The Heart Savior Protocol
A structured approach to detecting and managing atherosclerosis before the first clinical event.
Many physicians already apply elements of prevention. The difference is applying them earlier, more consistently, and in a structured way.
The Problem
Risk estimation and disease detection are not the same thing. A patient may score as moderate risk and still have significant atherosclerosis already present.
The Approach
Move from estimating future risk to determining current disease status. The protocol integrates both perspectives as a guide to structured, long-term management.
01
Detect
Early Disease Identification
Identify atherosclerosis before symptoms develop, not after. Standard cardiovascular risk assessment estimates the probability of a future event. It does not determine whether disease is already present. A patient may carry a moderate risk score and still have significant subclinical atherosclerosis.
This requires a deliberate choice to look earlier than symptoms demand, using imaging and targeted biomarkers to determine the actual state of the arterial wall rather than inferring it from population-level variables.
Risk estimation predicts probability. Imaging and targeted biomarkers identify presence. Both are needed. But the second changes clinical decision-making in ways the first cannot.
Relevant Tools & Approaches
DR. LO MONACO
Clinical Perspective
Preventive cardiology works quietly, years upstream of the events it prevents. Dr. Lo Monaco has built his practice around the conviction that standard cardiovascular risk assessment misses a signi cant proportion of patients who will eventually have a cardiac event.
His approach draws on advanced imaging, metabolic and in ammatory biomarkers, hormonal pro ling, and lifestyle architecture, tools that exist in the research literature but rarely reach routine clinical practice. The question he asks at every consultation is not whether a patient is sick, but whether they are on a trajectory that leads there.
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Italy – Servizio Sanitario
Nazionale
Trained within Italy’s universal public system. Deep understanding of a coverage model under fiscal pressure and where it excels at long-term prevention.
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United Kingdom – National
Health Service
Built his clinical career within the NHS. Intimate knowledge of its strengths, its waiting-list crisis, and its structural prevention gap
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United States – American
Medicine
Worked with US healthcare institutions. First-hand experience of the world’s most expensive system and its paradoxical outcomes in prevention.
Credentials At A Glance
MEDICAL TRAINING
Università di Pavia
FELLOWSHIPS
Harvard Medical School • New York Medical College
CURRENT PRACTICE
National Heart Clinic, Harley Street, London
U.S. LICENSE
Unrestricted, consults with U.S. institutions
YEARS IN PRACTICE
20+
HEALTHCARE SYSTEMS
Work & Collaboration
Beyond clinical practice, Dr. Lo Monaco is the author of Heart Savior, a comprehensive guide to advanced cardiovascular prevention, and The Practical Path, a physician’s case for incremental reform of American healthcare. Drawing on clinical experience across European and U.S. systems, both books reflect a career built at the intersection of medicine, policy, and prevention. He speaks internationally on preventive cardiology, longevity medicine, and healthcare system design, and welcomes speaking engagements, institutional partnerships, and strategic collaborations.