Did you know every 40 seconds someone in the U.S. has a heart attack—and 1 in 5 never even see it coming? This week, I am joined by preventive cardiologist Dr. Michael Twyman as we discuss cutting-edge diagnostics, the endothelial glycocalyx, nitric oxide biology, and why muscle mass is your heart’s best friend. Learn the practical steps and questions to ask to protect your heart before symptoms appear.

Together, we explore:

• Why silent heart attacks are so prevalent
• The role of nitric oxide and the endothelial glycocalyx in vascular health
• The critical link between muscle mass, VO₂ max, and heart resilience
• How advanced imaging and testing are changing prevention
• Debunking common myths around cardiovascular risk
• Supplements and diagnostics Dr. Twyman uses to optimize cardiovascular health

Who is Dr. Michael Twyman

Dr. Twyman is a board-certified cardiologist specializing in early detection and prevention of cardiovascular disease. Founder of Apollo Cardiology in St. Louis, he’s recognized for integrating advanced arterial imaging, mitochondrial health strategies, and personalized medicine to optimize long-term heart health. Dr. Twyman’s mission is to educate his patients on how to live better and longer by optimizing their mitochondrial function to become heart attack proof.

This episode is brought to you by:

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• Website - https://drtwyman.com/
• Apollo Cardiology - https://drtwyman.com/apollocardiology/
• LinkedIn - https://www.linkedin.com/in/drtwyman/
• Instagram - https://www.instagram.com/drtwyman/
• X (Twitter) - https://x.com/michaeltwymanmd

• Instagram:@drgabriellelyon
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• Apply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/
• Join my weekly newsletter – https://institute-for-muscle-centric-medicine.ck.page
• Get my book – https://drgabriellelyon.com/forever-strong/

• Prebiotic Nitrate and Nitric Oxide salivary test strips (https://myfitstrip.com/)
• Blood pressure monitors: Omron Evolve (https://omronhealthcare.com/)and Cardiex Conneqt Pulse (https://cardiex.com/products/conneqt-pulse/)
• EKG monitor: Kardia (https://kardia.com/)
• Heart Rate Monitor with VO2Max and 1 lead EKG: Frontier (https://fourthfrontier.com/products/frontier-x)
• iHeart Internal Age App (https://goiheart.com/pages/iheart-internal-age)
• Oura Ring (https://ouraring.com/)

00:00 – Intro: The silent crisis of cardiovascular disease

03:00 – What is heart disease really, and who is at risk?

09:30 – How to screen for early cardiovascular disease

13:45 – What is a calcium score and why it matters

17:00 – The endothelial glycocalyx: Your artery’s armor

21:10 – Nitric oxide: The overlooked key to vascular health

26:00 – Red light therapy, UVA light, and nitric oxide production

32:45 – Biomarkers that matter more than LDL

40:10 – The truth about stress tests and cardiac imaging

45:00 – Erectile dysfunction as an early heart warning sign

51:00 – Testosterone, estrogen, and cardiovascular risk

56:20 – GLP-1s and new therapies for heart health

1:00:00 – Can diet and exercise reverse heart disease?

1:05:00 – Supplements Dr. Twyman recommends

1:10:00 – At-home tools for tracking heart health

1:15:00 – Muscle and VO₂ Max as heart disease predictors

1:20:00 – Final thoughts: Don’t guess—test.

Disclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.