#405: Heart Attacks Aren’t What You Think | The Plaque LIE That Changes Everything (Cardiology 2.0) With Dr. Sanjay Bhojraj
Today, I’m joined by the deeply thoughtful and refreshingly honest Dr. Sanjay Bhojraj, a self-described “curious cardiologist” who spent decades treating heart attacks in the cath lab — before stepping away to ask a bigger question: Why are we waiting for the crisis instead of preventing it?
In this conversation, we unpack why most heart attacks don’t come from the massive blockages people fear, how chronic stress can be just as dangerous as cholesterol, and why new imaging tools like the CLEERLY scan are rewriting what we know about plaque, risk, and prevention. We also dive into hormone shifts in women, why perimenopause is a cardiovascular blind spot, and how cardiology is quietly becoming the frontline of longevity medicine.
If you’ve ever been told your labs look “fine” — or wondered whether traditional heart testing is actually telling the full story — this episode may completely change how you think about heart health, aging, and prevention.
Learn more from Dr. Sanjay Bhojraj below:
Instagram: @doctorsanjaymd
Website: www.lagunamedicine.com
12-week Metabolic Optimization Program: https://lagunamedicine.com/well12
What We Discuss:
Welcome to Longevity & episode setup … 00:00:00
Dr. Bhojraj’s shift from ER cardiology to prevention … 00:06:30
Why most heart attacks aren’t caused by big blockages … 00:09:15
Stress, nervous system load & heart attack risk … 00:13:10
CIMT explained: what it measures (and what it misses) … 00:26:40
Calcium scores vs CT angiograms … 00:35:45
CLEERLY scan: seeing dangerous soft plaque … 00:38:45
Can plaque actually regress? … 00:41:55
When heart scans make patients less afraid … 00:44:05
When should you test — even without symptoms? … 00:45:50
Why age 45 is a major cardiovascular inflection point … 00:47:10
Hormones, estrogen loss & women’s heart risk … 00:50:10
Why cardiology still misunderstands women … 00:54:30
Small dense LDL, ApoB & oxidized cholesterol … 01:02:00
Why fixing inflammation matters more than numbers … 01:05:50
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