In this Q&A session, Dr. Lily Johnston dives into complex viewer questions regarding cardiovascular health and emerging medical research. She covers the impact of hormone therapies on LP(a), the nuances of managing cholesterol after a heart attack, and how to interpret advanced imaging like CIMT and Calcium Scores.

The episode concludes with a fascinating look at a novel, experimental microsurgical approach for Alzheimer’s disease being studied in China, which aims to improve the brain's waste clearance through lymphatic connections. Dr. Lily breaks down the mechanistic rationale, the early clinical data, and the significant physiological and ethical concerns surrounding this "brain plumbing" surgery.

Timestamps
00:00 – Intro: Meet Dr. Lily Johnston, Vascular Surgeon & Cardiometabolic Specialist.
00:16 – Q&A 1: Can hormone replacement therapy (HRT) or testosterone reduce LP(a)?
02:53 – Q&A 2: Recovery after a STEMI—Statins vs. PCSK9 inhibitors and the role of Colchicine.
06:49 – Q&A 3: How to distinguish between stable and inflamed plaque using CIMT tests.
09:34 – Q&A 4: High Calcium Score (CAC) vs. CIMT results—Is a heart cath or CT angiogram next?
12:39 – Q&A 5: Does starting Menopausal Hormone Therapy (MHT) late increase cardiac risk?
16:48 – Addressing the "Omega minus-3" nomenclature (A quick biochemistry deep dive).
17:53 – Q&A 6: Does taking Phosphatidylcholine improve fish oil absorption?
19:02 – Q&A 7: Krill oil vs. traditional fish oil.
20:47 – Deep Dive: Deep Cervical Lymphovenous Anastomosis—A surgical treatment for Alzheimer's?
25:40 – Reviewing clinical evidence and controversies of Alzheimer's surgery.

Sign up for more information on my own practice here: https://corsighthealth.com/

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🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

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