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He’s A Cardiac Surgeon, But He Never Expected His Own Heart Attack
Author:
June 21, 2026
Assistant Health Editor
Assistant Health Editor
Sela Breen is the Assistant Health Editor at mindbodygreen. She is a graduate of the Medill School of Journalism at Northwestern University, where she studied journalism, international studies, and theatre.
Image by Jeremy London x mbgcreative
June 21, 2026
I’ve had a lot of powerful conversations on the mindbodygreen podcast, but my recent episode with Jeremy London, M.D. stopped me in my tracks.
London is a cardiovascular surgeon who has spent his career literally holding hearts in his hands. He exercises. He eats well. He doesn’t smoke. His blood pressure is under control. But three and a half years ago, he had a heart attack.
If that doesn’t make you want to pay closer attention to your own cardiovascular health, I don’t know what will. Since then, he has dedicated himself to heart health awareness. Keep reading for what he has learned in the years since his own cardiac event.
How a cardiac surgeon almost missed his own heart attack
When London woke up early one morning with a pain in his chest, he told himself it was reflux. He took an H2 blocker, the pain went away, and he told himself he was right. Then he and his family went out for a morning walk in 22-degree weather and London started sweating uncontrollably, peeling his clothes off because he was so hot. The moment he sat down, his symptoms disappeared completely.
That’s when he knew. Symptoms that come on with exertion and resolve with rest are a textbook red flag for coronary angina. He’s been doing this for decades. He knew exactly what it meant. But he said nothing.
That evening, he stayed behind at the cabin with his 15-year-old son. They went out into a field in the dark, and London was hit with sudden, crushing chest pain. No cell service. His son couldn’t drive. And London thought to himself: “I have got to pull this together because my son is gonna find me dead in this field and I cannot let that happen.”
He held it together, drove back into town, took an aspirin and a beta blocker, and went to sleep. The next morning, the chest pain came back while he was walking upstairs. He finally told his wife. She was furious. He called a cardiologist friend, who insisted there was no way anything serious was going on because London was too healthy. But London pushed, and when he walked into the office, the symptoms came on again. His friend took one look at him and said they were going directly to the cath lab.
His cardiologist found a 99% blockage, which became fully obstructed as the doctor was working on it. London woke up the next morning with a stent in his chest and his priorities completely rearranged.
What the labs missed
London was doing so many things right. And yet, the standard lab work he was getting every year told him nothing was wrong.
The fatigue he experienced in the years leading up to his event got chalked up to long COVID. He had even gone through a full functional medicine workup and everything came back normal. There were no objective findings pointing to cardiovascular risk — just progressive exhaustion that nobody could explain.
At the time of his heart attack, London was only running a standard cholesterol panel. Just the basic numbers that most internists order, and nothing that would have flagged the real picture of what was happening inside his arteries. He had never had a hemoglobin A1c drawn, and he had never had a fasting insulin level checked.
It wasn’t until his son Max suggested he try a continuous glucose monitor that things started to unravel. London initially put one on to prove a point, but within 48 hours it became clear that his glucose levels were chronically elevated regardless of what he was eating. When he finally got a hemoglobin A1c, it came back at 5.9 — high-end pre-diabetic.
And his ApoB? It came back at 180.
The numbers that actually matter
One of the most useful parts of our conversation was when London walked me through the specific lab values he looks at now and where he wants to see them. These aren’t exotic tests. Most can be ordered through your doctor, and they paint a much more complete picture of cardiovascular risk than the standard panel most people are getting.
Here’s what London tracks and where he wants the numbers:
- ApoB: The goal is less than 80. ApoB measures the total number of artery-clogging particles in your blood — London describes it as counting the dangerous trucks on the road. You can have a perfectly normal LDL-C and still have a dangerously high ApoB, which is exactly what happened to him.
- Hemoglobin A1c: London’s target is 5.5 or below. This measures the percentage of red blood cells with glucose attached, and even a 0.1 or 0.2% change is meaningful. His came back at 5.9 before he made dietary changes.
- Fasting insulin: The target is 5 or below. London considers this one of the most valuable early warning signals available. Your pancreas can compensate for insulin resistance for a long time, keeping your fasting glucose and A1c looking normal even when it’s working overtime. A fasting insulin level can catch that compensation before it shows up anywhere else.
- LDL-C: New guidelines from the American College of Cardiology have shifted targets lower, with less than 90 now considered the goal for primary prevention.
- Lp(a): A genetically controlled lipoprotein that London also monitors. His own Lp(a) came back near zero, which was one piece of good news in an otherwise sobering set of results. There is currently no FDA-approved medication to lower it, so if yours is elevated, the strategy is to control everything else as aggressively as possible.
Atherosclerosis isn’t something you get
Most people think about heart disease as something that happens to other people, or something you develop later in life if you’re unlucky or don’t take care of yourself. London’s view is different, and it’s backed by autopsy data. Studies of three-year-old children have found fatty streaks in their aortas, which are early cholesterol deposits. Studies of 18-year-olds, 25-year-olds, and people in their mid-30s who died from trauma have found plaque in their coronary arteries.
From this, London concludes that atherosclerosis is not something we develop later in life. It’s something most of us already have.
That reframe changes everything about how you think about prevention. It’s not about avoiding a disease you might develop someday. It’s about slowing a process that is already underway. And the earlier you start pulling the right levers, the more dramatically you change the trajectory. As London put it, making the effort earlier than we currently do “totally changes the trajectory for the rest of your life. It flattens that curve.”
Lifestyle isn’t failure, and neither is medication
This part of the conversation hit close to home for me. I’m in the lifestyle business. I’ve spent nearly 17 years building mindbodygreen around the idea that the choices you make every day are the most powerful medicine available. And for a long time, I had a real resistance to pharmaceutical intervention for something cholesterol. Then I found out I’m an ultra-absorber of saturated fat, heart disease runs in my family, and no matter how dialed in my diet was, I couldn’t get my ApoB where it needed to be. Ezetimibe changed that for me, and it gave me an entirely new perspective.
London’s response was one of the most clarifying things I’ve heard on this topic. He said that the mindset that taking medications is a failure is “absolutely a dangerous mindset.” The reality, as he put it, falls somewhere in the middle: you pull every lifestyle lever you can, then you investigate what changes maximize benefit and minimize risk. That’s every medical decision, and often medication is necessary to reach optimal health.
London himself went on Repatha after his event. He’s still working to get his numbers where he wants them, and he’s open to adding a statin if the particle count warrants it. Taking medication isn’t a surrender. It’s strategy.
The takeaway
London is a cardiovascular surgeon who knew exactly what his symptoms meant and still spent a full day in denial before nearly dying in a dark field with his teenage son. His labs looked fine. He was fit, he was healthy, and he had a 99% arterial blockage — because the tests he was running weren’t asking the right questions.
The standard cholesterol panel is a starting point, not a finish line. ApoB, hemoglobin A1c, and fasting insulin are the numbers that tell the real story, and most people aren’t getting them. Ask your doctor for the full picture. And if lifestyle alone isn’t getting you there, know that reaching for an additional tool isn’t giving up — it’s exactly what someone who takes their health seriously would do.
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