someone who has. i've got a secret to share -- with what we know right now? we could see the last heart attack in america. i've been investigating this for over a year. i've got lessons to share, things you need to know, things your doctor may not tell you. i was lucky i didn't die of a heart attack. >> reporter: former president clinton, like too many people, was busy. and for years he ignored warning signs from his heart. but in 2004, during an exhausting book tour, there was something different. >> i had a real tightness in my chest when i was getting off the airplane and the only time i'd had it unrelated to exercise. >> reporter: we're here outside new york presbyterian hospital. in just a couple of hours, former president bill clinton is scheduled to undergo surgery. >> so i immediately went down to our local hospital and they did a test, they said you got real problems. they hustled me down to columbia presbyterian and they confirmed the determination that i had serious blockage and needed the surgery. >> reporter: doctors immediately knew -- options were limited. the 58-year-old clinton needed to have his chest opened, his heart stopped, and surgery performed. >> there's no medical treatment for reversing the obstructions that had already formed in his blood vessels. >> i got hillary and chelsea there. all i remember is it happening fast and everybody who cared about me was scared and i felt serene. >> reporter: on labor day, 2004, mr. clinton had four blood vessels bypassed. >> starting this morning around 8:00 he had a relatively routine quadruple bypass operation. we left the operating room around noon and he is recovering normally at this point so i think right now everything looks straightforward. >> there was that period when you're just not sure you can come back. that bothered me. that and the pain. >> reporter: if it happened to him, could it happen to you? what about me? i'm a pretty typical guy in his early 40s with a family history of heart disease. so i decided to go on a mission to never have a heart attack. but how? when people talk about trying to end heart attacks in the world or in america at least, one of the ways to do that is to take a look inside the heart, see what's happening before someone ever has a problem. and that's what we're going to do here today. you're actually going to look for what? my heart? >> yes. for calcium which is part of athero sclerotic process. the plaques in the heart zplif's. >> i've never had a problem but you are looking for it anyways. >> yes, if you are heading for a heart attack in 5, 10, 20 years, you're already have plaque. >> you may recognize him as the author of the south beach diet books. but he's also the inventor of the coronary calcium scan. that's the test i'm having done. he doesn't make any money from it. we all know plaque is bad. it blocks your blood vessels. plaque is formed by ldl cholesterol in the blood. the bad cholesterol. think of it as l, for lousy. building up on the walls of your arteries forming plaque. it can accumulate slowly, over time, narrowing the blood vessels like something building up inside a pipe. this narrowing in the blood vessels leading to your heart can cause chest pain, called angina. it can also cause a heart attack. did you ever wonder how seemingly healthy people can have a heart attack? this may surprise you. most heart attacks happen in people with no symptoms. in people whose arteries are less than 50% blocked. here's how. cholesterol can cause unstable bubbles or blisters of plaque to form in your arteries. these can be incredibly dangerous. most are covered by a cap, but inflammation and stress can cause the cap to thin and rupture resulting in a clot that blocks the flow of blood to the heart. robbed of oxygen, the heart muscle can't function properly. heart attack. therein lies the key, he says. we can now find clues before heart trouble gets dangerous, even before the first symptoms. well before you get to the stage president clinton was. bill clinton, former president, arguably had at least eight years of some of the best health care in the world. it was after he left office. he had significant heart problems. that surprised a lot of people. how could it be he could get this level of health care and still have heart problems? >> he had multi-vessel disease. so he had a lot of plaque. that plaque certainly could have been identified with a heart scan years before. >> i don't want to sound glib, but why wasn't it done? again, you would assume the white house doctors, the president of the united states, they'd be doing that for him. >> well, yeah. it was not the standard of care then. we are past that. >> reporter: i decided to ask bill clinton about that. turns out he did have a coronary calcium scan just months after leaving office but technology was so new then doctors weren't quite sure what to do with the results. >> they said i had some calcium build-up around my heart that put me basically in the top third of risk. but they said there was no evidence of blockage because i'd done so well on the stress test. for a few months before this happened, i noticed whenever -- not every time, but often when i would do rather strenuous exercise, there are some really hilly areas in the town where i am. i'd climb those hills and have to stop and take a breath. i didn't take it seriously, because every time that happens i just lowered the exercise level, got my breath back, and it was never painful. it was just tight. >> if this isn't good for my heart, i don't know what is. >> reporter: by the time he felt the first symptoms, that tightness in his chest, president clinton's heart disease was well advanced. it had been decades in the making. >> you don't die with your first plaque. you develop atherosclerosis blockages really your whole life for many, many years before it causes a heart attack or stroke. >> reporter: and what dr. aggateson told me next should ring a bell of hope for just about anyone who's ever worried about a heart attack. it doesn't have to happen. >> one of the best kept secrets in the country in medicine is that doctors who are practicing aggressive prevention are really seeing heart attacks and strokes disappear from their practices. it's doable. >> you're saying with what we know right now, we don't have to have any more heart attacks in this country. >> i'll never say not any, but the great majority, yes, absolutely. >> it is the biggest killer of men and women, heart disease in this country. >> it is completely preventable. >> coming up, more tests to gauge my heart attack risk. and can you really tell who is a heart attack waiting to happen? 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[ male announcer ] this is our beach. ♪ this is our pool. ♪ our fireworks. ♪ and our slip and slide. you have your idea of summer fun, and we have ours. now during the summer event get an exceptionally engineered mercedes-benz for an exceptional price. but hurry, this offer ends august 31st. two of the most important are energy security and economic growth. north america actually has one of the largest oil reserves in the world. a large part of that is oil sands. this resource has the ability to create hundreds of thousands of jobs. at our kearl project in canada, we'll be able to produce these oil sands with the same emissions as many other oils and that's a huge breakthrough. that's good for our country's energy security and our economy. with a family history of heart disease and a lifetime of bad eating habits, president clinton told me he was a heart attack waiting to happen. but what does someone really look like who is about to have heart attack? you probably wouldn't think this guy. tom behar, 53, thin, seemingly healthy, and one step short of a full-blown heart attack. in fact, he's checking into this hospital in lincoln, nebraska for open heart surgery. it's an important lesson. what you see on the outside doesn't always match the inside. >> obviously closed down quite a bit. >> reporter: the surgeon shows us the striking images on the angiogram of behar's heart. >> you can see this tight narrowing right there where that closes down so that limits the amount of blood that can get out. then you've got a real tight narrowing right up here where that vessel on the side takes off, then another narrowing here, then you've got a pretty tight narrowing there. >> reporter: all the major blood vessels supplying blood to the heart -- blocked. yes, that is the very picture of a heart attack waiting to happen. >> he's at risk for heart attack just because of the amount of plaque that he has in there. >> reporter: like me, behar has a family history of heart disease. that's why four years ago he underwent the coronary calcium scan that we just learned about. his results were not good. >> the score was 111. >> reporter: zero is the best. over 100 means an increased risk of heart attack. even sudden death. >> and you may breathe. go ahead, rest your arms down if you'd like. it is going to take me a couple of minutes to check these images, make sure we have everything we need. >> reporter: bare went through the test again this year and the score was up to 243. the average score for someone his age -- 5. >> i was doing some exercise about three weeks ago, jogging routine that i do and made it about .3 mile and then had the classic symptoms, chest pain, and then pain down the left arm and shortness of breath. >> what room is this? >> reporter: as in the case of bill clinton, bare was told he had no options by the time he saw the doctor. within days woe need bypass surgery. >> in this instance this is sort of what i consider a medical failure. in other words, he got these narrowings and plaque despite our efforts to prevent it from progressing. and my goal would be, even though i'm a surgeon and treat these things, is to not have them get to this point. from a public health standpoint we have to do this, because this bypass operation is going to be very expensive. >> reporter: he's not kidding. average cost in the u.s. -- $112,000. and there are about 450,000 procedures performed every year. total price tag -- more than $50 billion. >> our money would be better spent years ahead of this to prevent him from getting to this point. >> reporter: prevent ever getting to this point. that is precisely my goal. for me, and for you, the last heart attack. the doctor has guaranteed he can see trouble coming, years in advance, well before i'd need surgery, if i do the right tests. >> so here is where the blood is flowing. this is the lining. >> he's using ultrasound to look for plaque in the carotid artery leading to the brain. a blockage here would cause a stroke and would be a sign i'm at increased risk for heart attack. >> unless you do the imaging and advanced testing, you are really playing russian roulette with your life. >> reporter: your body needs cholesterol. actually makes it. it is in the lining of every cell in your body. the liver sends out ldl cholesterol and when everything works right the good, hdl, scavenges excess ldl and brings it back to the liver. you also get cholesterol in foods, things like meat, french fries, eggs, butter, desserts, ice cream. your cholesterol number is a good measure of what's in the blood. but here's the problem -- it doesn't tell if you it is building up in the walls of your blood vessels forming plaque. it's the plaque that causes heart attacks. >> if you look in the coronary care unit at people that have heart attacks, the cholesterol levels of those who have heart attacks versus those in the street who have it are essentially the same. >> that is kind of surprising. right? because you'll hear people exchanging their cholesterol numbers. if it is low they seem quite proud of it. if it is high, there's cause for concern. you say that that's -- you know what? you're not looking in the right place. >> that's essentially useless. >> reporter: here's what does matter, he says. the size of your ldl, or bad cholesterol particles. larger ldl particles don't pose much of a threat because they pass through the blood vessels without sticking. it is the smaller ldl particles that are more likely to lodge in the walls of blood vessels and cause a build-up of plaque. >> if they're small, you can have a lot of little particles that penetrate the vessel wall more easily. there are a lot of little old ladies in their 80s with very high cholesterols who have squeaky clean vessels. they have very large cholesterol particles and they don't get in to the vessel wall. >> so you have to ask about the size of the particles as well when it comes to bad cholesterol. >> yes. >> reporter: that's why the doctor wants a blood sample. >> i don't think anyone likes getting their blood drawn. >> reporter: he wants to find out if i have a lot of small ldl particles. a sign that i could be prone to building up plaque no matter what my overall cholesterol number is. coming up -- i was incredibly lucky that something more severe didn't happen. >> lessons from former president clinton. and pictures don't lie. i learn if my arteries are young or old. time to find out what fate has to offer me. and a controversial diet. this 66-year-old woman says she's eating her way to heart health. >> we're never going to end the epidemic with stents, with bypasses, with the drugs, because none of it is treating causation of the illness. just one phillips' colon health probiotic cap a day helps defends against occasional constipation, diarrhea, gas and bloating. with three strains of good bacteria to help balance your colon. you had me at "probiotic." 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