Home Interviews Exclusive Interview With One Of The Top Cardiologists In The U.S.: Dr. Manshadi MD
Exclusive Interview With One Of The Top Cardiologists In The U.S.: Dr. Manshadi MD PDF Print E-mail
Written by Patricia Turnier   
Friday, 07 September 2012 16:06

Dr. Ramin Manshadi, MD, FACC, FSCAI, FAHA, FACP is an Interventional Cardiologist who treats patients from prevention to intervention. He is a CMA (California Medical Association) member since 2001. He is a Board-Certified physician with the American Board of Interventional Cardiology, American Board of Cardiology. He combines private practice with Academic Medicine. Presently, he serves as Associate Clinical Professor at UC Davis Medical Center and as Clinical Professor at University of the Pacific among other positions. In addition, he is the Chair of Media Relations for American College of Cardiology, California Chapter.

The multi-faceted physician is licensed and certified in nuclear medicine, a subspecialty of radiology. In this regard, he is a member of the American Board of Nuclear Cardiology.

It is noteworthy to mention that in his practice, he likes to use innovative tests. For instance, he was the first cardiologist in Stockton to offer MTWA (Microvolt T-wave alternans) and one of the first to provide CVP (Cardiovascular profiling). The MTWA test helps identify the risk of life-threatening heart rhythm problems that can lead to sudden cardiac death. CVP is used to assess a patient’s cardiovascular health, and determines their risk for blockages in the arteries and/or heart attack. In addition, Dr. Manshadi is known to offer state-of-the-art interventional procedures that are excellent alternatives to open-heart surgery and carotid artery surgery, which are long-proven and highly successful.  The competencies of Dr. Manshadi in his intervention include cardiac catheterization, coronary artery stenting, renal artery stenting, iliac stenting, drug-eluting stents, balloon angioplasty, pacemaker implantation and defibrillator implantation. Dr. Manshadi performs interventional procedures — the majority of which are done on an outpatient basis — at St. Joseph’s Hospital and Dameron Hospital.

The physician is also known for his expertise in athletic heart evaluation.  He has provided outstanding care to more than 10,000 patients in and around Stockton. Dr. Manshadi intends to continue researching the latest advances in cardiology in order to provide the highest level of care possible.

Dr. Manshadi is open to the world. He speaks several languages: English, Spanish & Persian. Being multilingual is definitely a great asset for his practice. Moreover, he has a website http://www.drmanshadi.com/ which gives an innovative worldwide platform to share his expertise. The internauts can also connect with him via social media such as Facebook and Twitter. In addition, Dr. Manshadi has his blog and he is on LinkedIn.

Heart disease, also known as cardiovascular disease, is the leading cause of death in the U.S., accounting for more than 900,000 deaths per year1. Heart disease includes coronary heart disease (heart attack or angina), congestive heart failure, stroke and high blood pressure. Dr. Manshadi has written The Wisdom of Heart Health: Attaining a Healthy and Robust Heart in Today’s Modern World. The physician uses his expertise in his book to educate all interested in improving their health. Prominent people have endorsed Dr. Manshadi’s book, such as Dr. Brindis, the President of American College of Cardiology; Dr. Wiley, the President and CEO of St. Joseph’s Medical Center, and others. The book comprises a wide range of important topics related to heart health. The Wisdom of the Heart Health is a guide and an eye opener which provides thorough information about heart functions and the best ways to take care of it. Thus, the book covers important themes, such as congestive heart failure, cholesterol, females and heart disease (the overmuch mortality of females due to cardiac arrest became a feminist cause endorsed by the singer Barbara Streisand), the different myths about heart health, the signs and symptoms of a sick heart, the strong connection between diabetes, gum disease, arthritis and heart health, etc. This health book penned for the public is structured in 46 short chapters that comprise different topics (aforementioned) in heart health from women and heart disease to the effect of stress and the maladies of the heart. It must be emphasized that Dr. Manshadi is a man of action and not just a man of words. He has generously pledged proceeds from his book to help purchase automated external defibrillators (AEDs) for placement in schools throughout California. This project is a partnership with St. Joseph’s Hospital. If he creates other alliances in the future, he hopes to implement this project nationwide in every school.

Incidentally, I am an avid reader, and when I had The Wisdom of Heart Health in my hands it is seldom that I observed such reactions (compared to other books that I read) from several individuals: I saw strangers looking at the book with a smile. It is as though they could feel Dr. Mashandi’s genuine empathy for his patients and they sense that this physician truly cares to share his expertise with the public.

To summarize, The Wisdom of Heart Health is an important book. What makes the book unique is the thoroughly researched chapter regarding the heart pathologies among females. Wrongly thought of as a man’s issue, heart disease is just as common in women and deadlier. What is also interesting in the book is the fact it covers many subjects which can affect health, such as stress in several areas of life (conflicts in couples, work, the speed of modern life with all the new technologies, etc.) and advice on how to diminish them. Hence, it goes beyond the medical field and Dr. Manshadi uses a bio-psychosocial approach.

Throughout his career, Dr. Manshadi has received numerous awards from reputable organizations, including Consumers Research, which classed him among America’s Top Doctors. In 2007, he was voted “America’s Top Interventional Cardiologist” by Castle Connelly, Ltd. For 2006-2007 he was named “America’s Top Cardiologist” by the Consumers Research Council, and in 2008 “Future leader Award” by the American College of Cardiology. Furthermore, Dr. Manshadi became the first recipient of the San Joaquin Medical Society’s Young Physician of the Year Award in June 2010, and last year he was named “2011 Top Cardiologist” by U.S. News & World Report. Dr. Manshadi has also been interviewed by the media including Fox News.

On a more personal level, when he isn’t at the office, Dr. Manshadi enjoys spending quality time with his wife and their three children. The physician stays active by doing sports with his kids. Moreover, he enjoys playing golf and tennis. He also swims.

Mega Diversities had the pleasure to speak to Dr. Manshadi last spring.

[The Wisdom of Heart Health is part of our Top 20 Books for Summer 2012: http://megadiversities.com/index.php?option=com_content]


P.T. In your book, we learn that when your mother was about to deliver you, she had complications. Can you share with our readers the lovely story about what she asked God if he would answer her prayers regarding your safety?

Dr. M. My mother was born in Russia. She later lived in Iran and Paris. She married my father and ended up with him in Israel. Before me, she had multiple miscarriages. When she was pregnant with me, on several occasions the doctors recommended that she aborts because she bled significantly. At that time, she prayed. Our religion is Bahai. While looking at the temple nearby, she asked God that if He allows her to have a pregnancy which will go to term and have a healthy baby, she will make sure that her child becomes a philanthropist and a humanitarian doctor. This way, he will give back to the community by saving lives. This story remained with me throughout my childhood life and actually my entire life. It definitely shaped me and influenced me for the profession I chose later.

P.T. Besides the story related to your mother, what inspired you to become a physician and later a cardiologist?

Dr. M. I never considered other professions throughout my life. All professions are important, but in my book, I feel that the most humanitarian professions are in education, farming and medicine. I truly believe that almost everything which happens in life occurs for a reason. Pretty much everything is meant to be, and God allows us to make choices. On many occasions, if you try to do what is best for yourself, your neighbors and humanity, good things will happen to you. This is my philosophy of life and the model I try to follow. Another significant event happened in my life during my childhood. It was the death of my grandfather when I was 4-years-old. Everything related to life and death stayed with me. I grasped the importance of doing my best for people to survive and live healthy. Later on, I was precocious and finished high school when I was 16. 

P.T. Likewise, and if my parents allowed me to skip another grade, I would have finished when I was 15.

Dr. M. This is very interesting! When I was 16, I was very enthusiastic because I did research with a cardiologist, Dr. Amsterdam, who was passionate about his work. I truly enjoyed everything he taught me about the physiology of the cardiac system. He remained my mentor till today, and he still is practicing in his seventies. This great experience definitely influenced me to embrace a career in cardiology.

I made the decision to make a career in medicine, specifically interventional cardiology, because it involves helping patients to live longer and have healthier lives, which is very rewarding to me. I also enjoy the wide variety of ways I get to care for patients — everything from preventive measures and diagnostic testing to the latest interventional procedures. For me, it is important to be available for young people who want to espouse my specialty. A good mentor is always important for whatever profession you are in. I mentored several young people and it is definitely something that I want to continue doing.

P.T. In the past 40 years, childhood obesity has doubled for kids 6-12 and type 2 diabetes (which normally occurs in adulthood) among children in the U.S. is rapidly rising. There are American Studies which predict that for the first time in history the next generations will not live as long as their parents if this trend continues. What needs to be done to correct this situation?

Dr. M. I think we are on the right track. Laws and regulations are required. People need to be more educated about good nutrition. Children need to exercise more. The population has become more sedentary. Many people spend hours in front of the television or the computer. Children need to play more outside and do sports, such as soccer and swimming. It is very important for kids to stay active physically. Among my patients, the ones who have healthy habits are the ones who recover better. Recently, I met Dr. Oz. He has a Core Health Program. The main idea is to educate high school students about diet and exercise. They are making a curriculum. It has been quite successful. Thirty high schools in the U.S. are using it, and there plans to implement it in other schools. So, there are physicians involved in educating the youth about diet and exercise.

Personally, I coach my kids on their soccer teams because it allows us to exercise while doing a sport we all enjoy. It is important to be a role model to your children. They pay more attention to what you do than what you say. So, they see me exercise and eat well. I believe that education is the number one avenue, and people have to be encouraged to exercise.


Dr. Manshadi presented the Future Leader Award for American College of Cardiology, California Chapter with Dr. Gordon Fung (president ACC California) and Dr. Jim Dove (immediate past president ACC National)

P.T. On your official website, there is a video where you talk about SCD (sudden cardiac death) among children. Can you elaborate on that? In addition, inform us about the main juvenile heart problems (the prevalence…) and tell us how they can be prevented.

Dr. M. Thank you for mentioning this because it is quite an important issue. SCD occurs often among athletes2. This cause is very dear to me. When I was younger, I was an athlete. Staying active, helped me avoid trouble and not getting involved with gangs. AEDs (automated external defibrillators) are important for young children. There are young athletes who get sudden cardiac arrests on the field. They have undetected cardiac conditions. Suddenly, it happens when they pass out and if we don’t give them assistance immediately, they can die. One way to prevent this is by using an AED which provides 90% of survivals. If a high school doesn’t have one, the chance of survival will be 5% even if you call 911.

P.T. It would be too late.

Dr. M. Exactly. Time is critical. So high schools should have at least one AED with a staff that knows how to use it. AED is a very important machine to have. In addition, physicians need to know how to conduct the particular exams to detect the conditions aforementioned in children with EKGs, I mean the electrocardiograms. It is a painless test that records the heart's electrical activity. This exam can help reduce the incidence of sudden death among athletes. This condition happens more often when people get older. The sudden cardiac death of a child or adolescent accounts for about 100 deaths per year in America. Statistics demonstrate that 90% of these sudden deaths occur immediately post training or competition: football and basketball have the highest incidence.

More specifically, the prevalence among young people is lower. Sudden cardiac death represents 19% of sudden deaths in children between 1 and 13 years of age and 30% between 14 and 21 years of age. Actually, the most incidences of SCD happen between birth and 6 months of age because of the sudden infant death syndrome, and between 45 and 75 years of age as a consequence of coronary artery disease. This is quite tragic because it is preventable especially for young people who are supposed to be best in shape.

There are different conditions which can cause SCD among young people. The most common etiology in the U.S. is due to hypertrophic obstructive cardiomyopathy. When some children become teenagers there is a muscle within the heart which overgrowths and can lead to arrhythmia or chaotic heart beatings. This condition can make people pass out.

In 2007, the American Heart Association created guidelines to evaluate athletes who may be at risk for sudden cardiac death. A deep history, a physical exam with a competent questionnaire are a prerequisite. The history that should be taken into account on any athlete who is being screened for sports participation needs to include a medical history of any unexplained or sudden death in a family member.

After a good history is taken and updated annually, it has to be assessed. In addition, the child/adolescent requires a complete and thorough physical exam. This test should include blood pressure measurements and a deep cardiac exam. Heart abnormalities or potential SCD triggers can be detected through a physical examination that would include a standardized medical history (anamnesis) questionnaire and aforementioned an electrocardiogram (EKG) administered by a cardiologist or internist. An EKG records the electrical activity of the heart over time. An abnormal reading could signal a problem that would require follow-up.  Researches demonstrate that about half of pediatric patients who succumb to sudden cardiac arrest had experienced a warning sign. There are about 20 causes for SCD, with the most common conditions being hypertrophic cardiomyopathy and anomalous coronary artery.

To summarize, whether SCD is prevalent or not among the youth, I believe this condition should be minimized with thoroughn preparticipation screenings, especially among high school and college athletes, whose heart related problems tend to be structural defects and not related to cardiac disease in most cases. For prevention, I think that an automatic external defibrillator and a trained responder should be present at all athletic events. No such mandate exists at the high school or collegiate level. According to the California Interscholastic Federation, the state's governing body for high school athletics, requires student-athletes to pass a physical exam each calendar year given by their family or high school doctor.

P.T. You have the project to give defibrillators to 90% of high schools in California. Tell us more about your AED (automated external defibrillators) program and share with us how it is evolving. Furthermore, in the future are you looking for alliances which will allow you to implement your project nationwide?

Dr. M. I have been working very hard since the past two years to raise awareness about the importance of getting AEDs in high schools to prevent SCDs among young athletes. With the economy going down, institutions won’t put emphasis on this, so it doesn’t make my activism easier. Initially, I made alliances with local hospitals. I have been successful with the local high schools. I think if laws are passed to make it mandatory to implement AEDs in high and middle schools, it will have a powerful impact. Another avenue is like what you said, making alliances with other companies. I am talking to some to see how we can get more money to put additional AEDs in high schools. In addition, as they say the media is the fourth power which allows us to reach the masses, raise awareness and attain the people who are interested in the cause.

With my book and a partnership with St. Joseph’s Hospital, I will use some percentage of the proceeds to purchase more AEDs for high schools, especially throughout California. It is a great feeling to give back to the community. All the donations we receive are tax deductible. Placing AEDs in schools can significantly reduce the chance of dying from sudden cardiac death. My goal is to place AEDs in at least 90% of high schools in California within 3 years. Given that the educational system is going through tough times and cannot afford to do this, I am utilizing various avenues to raise awareness and funds to be able to make this a reality.

I originally thought of this project after I noted in the past that there were two SCDs within a month in the Sacramento High Schools. This along with the push at the time from American College of Cardiology president's message for "The year of the Patient, " led to a very successful dinner symposium with elite athletes, high school through university representatives, and the media. The critics raised a question as to how I will be able to raise the money to do this. Because of this challenge, I have taken upon myself to make this happen. In collaboration with Dameron Hospital and Saint Jude Medical, I was able to donate 8 AEDs to the local high schools. And as I said, in the future I intend to implement it in many other schools with the funds we receive.




P.T. Obesity, heart disease and diabetes are three pathologies which affect Blacks more. Obesity, diabetes, high blood pressure (another condition where many Blacks are prone to) can all lead to heart diseases. Furthermore, The American Heart Association stated that the chances of stroke tripled among diabetics treated for more than 10 years. Since 1973, 2,266,789 deaths occurred in Black America related to heart problems according to the U.S. Center for Disease Control. It is a major health concern. What can be done to decrease these numbers? Since the prevalence is higher for Black women what advice do you have for them?

Dr. M. In general, it goes back to education. There are some genetic variations to consider. Regardless of race, the number 1 cause of death is related to cardiac disease in North America. With research, education, better medication and technologies, the American Cardiology has been able to observe a reduction of 30% of pathologies related to heart problems for the past ten years. Women in general are quite difficult to diagnose and treat. As you know, African-American females have high risks with other conditions such as hypertension. The diet is important; they can’t eat salty food. They have a tendency to be salt sensitive so they have to be careful. They need to maintain their ideal body weight. The right medication is imperative also to lower the blood pressure. In addition, diabetic people need to be careful with their weight and diet because it is susceptible to affect the cardiac system in the long run. I truly feel that the best intervention is prevention with routine exercises. If people reduce their body weight by at least 10% to get to their ideal weight, it can reduce significantly hypertension, stroke and heart attacks.

As you and I mentioned, there is definitely an interconnection between obesity, diabetes and hypertension because I see more and more younger people in my office with these conditions. 90% of these young patients are extremely obese. It goes back again to the lack of proper education and sedentariness. Moreover, it would be important to pass laws to forbid middle schools and high schools to sell drinks with high sugar content which can cause obesity such as sodas. There are legislations for this issue and we need to see more of it. It has to be implemented nationwide. This would be a positive step to reduce the prevalence of these pathologies.

More specifically about Black America, studies have documented that Blacks are treated less aggressively than Whites for heart problems. This issue has been stated by Dr. James McPherson, medical director of the Los Angeles Cardiovascular and Thoracic Surgery Group and a spokesman for the American Heart Association. This spokesman also said that Blacks are less likely to have health insurance, so they are apt to be treated later in the course of heart disease3. So, a better accessibility for Black Americans to health care might occur in the future with our American health system which is transforming, and it will allow a decrease of the prevalence for these citizens.

P.T. Studies show that heart disease often looks different in women, making it more difficult to diagnose. What advice do you have for females regarding this issue? Also, what are the risk factors and the symptoms to recognize?

Dr. M. This is a highly important topic because we tend to not listen to women as much because there is a misconception that they are less subjected to suffer from heart attacks compared to men. The reality is when they suffer from heart attack they will die more than men. The reason is when we are at the stage to diagnose them after taking their comments more seriously the pathology is already advanced. I am going to talk about the symptoms first. They are quite different than men. The classic symptom for men is when they are walking or running for instance they will feel chest pressure and tightness in the jaw, after it goes away most of the time. Usually at that stage there is a significant blockage of arteries around the heart. On the other hand, women can have no chest pain but they will have a significant sweating or sudden fatigue. This condition can be a sign of heart attack or an important blockage of arteries. They might have pain in the upper back, shoulders or arms and not necessarily in their chest. Women need to know their risk factors (if they are diabetic, have high cholesterol, etc.), their family history, a stressful job situation and so on. In these types of situations, you need more regular check-ups and earlier. Don’t wait till you are past 50, seeing that females generally are 10 years behind because of their hormones which protect them from heart disease before menopause. Women have hormones’ releases when they are pregnant, etc. Later in life, the hormone imbalances can lead to heart problems. Furthermore, anatomically their blockages are quite different than men. When we make the tests, we find out in women that the plaque is not just in one area; contrary to men, it is spread throughout the artery.

In summary, the discrepancies between genders in connection to heart disease are found in these main components:

-Microvascular Dysfunction
-Plaque Erosion
-Abnormal Coronary Reactivity
-Higher Cholesterol
-Calcium Scores
-CIMT Results (CIMT measures the thickening of the inside lining of the neck’s carotid artery that goes to the brain)
-Response to Emotional Distress
-Likelihood of Obesity: The obesity epidemic in this country appears to be striking women more than men. Two-thirds of the female population is obese. Obesity is a risk factor for developing heart disease (as well as diabetes).
-Vitamin D Deficiency: a recent study points to vitamin D deficiency in younger women possibly elevating risks of high blood pressure in mid-life. The pre-menopausal women in the study with this vitamin deficiency were three times more likely to have systolic hypertension (in other words, high blood pressure within the arteries when the heart muscle is contracting) 15 years later, when contrasted to others with normal vitamin D levels.

Furthermore, there are circumstances linked to heart problems that are unique to women. A recent study (conducted last year by The European Prospective Investigation into Cancer and Nutrition (EPIC)) showed that the risk of a heart attack for a woman who’s had at least one stillbirth was 3.5 times higher than for women who’d had none. Those who have experienced more than three spontaneous miscarriages had a five-fold increase in their likelihood of having a heart attack.

The myth that women are somehow more immune to coronary disease than men is fading. Females need to be just as conscientious about their health habits as men, and similarly consult with a cardiologist when necessary. As discussed, their warning signs can be more diverse than the classic indicators, which mean that in some cases, females may proactively need to “educate” their own doctors to current information.

Heart Disease is the number one killer of women. Recognizing symptoms and risks, making lifestyle changes and getting timely care can save a woman's life. Females’ symptoms, especially those that are milder, often go ignored. Women often miss out on critical opportunities to save their own lives. So, it is imperative to be aware of the warning signs by continuously educating themselves.

P.T. In France, one woman out of three dies from heart disease, likewise in the U.S. In your book, you wrote that more women die from coronary disease in the U.S. than men. 52% of females compared to 42% of males die from sudden cardiac attack. You added that one of the main reasons is the fact that women tend to seek out cardiology doctors less frequently than men. You also noted that many physicians are not as proactive in treating females’ cardiac problems as much as men’s. Studies show that females are subjected to less complementary tests and less fast treatments such as thrombolysis and angioplasty. How do you explain this situation? What needs to be done to decrease gender disparities?

Dr. M. We talked a little bit about some of the issues that you raised previously. The whole idea is the fact that women tend not to have the classical symptoms. The sweating for instance can be perceived as fatigue by women. When they go and see the physicians, often they will run a typical blood test without further testing because they don’t suspect the possibility of a heart attack. Again, education is the key and we will be one step ahead. Women and general practitioners need to know how the symptoms are presented differently among females compared to males regarding cardiac problems. The physicians need to have a more proactive approach by checking cholesterols and so on at a younger age among women and treat them more aggressively with diligence.

Different tests are required for female patients such as:

Treadmill stress test — It measures your body’s reaction to physical activity in a safe and controlled environment. It indirectly assesses the presence of coronary disease.
Electrocardiogram (ECG or EKG) — It monitors electrical activity of the heart, picking up potentially dangerous abnormalities.
Echocardiogram — It is an ultrasound test that can identify problems of the heart valves and muscle function.
Carotid ultrasound — It assesses carotid stresses and prevention of stroke. The carotid is one of the two principal arteries (one on each side of the neck) which convey the blood from the aorta to the head.
Ankle-brachial index test (ABI) — It measures blood pressure at the ankle and in the arm to predict peripheral artery disease (PAD).
CTA is a simple, non-invasive test that is highly effective at evaluating the health and function of blood vessels.
Framingham Risk Assessment: It is designed to determine if the patient is at low or high risk for developing heart disease or attacks in the future)

The Reynolds Risk Score is male/female specific, and considers the following variables such as:

• age
• gender
• systolic blood pressure
• Total Cholesterol
• Hemoglobin A1C (a marker for diabetes)
• smoking
• family history

Nuclear stress tests can detect inadequate blood flow to your heart muscle at rest and during stress.

These exams help to determine the most appropriate intervention(s) required.

To finish, here are some preventive measures that I recommend for females:

A proactive approach to good heart health includes annual physicals, maintaining a healthy diet and exercise by choosing a physical activity they enjoy. It is important to get regular cholesterol and blood pressure checks and to take your medications as directed by your physician. In addition, they need to maintain a healthy weight for their body type so their heart doesn’t have to work as hard. If you’re diabetic, properly manage your blood sugar levels. If you have episodes of blacking out or a racing heart, see a doctor as either of these could be a warning sign of heart disease. And if you smoke, do your heart a favor and quit. People have a personal responsibility regarding their health.

P.T. In the third chapter of your book, you mentioned that Britons in the Middle Ages experienced heart disease, but much less than today. You added that English people then tended to eat healthier and more natural food (without chemicals like today). In addition, you wrote that it is after the Industrial Revolution that the rate of heart disease increased. I have Haitian origins and I have been informed that one of my ancestors in Haiti lived until he was 120 years-old. It has been reported that the Haitian who lived the longest was 140 years-old. I would not be surprised if they were agriculturists who cultivated their own food and ate it. There are studies which state that when people grow their own food and eat it they are healthier, and in your book you talk about the long-term benefit of eating natural food. Do you think that in our modern lives (including the creation of new machines which can produce less healthy foods) we have gone backward in terms of not having good health habits (being more sedentary, etc.)? Are we reinventing the wheel by not applying the wisdom and knowledge of our ancestors? In addition, do you think that the American health system focuses enough on prevention?

Dr. M. This is a very interesting issue that you brought up. There are several factors to consider in the increase of heart maladies: the added stress in our fast lifestyles, our eating habits, etc. which all can lead to health issues such as cancer, beside cardiac problems. Moreover, we lost our survival techniques, and most of us don’t grow our own food. We went backward in some ways. Long ago, people didn’t have access to junk food. It is quite true that the modern process to make food available for masses of people have basically reduced the nutrients of foods and the benefits. I really feel that people can be healthier if they eat more natural foods not produced in industrialized environmental toxins; I am referring to rural areas instead of cities. I am for natural food but I am not for people going to health stores and buying natural pills because they are not necessarily FDA approved. In addition, we don’t know all the side effects. In this regard, adopting healthy dietary habits is imperative. As an example, fish is good. People need to be careful with red meat and so on. Walking is a proper and simple exercise: with an hour and a half of exercise per week compared to none, the life expectancy can be raised by almost ten years. My patients who don’t eat properly and are sedentary are the ones who have the most complications with a much shorter life expectancy.

It is noteworthy to mention that cardiologists work on all these bases with the population from prevention to intervention. Throughout the past decade, the American Cardiology Association and the AMA (American Medical Association) worked hard by educating people. Personally, I make preventive care an important part of my practice. To finish, passing laws which forbid, firstly, kids from having access to junk food in schools could be a great start.

P.T. Why was it important for you to write the book and how has it been received so far by the public?

Dr. M. Thank you for asking this question. Heart disease is the leading cause of death in the U.S. for both genders. Every year about 785,000 Americans have a first heart attack. Another 470,000 already had at least one attack. In 2010, heart disease cost my country $316.4 billion. So, with these serious data I thought it was important to share my expertise with the public. With education, it is possible to reduce the prevalence.

Four or five years ago, I noticed that my patients who were more educated responded better to follow through on my advice. In other words, throughout my career, I realized after years of conducting my cardiology practice that my most knowledgeable patients are the ones taking the best care of their bodies. I made research and realized that I could not find a book that I could recommend to my patients which can help them understand their conditions. So, I decided to pen the book. It is my way to give back to the community and I am not looking to make money out of it for myself. I worked diligently to write a book to make it as simple as possible while explaining the complexities of the cardiac diseases. My book was received quite nicely in the scientific realm and beyond. Readers told me that family members borrowed the book and didn’t give them back [Laughs]. The book is doing really well in Northern California because people know me there. Nationwide it is doing OK. It is available in North America and on the Internet. It is really well received in the media such as yours, radio and television. The Wisdom of Heart Health was endorsed by Dr. Brindis, the President of American College of Cardiology, etc. The book industry is very competitive. If more people purchase it, this will allow me to push more my project for purchasing AEDs. Furthermore, it will give to the public the opportunity to educate itself.


Dr. Manshadi collaborating with the Italian Red Cross.

P.T. Since you master other languages, are you thinking in the future to translate your book into Spanish for instance, seeing that over 200 million people in the world speak this tongue?

Dr. M. Yes! In fact, in the U.S. there is a significant number of Hispanic speaking people. Actually, I took French in high school and I focused more on science afterward but learning different languages definitely has been an asset in my career. For instance, when I meet Spanish patients it is such a relief for them when they see that I can communicate with them. Maybe later this year, I will translate The Wisdom of Heart Health into Spanish. I would be happy to put my book at the disposal of the Hispanic community as an educative tool.

P.T. What is your assessment of the current American health system and what changes you wish to see in the future?

Dr. M. I have seen significant changes in my country throughout my medical career in the delivery of health care. There is no perfect health system in any country. My worry is the autonomy of physicians which is being taken away and we are being told how to treat patients. I believe that it would be bad if the government starts to tell us or dictate to us how to take care of patients. Insurance companies dictate physicians’ practices; it is a business. Some companies push prevention. I am definitely for it. However, when we want further tests for patients, we often have to go through so much bureaucracy to get approval, and during that time the condition of the patients worsen.

On the other hand, I know that health is the most important aspect of one’s life so everyone should have access to health care. I am for universal health care. I believe there is money not well spent in our country. For instance, people who are healthy, not working and living at our society’s expense need to be put in the workforce and this money should fund the health system instead.

However, I am afraid that in the future there may be a tendency to not give full care to an elderly for instance, seeing that he/she would be seen as someone who lived his life already (because of our problems with our economy, they would want to conserve money). This would be ageism and a form of eugenic practice. This is an avenue that I would not be happy to see.

I would also hate to see a young child who is sick that we could not treat because the family is not able to afford the care and end up dying. Personally, it happens that I give free care. I used to do more of that, but I had to readapt my practice because of money cuts and changes in medicine. There are other physicians who do pro bono work. We have to find a balance because we also need to feed our own families in the medical field. I think one of the best solutions is to make sure that people are accountable for their health care. Overall, we need to find more balance in our health care system. I just hope with all the pressures which are coming through, it doesn’t affect my field negatively. This situation might make the medical field less attractive to young, bright people, and we will be in trouble when we get older ourselves.

P.T. I guess that you would also like to have more time with patients instead of having to worry about paperwork.

Dr. M. Definitely! It is very important because it takes away time from care. Unfortunately, this issue is becoming more and more time-consuming and it costs greatly to the health care system, over $294.3 billion per year. This money should be spent in treating patients instead.


Dr. Manshadi volunteering in Honduras.

P.T. What advice do you have for young people who want to embrace the medical career and wish to become cardiologists?

Dr. M. I have often given lectures to the graduating classes of my alma mater. Too many people in our society do not have a clear focus of what they want to do and why. They need to thoroughly assess their lives’ goal short-term and long-term. When you make your choice, be focused. There are no easy professions, so make sure that what you chose is what you really love because this is what will keep you motivated and determined, otherwise there is a great chance that you will surrender. When you choose a career it is like a professional marriage, so it is important to make the choice which is right for you. You have to be passionate because this will be the driving force of your goals.

To be in medicine, obviously, you need to be people oriented. If you are in medical school and you get Cs do not listen to people who will tell you that you are not cut out to become a physician. This happened to me. I responded to the person: “Who are you to tell me that I cannot be a doctor just because I got a C?” I was very focused, I had a goal and a vision, and faith in my capabilities. I sticked with all this. You will always meet naysayers and if you listen to them, you give them power to determine your future.

Finding the right mentors is also important when you make a choice of the future career you want to embrace. This process cannot remain an abstract idea. You need to speak and spend time with people who are doing the profession of your choice to be sure that you like it and to have a more concrete idea of what it is. This is what I did since the age of 16 with my mentor, Dr. Amsterdam.

I entered the medical field to give humanitarian services. To become a doctor, your intention has to be pure and you need to really want to help humanity in this domain. You will be successful if you go in there for the right reasons. A physician needs to handle stress efficiently, he/she has to be a team player and must know how to operate well in a multidisciplinary team. Empathy and great communication skills are imperative. You have to be intellectually curious and always update your knowledge to give the best care to your patients. There are many ways to keep yourself informed by going to scientific conventions, etc. It is important to provide innovative testing for the most appropriate care. This is what I do in my practice. To do this, you need to be constantly aware about the evolution of the specialty. The philosopher Aristotle used to say "We are what we repeatedly do. Excellence, therefore, is not an act, but a habit." So again, learning is a lifelong process and it is even more true when you are a physician. Constantly, you need to educate yourself about the new technologies and progress in the medical field. In this regard, to embrace this career you have to be passionate about finding new information which can provide the best treatment for your patients.

To espouse cardiology, you need to have a passion for this specialty. I love to treat patients from prevention till intervention and the cardiology specialty allows us to do that. I see patients before they have heart diseases, but have risks factors such as cholesterol, and I work with them to prevent heart attacks. If they end up having one, within my skills, I do the required surgeries and follow them after to make sure that they recuperate well. I like cardiology because you find the combination of physics and physiology. I work in the office with patients and I do the surgeries in the hospital. I get the best of both worlds. It is quite demanding, but things change dynamically with new research and new technologies. Cardiology is one the most prolific topics in the medical field because it is the number 1 cause of death in our country. I feel that I am contributing, seeing that there is an unfortunate big number of heart pathologies. For me, this specialty is very gratifying and I think it is on these bases that future physicians need to embrace this expertise.

To summarize, it may seem cliché to say this, but you need to really love medicine to enroll in this field. It is a vocation. If you are in there for the money, you will eventually leave because of the amount of time and work that you have to put in. You are there to help the patients. Go to the business industry if you are after the money. It is about truly wanting to help humanity.

In addition, in my field there is the science part and the art part. The difference between an average physician and a great one is about mastering the art over the science, meaning that you have to be able to generalize and visualize the care that the patient needs. You must have the competency to assess the patient in its entirety and know that the genetic makeup in every case is different. I pride myself on delivering innovative, proven solutions with a human touch. I spend the time with my patients to educate them on their condition and their treatment options in simple, easy-to-understand terms. This personalized approach helps make the whole process a positive one for patients and their families. I also enjoy complementing my private practice with academic medicine.

P.T. Thank you Dr. Manshadi for being generous with your time and for sharing your expertise. It was an honor and a privilege to interview you! In addition, I hope that your innovative AED program will be implemented nationwide and that other countries will do the same for the youth.

Dr. M. Thank you for agreeing to speak to me and for promoting this important cause! I really appreciate it so much!



This book is available on www.amazon.com or .ca and www.barnesandnoble.com


“Beautifully written in a readable style … inclusive and extensive. Does not insult the intelligence of the layperson nor talk over their heads in overly-scientific jargon.”
--Ralph G. Brindis, MD, MPH, FACC, FSCAI
President, American College of Cardiology

“It is for everyone who has an interest in the heart from health care providers to the general public. Great book for emphasizing cardiovascular health and not the disease!”
--Alan C Yeung, MD Division Chief, Director Interventional Cardiology Professor, Stanford

“Dr. Manshadi covers a wide range of important topics related to heart health that should be mandatory reading for everyone concerned about cardiovascular disease.”
--Donald J. Wiley, B.S.N. M.P.H., President and CEO, St. Joseph’s Medical Center

Dr. Manshadi in brief:

Board-Certified: American Board of Interventional Cardiology, American Board of Cardiology, American Board of Internal Medicine, American Board of Nuclear Cardiology (Board Eligible)
Fellow: American College of Cardiology, American Society of Angiology and Intervention, American Society of Angiology, American Heart Association
Fellowship: Cardiology, Department of Cardiology, UC Davis Medical Center, Davis, CA
Residency: Internal Medicine, Department of Internal Medicine (UCSF/CPMC Medicine Program), California Pacific Medical Center, San Francisco, CA
MD: University of Health Sciences, The Chicago Medical School, Chicago, IL
Associate Clinical Professor: Department of Cardiology, Ambulatory Care Center, UC Davis Medical Center, Davis, CA
Clinical Professor: School of Pharmacy, University of the Pacific, Stockton, CA
Council: American College of Cardiology, California Chapter Media Relations Chairman
Voted: “America’s Top Interventional Cardiologist, 2007” by Castle Connelly, Ltd.; “America’s Top Cardiologist, 2006-2007” by the Consumers Research Council; “Future Leader Award, 2008” by the American College of Cardiology, among others
Member: Society of Cardiovascular Computed Tomography

The public can find valuable information about health on Dr. Manshadi’s website: www.DrManshadi.com.


U.C. Davis Medical Center
Department of Cardiology
Ambulatory Care Center
Cardiology Fellow, 1997- 2000
California Pacific Medical Center
Department of Internal Medicine (UCSF/CPMC Medicine Program)
Residency 1994-1997
University of Health Sciences/ The Chicago Medical School
M.D. June 1994-1994
University of Health Sciences/ The Chicago Medical School
M.S. Applied Physiology, June 1989-1991
University of California, Davis
B.S. Physiology 1985-1988
CRC 1983-1985
Postbaccalaureate Studies 1988-1989


Cardiovascular Morbidity and Mortality Committee Member, 1995-1997
Teaching Assistant, Clinical Anatomy, Chicago Medical School, 1992
Teaching Assistant, Neuroscience and Biochemistry; Chicago Medical School


American Board of Interventional Cardiology 2003
American Board of Cardiology Re-certified 2011-2021
American Board of Nuclear Cardiology (Board Eligible)
American Board of Internal Medicine 1998, Re-certified 2020


Medical Board of California
Nuclear Medicine


Associate Clinical Professor
U.C. Davis Medical Center, Department of Cardiology
Ambulatory Care Center
4680 Y Street, Suite 2800 Sacramento, CA 95817 2005-Present
Clinical Professor University of Pacific, School of Pharmacy Stockton CA 2000 to Present


Council, American College of Cardiology, California Chapter 2003-2007
Media Relations Chairman, American College of Cardiology 2007-Present
Vice President, San Joaquin Cardiology Medical Group
Board Member, San Joaquin Medical Society
Member, St. Joseph’s Quality Committee 2009-Present
Member, St. Joseph’s Credentialing Committee
Member, ACC California Chapter Government Relations Committee


Stanford Medical Center, Palo Alto, CA
U.C. Davis Medical Center, Sacramento, CA
St. Joseph’s Medical Center, Stockton, CA
Dameron Hospital, Stockton, CA
Lodi Memorial Hospital, Lodi, CA
Sutter Tracy Community Hospital, Tracy, CA


National Register’s Who’s Who in Executives and Professionals
Metropolitan Executive and Professional Registry, 2003
Who’s Who, Honored member Global Directory
Fellow American College of Cardiology
Fellow American Society of Angiology
Fellow American Society of Angiology and Intervention
Fellow American Heart Association
Fellow American College of Physicians
American Medical Association
American Heart Association Speakers Bureau
Community Outreach Program El Corazon
Health for Humanity
American College of Cardiology
American Society of Geriatric Cardiology
American College of Physicians
Associate of Bahai Studies


12/16: National Web Outlet interview (via email) with SheKnows.com (circ. 55 million) in Bozeman, MT-
12/17: National Radio interview with Roy Green Show in Hamilton ON
12/22: Radio interview with WILS in Lansing, MI
12/23: Radio interview with CFAX in Victoria, BC
1/19: Web outlet interview (via email) with AOL Latino
1/20: Magazine interview with Newsmax in West Palm Beach, FL
•1/27: National radio tour with Fox News Radio in New York, NY
•1/30: Radio interview with WFOB in Fostoria, OH•1/30: Radio interview with CKNW in Vancouver, BC
•1/30: Radio interview with CHNI in Halifax, NS
2/6: Radio and print interview with NPR
•2/23: Newspaper interview with the San Francisco Examiner in San Francisco, CA
•3/1: Radio interview with KGLO in Mason City, IA
•3/6: National radio interview with Valder Beebe Show in Dallas, TX
•3/8: Web outlet interview (via email) with Everyday Health in New York, NY (circ. 28
million unique visitors/month)


U.S. News and World Report 2011, America’s Top Doctor
Patients Choice Physician Award, 2011 given to top 5% of physicians nationally
San Joaquin Young Physicians Award in recognition of outstanding service to patients, community
and medical colleagues May 2010
Castle Connolly, Americas Best Doctors, featured in American Airline Magazine Sept. 2008,
March, May 2009
America’s Top Cardiologist, Consumers Research Council of America 2006-2007
Best of the U.S. in Cardiology, bestofus.com
Future Leader Award, American College of Cardiology, 2008
St. Joseph’s Medical Center, We CARE Award 2006
Cardiologist of the Year, Strathmore’s WHO’S WHO, 2006-2007
Alumni of the Year, Cosumnes River College, 2003
America’s Top Physician, Consumers Research Council of America 2003


Abbott Pharmaceuticals
Daiichi Sankyo Pharmaceuticals
Forest Pharmaceuticals
Glaxo Smith Kline Pharmaceuticals
Novartis Pharmaceuticals
St. Jude’s Medical
Pfizer Pharmaceuticals
Lily Pharmaceuticals
Gilead Pharmaceuticals


Review in Cardiovascular Medicine,“The Athlete’s Heart: prevention of sudden cardiac death” by Ramin Manshadi, MD, Volume 9, No 4 Fall 2009

Pioglitszone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective, Evaluation 2003-ongoing

A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Forced-Titration, 2x2 factorial design Study of Efficacy and Safety of Long Term Administration of Nateglinide and Valsartan in prevention of diabetes and cardiovascular outcomes in subjects with impaired glucose tolerance (IGT) 2003-ongoing

“Blockage of Adenosine receptors with Aminophylline”, “Limits Ischemic Preconditioning in Human Beings”, Published in the American Heart Journal, September 2000

Assessing the vasodilation effect of homocystine in pig, Coronary Department of Cardiovascular Medicine U.C. Davis Medical School, 2000

The prevalence of vascular disease found in echocardiograms referred for heart murmur Department of Cardiovascular Medicine U.C. Davis Medical Center, 1999

Outcomes of octogenarians post coronary angiogram and intervention, Department of Cardiovascular Medicine, U.C. Davis Medical Center

1999 (abstract published March 2009: Geriatric Cardiology)Assessing the cardiopulmonary effect of amiodarone on heart transplant patients, Department of Cardiovascular Medicine, California Pacific Medical Center 1994-1995


1 According to the American Heart Association every minute, one woman in the U.S. dies from heart disease which is twice as common in Black women as in Whites. More than 100 000 Black women die from cardiovascular disease each year according to Dr. Miries., MD co-author of the book Heart Smart for Black Women and Latinas.

SCD happens unexpectedly in people of all ages presumably due to a heart-related problem. In the U.S., 310,000 die each year from cardiac arrest without being admitted into a hospital or emergency room. Some of the more publicized SCD cases among athletes include running guru Jim Fixx in 1984, Olympic volleyball player Flo Hyman (1986) and NBA player Reggie Lewis (1993). SCD among athletes is not new. A legend says that Pheidippides died immediately after announcing the Persians had been defeated at the Battle of Marathon in 490 B.C.

3 Source:  http://www.twincities.com/alllistings/ci_20800030/life-expectancy-gap-between-blacks-and-whites-narrows?source=rss.