Hello I thought today I would discuss screening for heart disease. I have noticed patients tend to ask me how to figure out if they have heart disease. What we will address is coronary artery disease, which means blockages in the blood vessels that supply blood to the heart. When looking to see if you have blockages, there are several tests you can perform. All tests are different as far as accuracy, amount of time, etc. Tests are really patient specific and depends on the reason you are getting the test. For example, if you have a suspicion that there is a high probability of the patient having blockages, that may require a more invasive test to determine that. Stress testing is a very good test for screening patients for heart disease. Stress testing involves exercise on a treadmill or bicycle. You can also do chemical stress testing that involves giving patients medicine to stress the heart to determine if there is blockages. This is usually reserved for patients who would not be able to exercise. You will get the same information from both tests. There is stress testing with just an EKG tracing which is a decent test as well. However if you add imaging to the test it becomes an even better test. You can use either ultrasound or nuclear tracing that allows you to determine if there is evidence of blockages. Most patients will receive some type of stress testing to screen for heart disease. Another type of test that allows you to test if people have heart disease is coronary calcium scoring and coronary CT angiography. I am sure many of you have received brochures in the mail to come get your heart scan. That is exactly what this is. Calcium can deposit in our blood vessels and based on the amount it puts a patient in a certain risk category for having heart disease. That is what calcium scoring tells you. CT angiography is similar to having an angiogram but without the invasive part. It allows a direct visual of the blood vessels that go to the heart. Very good test obviously and more accurate than stress testing. The problem with this test is mostly insurance coverage for patients. Insurance is very strict about covering their patients for this test and usually require patients had some stress test and a reason to perform more testing. Lastly is direct coronary angiography. This is where you go to the heart lab and you get catheters that go thru your body and inject dye into the blood vessels and directly visualize them to see if there is any blockages. This is the most accurate test of all and also allows us to be able to put stents in patients right away if they need them. It sounds scary, but it is not a bad test and really has a very low risk. However, I do not recommend this test to be done right away unless there is very strong reason that you have blockages. So that is how to screen for heart disease in a nutshell. If you have symptoms you think may be heart disease, or multiple risk factors such as high blood pressure, diabetes, high cholesterol, family history, etc and would like to be screened for heart disease, please come by and let us figure out what test is best for you.
Posted on: Sun, 20 Oct 2013 11:04:14 +0000
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