, Neil. Pleasure. Thank you, Doctor.

• 48:45Speaker 02

  Thank you.

• 48:46Neil deGrasse Tyson?

  Fielding grass Tyson here, your personal astrophysicist, as always. Keep looking up.