Evidence-based heart health
Understand your numbers, know which test answers which question, and walk into your next appointment prepared.
Get the launch announcement and early access to the tools as they open up.
It started with a number
641
Calcium score
One result, flagged as urgent. Ten cardiologists who didn't agree. A patient who felt perfectly well. The number was an alarm, not a verdict.
The approach
Anatomy
What the artery looks like.
A narrowing on a scan. It's the image that pulls attention toward intervention.
Physiology
What the heart is doing.
Whether the muscle is actually short of blood. You can't see it by looking at the artery alone.
In stable disease without limiting symptoms, intensive medical therapy may provide outcomes comparable to routine stenting. Acute coronary syndromes are different.
Interactive tool
Each level answers a different question. Walk from anatomy (what the artery looks like) toward physiology (what the heart is actually doing).
Use the left and right arrow keys to move between levels when the step list is focused.
Level 1 of 5 · Measures anatomy
Costs and ranges shown are illustrative and vary by region, facility, and insurance.
The ladder is a decision framework, not a checklist. Many patients will not need every step, and symptoms or acute findings may require a faster route to invasive evaluation. The purpose is to show that each test answers a different question, and that no single test tells the whole story.
heartCEO.ai is for informational and educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a qualified physician about your health and before making any medical decision. Seek urgent care for acute symptoms.
The method
Know your ApoB, not just your LDL. LDL-C measures the cholesterol carried inside particles. ApoB estimates how many atherogenic particles are circulating: the number with an opportunity to enter the arterial wall.
Know your Lp(a). It is largely inherited, is not included in most standard lipid panels, and usually changes little with diet or exercise. Most adults need it measured at least once.
Consider a coronary artery calcium score when appropriate. It is a quick, noncontrast CT test that can reveal whether calcified coronary atherosclerosis is already present. It is an alarm, not a complete investigation.
Understand what anatomy can and cannot tell you. A calcium score and CCTA show plaque and narrowing. They do not, by themselves, establish whether the heart muscle is being deprived of blood.
Separate anatomy from physiology. A frightening-looking narrowing and a flow-limiting lesion are related findings, but they are not the same finding. Sometimes both questions must be answered.
Plaque burden and plaque biology both matter. The amount of plaque, what it is made of, and whether it is changing can add information beyond the percentage narrowing reported on a scan.
In stable disease, intervention is not automatically the best first answer. For many stable patients without limiting symptoms or high-risk functional findings, intensive medical therapy may provide outcomes comparable to routine stenting. Acute coronary syndromes are different.
Use AI to prepare, not to prescribe. AI can explain vocabulary, locate studies, compare tests, and help formulate questions. It cannot examine you, validate every source, or replace a qualified clinician.
Take ownership without pretending to be your own cardiologist. The goal is not to overrule expertise. It is to understand the decision well enough to participate in it, ask better questions, and recognise when the evidence is incomplete or conflicting.
A better question
The goal is not to overrule expertise. It is to understand the decision well enough to participate in it. These are questions to raise with your physician, not recommendations.
The distinction the book keeps returning to.
Several of these are absent from a standard panel.
Understanding the decision well enough to participate in it.
heartCEO.ai is for informational and educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a qualified physician about your health and before making any medical decision. Seek urgent care for acute symptoms.
Other stories
Accounts from other patients who navigated their own cardiovascular care. Each is one person's experience, not a recommendation for anyone else.
I met Gaurav through a personal friend early in my own heart journey, and we've kept in touch ever since. His story has stuck with me for the same reason it belongs here: he did almost everything right, and it still nearly wasn't enough.
Gaurav was 49, an avid road cyclist living in the South Bay, working at Google. He felt great. Nothing in his outward profile would have suggested elevated cardiovascular risk.
Read the full story: Gaurav's StoryheartCEO.ai is for informational and educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a qualified physician about your health and before making any medical decision. Seek urgent care for acute symptoms.
Praise
I put stents in for a living, and I still think every cardiologist should read this book. Steve Kaplan didn't reject the cath lab, he did the work most patients never do: he separated anatomy from physiology, chased down the functional data, and walked into every consult prepared enough to change the conversation. The real story here isn't one man's decision to decline a procedure; it's a repeatable process showing what AI, advanced imaging, and an engaged clinician can accomplish together that none of them can alone. Stents save lives in the right patient. This book is about doing the work to find out whether you're that patient before anyone opens the tray.
This is a very valuable, impressively well-researched book. Steve Kaplan takes readers through a genuine deep dive into the pathophysiology of coronary disease and the therapies now available to treat it, material that is both credible and remarkably understandable for a lay audience. I've spent much of my career in cardiovascular medicine thinking about the ethics of intervention, not just whether a device or procedure can help, but what is best for true long-term benefit. Steve applies that same rigor and discipline to his own medical journey. It's a rare and valuable thing: a patient who did the ethical reasoning most of us wish every physician would embrace, and every patient could do.
The future of cardiovascular care has always depended on the marriage of engineering and medicine, better tools, better data, better decisions. This book applies that same principle to the patient's side of the table, showing what happens when a person combines rigorous data, imaging, and AI-assisted reasoning to genuinely understand his own disease. A thoughtful case for where the democratization of data, knowledge and intelligence for personalized decision process is here today.
Foreword
“If anyone's career makes the case for stenting, it is mine. That is precisely why I wanted to write this foreword.”
The book
How AI Made Me CEO of My Heart
A true account of one result flagged as urgent, ten cardiologists who didn't agree, and the disciplined inquiry that made it possible to participate in the decision instead of simply receiving it.
Adventures in writing the book
Short pieces about the experience of writing: where AI helped and where it did not, what the reviewers pushed back on, and what I got wrong the first time.
Newsletter & early access
Get the launch announcement and early access to the tools as they open up.