Good Life Project — Future of Medicine: Breakthroughs in Heart Health (Ep. 4)

Date: November 24, 2025
Host: Jonathan Fields
Guest: Dr. Ami Bhatt, Chief Innovation Officer, American College of Cardiology
Theme: The evolving landscape of cardiovascular medicine at the intersection of AI, technology, and patient-centered care.

Episode Overview

This episode of the Good Life Project explores the dramatic changes transforming cardiovascular health and treatment, focusing on how advanced diagnostics, wearables, AI, and digital medicine are reshaping prevention and care for heart disease. Dr. Ami Bhatt, a leader in blending digital tools with real-world clinical insight, joins Jonathan Fields for a deep dive into cutting-edge innovations, health equity, diagnostics, the role of lifestyle and prevention, and what’s on the horizon for accessible, personalized heart health.

Key Discussion Points & Insights

1. Understanding Cardiovascular Health & Disease (04:19–10:09)

• Cardiovascular health: Not just the heart, but all the blood vessels throughout the body are involved. Includes conditions like heart disease, heart failure, arrhythmias, and vascular conditions like stroke.
  • "We're talking about our heart, the blood vessels throughout our body. That includes kind of the brain, arms, legs, abdomen... often we're not just talking about the heart." — Dr. Ami Bhatt [04:37]
• Heart attacks: Explained as the heart muscle losing its blood supply due to blocked coronary arteries. Symptoms can be diverse, including pain, gastrointestinal symptoms, back pain, and often a distinct psychological sensation.
  • “The one shared common feeling by everybody is there is something really wrong. That impending doom feeling... That's that feeling. We say, please listen to it.” — Dr. Ami Bhatt [07:43]
• Stroke linked to cardiovascular health: Vascular health affects the brain as well as the heart.
  • "Same process anywhere in the body, including the brain, that can lead to a stroke." — Dr. Ami Bhatt [06:15]

2. Symptom Recognition, Bias, and Self-Advocacy (10:09–12:24)

• Trust your instincts: Dr. Bhatt urges patients to trust their feelings and seek care if they sense something is wrong.
  • “The most important thing about that is to trust yourself... I'd rather you take yourself seriously.” — Dr. Ami Bhatt [10:09]
• Bias in care: Women and minorities often have symptoms dismissed as anxiety; implicit bias is now a core part of medical education.
  • "A majority of women, including myself... raised their hand and said, yeah, you've been told that it was anxiety." — Dr. Ami Bhatt [10:57]

3. Risk Factors and Prevention (12:24–18:06)

• Key risk factors: LDL ("bad") cholesterol, inflammation, diabetes (hemoglobin A1c is key), high blood pressure, obesity, family history, and now sleep.
  • “When you say direct plaque development... the inflammation, the cholesterol, the tendency of diabetic people... and then your blood pressure. Those are the things that we want you to be aware of.” — Dr. Ami Bhatt [14:51]
• Genetic vs. lifestyle risks: Some cholesterol issues are purely genetic, requiring medication even with a healthy lifestyle.
  • “How much are you not gonna eat? Why not get yourself some medications to help lower that? Because there may be a level at which you just need that help.” — Dr. Ami Bhatt [17:25]

4. Aging and Heart Health (21:55–23:38)

• Role of age: Reaching age 50 with good blood pressure, cholesterol, and glucose control can extend life by up to 14 years.
  • "If you can make it to age 50 with no high blood pressure, diabetes, significant cholesterol, you are likely to live 14 years longer." — Dr. Ami Bhatt [21:57]
• Improvements at any age: Even after 50, getting these factors under control adds years.

5. Diagnostics — Now and Next (25:15–30:55)

• Current tools: BMI, blood pressure, cholesterol, hemoglobin A1c, basic labs—these remain fundamental.
  • “It seems not very attractive to... do the boring things, but in fact doing the boring screening, weight, blood pressure, cholesterol, sugars, that is the best thing you can do.” — Dr. Ami Bhatt [28:03]
• Inflammation markers: CRP, IL-6, and similar tests are being integrated into guidelines to guide preventive action.

6. Wearable Technology and Patient Empowerment (30:40–33:59)

• The promise of wearables: Devices measuring heart rate, variability, sleep, etc., are giving patients agency to monitor and understand their health.
  • “It's our health, so we should be on top of it. We should be our own kind of agents of our own health.” — Dr. Ami Bhatt [30:55]
• Doctor–patient collaboration: Dr. Bhatt advocates making healthcare systems embrace "patient agency" with wearables, not view it as “consumerism.”

7. Expanding Access: Telemedicine & AI-Enabled Care (36:20–46:42)

• Telemedicine's rise: Dr. Bhatt's early work in telehealth was hindered by lack of reimbursement, but now it's vital for reaching underserved areas.
  • “There are areas of our country... that do not have specific versions of care. In this case, cardiovascular care.” — Dr. Ami Bhatt [36:49]
• Community health & AI: Non-doctor caregivers, aided by AI decision support, can triage and escalate care, improving equity.
  • Collaborative intelligence: “The phrase I love is collaborative intelligence. That's what it is. And we can use it at any level.” — Dr. Ami Bhatt [40:51]
  • “AI should not be making any decisions... can you use the AI to get to the right information at the right time to make the best decision?” — Dr. Ami Bhatt [41:19]
• Wearables as a bridge: Insurance companies are starting to send wearable kits to members, incentivizing health engagement.

8. AI in Diagnostics and Workflow (46:57–55:58)

• AI-enabled testing: AI is already in radiology, advancing to novel diagnostics like plaque analysis—from CT scans predicting plaque stability to identifying disease risk in previously “invisible” cases.
  • “Now we have an opportunity to look at the heart using physiology. How likely are you to have a heart attack from one of these blockages?” — Dr. Ami Bhatt [56:30]
  • "AI can tell us things that we wouldn't necessarily be able to confirm with our own eyes because it gets insights from how those numbers, words, graphs, signals come through that we don't see." — Dr. Ami Bhatt [48:13]
• Triage and reassurance: AI not only detects risks but can help reassure healthy patients, reduce unnecessary doctor visits, and improve resource use.
• AI for documentation: Tools that transcribe visits enhance doctor–patient connection, returning attention to the patient instead of the computer.
  • “That's what we want. We miss that. ... looking people in the eye... that's not great. That's not what you went into medicine to do.” — Dr. Ami Bhatt [54:30]

9. Breakthrough and Future Technologies (55:58–64:50)

• Breakthrough diagnostics: Plaque analysis via AI-enhanced CT (non-invasive) now goes beyond anatomy to assess risk of rupture—even for seemingly minor blockages.
  • “Plaque analysis is what people are looking for... It's going to be game changing because now... you're finding heart disease earlier and then you're following it to know that you've made it better with your meds.” — Dr. Ami Bhatt [56:30]
• GLP-1 drugs: Besides aiding weight and blood sugar, these drugs show real promise for improving heart health, though they require thoughtful, individualized prescribing.
  • “There are clearly significant benefits... I think it's a good drug. I think it's important in the people for whom guidelines say you should use it.” — Dr. Ami Bhatt [59:31]
• Looking ahead: AI for personal risk prioritization: Dr. Bhatt envisions AI models that, in 5–15 years, will tell you which of your personal risk factors most threaten your health or quality of life, helping prioritize interventions and improve outcomes.
  • “What AI could do is tell me, hey, Ami, for you, your diabetes is most likely to affect your mortality compared to this, that, and the other thing. But, Jonathan, for you, we're going to see that this other thing is most likely.” — Dr. Ami Bhatt [62:01]

Notable Quotes & Memorable Moments

• On the universal sensation of a heart attack:
  “The one shared common feeling by everybody is there is something really wrong. That impending doom feeling... Please listen to it, because you're about to have a real problem.”
  — Dr. Ami Bhatt [07:43]

• On bias and advocacy:
  “How many people here have gone in with a real symptom and been told that you had anxiety? ... a majority of women, including myself, ... raised their hand.”
  — Dr. Ami Bhatt [10:57]

• On the transformative potential of AI and collaborative intelligence:
  “The phrase I love is collaborative intelligence... can you use AI to get to the right information at the right time to make the best decision?”
  — Dr. Ami Bhatt [40:51, 41:19]

• On wearables and patient agency:
  “It's our health, so we should be on top of it. ... We should be our own kind of agents of our own health.”
  — Dr. Ami Bhatt [30:55]

• On breakthroughs in plaque analysis:
  “Now... you can affect that by using certain medications, change the things that you do, pay attention to it... That exists... It's going to be game changing.”
  — Dr. Ami Bhatt [56:30]

• On the future of personalized AI in medicine:
  “AI could tell me... for you, your diabetes is most likely to affect your mortality... But, Jonathan, for you, we're going to see that this other thing is most likely. So ideally, you are going to prioritize the treatment of this disease over that one.”
  — Dr. Ami Bhatt [62:01]

Timeline of Important Segments

| Timestamp | Segment | |------------|--------------------------------------------------------------------| | 04:19 | What is cardiovascular health/disease really about | | 06:15 | How strokes relate to cardiovascular health | | 07:43 | Recognizing heart attack symptoms and the role of intuition | | 10:09 | Medical bias, self-advocacy, and the importance of trust | | 12:24 | Key risk factors—cholesterol, inflammation, diabetes, blood pressure| | 21:57 | Impact of age on heart health and longevity | | 25:15 | Basics of diagnostics and how often to check them | | 30:40 | Wearables and the “agency” of health data for patients | | 36:49 | Telemedicine, healthcare deserts, and digital monitoring | | 40:51–41:19| The power and philosophy of collaborative intelligence and AI | | 46:42 | AI-enabled clinicians and equipping caregivers with AI tools | | 48:13 | How AI is transforming radiology, diagnosis, and early warning | | 54:30 | How AI note-taking is restoring the patient-doctor relationship | | 56:30 | Breakthroughs in AI-based plaque analysis and predictive screening | | 59:31 | The role (and caution) of GLP-1 drugs in heart health | | 62:01 | Dr. Bhatt's vision: personalized risk profiling via AI | | 64:50 | Closing remarks |

Tone and Atmosphere

Warm, accessible, and practical—a conversation grounded in clinical experience, advocating for patient empowerment, health equity, and thoughtful use of technology, while always returning to the fundamental importance of the doctor-patient relationship.

Summary for the Uninitiated

This episode is a must-listen for anyone interested in how new tools—AI, wearables, advanced diagnostics—are revolutionizing heart health and what it means for patients, communities, and clinicians. Dr. Bhatt provides not just visionary glimpses of where medicine is going but also practical, evidence-backed advice for individuals wanting to be proactive about their own cardiovascular wellbeing. Underneath it all is a powerful case for agency, equity, and the irreplaceable human side of healthcare.