The Heart Attack No One Sees Coming and How to Stop It w/ Dr. Ronney Shantouf

Many of us know about someone who seemed perfectly healthy, and then one day, without warning, they had a cardiac event. No symptoms on the surface, and no sign their heart was struggling behind the scenes.

We’ve been taught to think of sudden cardiac death as something random and unstoppable: a tragic event with no warning and no chance of prevention. But the truth is: up to 63% of sudden cardiac deaths could be avoided with simple, consistent lifestyle choices. Not pills or high-tech devices, just the way we live every day.

That’s the message buried inside the latest data that most people, including doctors, aren’t talking about. Better cardiorespiratory fitness can outweigh the risk posed by obesity. A handful of nuts and a walk might protect you more than a statin ever could. Even your attitude, your sense of connection, your stress response, and your sleep can shift the odds in your favor.

Yet most people still believe sudden cardiac events are just “bad luck” or genetics. They don’t realize how much control they actually have. And when lifestyle is this powerful, the real question isn’t “What’s my risk?” It’s “What can I do today to lower it?”

In this episode, I’m joined by Dr. Ronney Shantouf, a preventive cardiologist who bridges both sides of medicine: procedures that save lives in the moment, and lifestyle changes that prevent the crisis from ever happening. 

We get into what actually lowers the risk of sudden cardiac death, and what most people get wrong about it.

People are overly focused on certain aspects of lifestyle behavior, but are really negating the other things. I really like to focus on multiple pillars. -Dr. Ronney Shantouf

Things You’ll Learn In This Episode

Lifestyle can beat the odds
Up to 40–63% of sudden cardiac deaths are preventable through behavior, not medication. So if genetics isn’t destiny, what daily choices create the biggest impact?

Not all exercise is equal
Consistent, moderate activity dramatically lowers SCD risk. But sudden bursts of vigorous exercise? They can temporarily increase it. How do you train smarter, not just harder?

Food isn’t fuel, it’s a signal
Whether you're low-carb, plant-forward, or Mediterranean, one pattern wins: real, minimally processed food. What are the dietary patterns that protect your heart, and the ones that quietly push risk higher?

Stress and sleep don’t just affect heart health; they can trigger it
Emotional stress can provoke dangerous spasms and arrhythmias. Poor sleep creates inflammatory conditions the heart can’t hide from. How can we stop treating stress and sleep as “soft” lifestyle advice and see them as medical priorities?

Guest Bio

Dr. Ronney Shantouf, MD, is a Staff Physician at the Heart, Vascular & Thoracic Institute at Cleveland Clinic Abu Dhabi, where he serves in multiple leadership roles, including Director of the Cardiac Catheterization Lab, co-Director of the Complex Coronary Program, and co-Director of the Invasive Coronary Spasm and Microvascular Dysfunction Program. In addition to performing advanced interventional procedures, he oversees the Cardiac Wellness Program and specializes in cardiac prevention and advanced lipid management. Before joining Cleveland Clinic Abu Dhabi, Dr. Shantouf was a Health Sciences Assistant Clinical Professor of Medicine at the David Geffen School of Medicine at UCLA. There, he served as Director of the Cardiac Catheterization Lab at Olive View-UCLA Medical Center and chaired the Cardiology Education Course for the Internal Medicine Residency Program. Dr. Shantouf is triple-board certified in Internal Medicine, General Cardiology, and Interventional Cardiology. He earned his Bachelor of Science in Neuroscience and his Medical Degree from UCLA, graduating summa cum laude. He completed his Internal Medicine training at UCLA Medical Center, followed by a General Cardiology fellowship at Harbor-UCLA and an Interventional Cardiology fellowship at USC. Connect with Dr. Shantouf on LinkedIn. 

Life’s Essential 8: https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8.