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Test predicts potential for heart disease

By Richard Greene | Published Wednesday, February 1, 2012

At an early age I learned about heart disease as my father had his first heart attack at 42.

Just 10 years later, at 52, he suffered a fatal heart attack.

Richard Greene

Out of that tragedy, I decided to change my life, hoping to avoid such a fate at a relatively young age.

Recently, at Wise Regional Health System in Decatur I received a calcium screening test to gauge my risk for coronary heart disease and to see if the choices I’d made in my life were helping avoid a possible heart attack.

The test conducted in the radiology department identifies calcium deposits in the coronary artery.

“It’s basically looking to see what’s in your heart and see that there’s no blockage,” said Damian Morales, a CT tech at Wise Regional.

Cardiologist Bruce Gordon of Advanced Heart Care in Decatur said the test is an effective way to identify patients at risk for heart attacks.

“We know from decades of research that the stress testing that we use to assess risk is far from a perfect study,” Gordon said. “You could have a stress test that is normal and have 50 percent blockage in all three main arteries.”

He pointed out that almost half of heart attacks are in patients with minor blockage, and they may not show any symptoms.

“In 50 percent of patients, the first symptom is death,” Gordon said. “The key is to identify problems early and prevention.”

Around the time of my father’s death I was 21 and going through college potato phase. My weight ballooned to 230 pounds.

To shed some of the 60-plus pounds that I had put on during college, I decided to start running. One morning, I left my apartment in Denton and tried to run a mile. I got to the end of the trail and doubled over out of breath. Shamefully, I walked home a little disappointed. But the next morning, I woke up and did it again.

Within a year, I ran my first 5K, completing it without walking. Two years later, I completed my first marathon, slimming down to 175 pounds.

At age 33 and 15 marathons later, I felt like I’d done the best I could to keep my ticker healthy. But this was the true test.

Admittedly, I was a bit nervous to undergo the screening. Who likes to face their mortality and realize something is wrong? But finding out at my age would give me time to correct it with diet and other lifestyle changes.

I am a bit younger than the typical patient that has the screening.

“At 40 and above the heart starts slowing down, and there’s more potential for plaque buildup,” Morales said. “That’s why it’s good for 40, 45 and above. But family history brings up the risk. Finding out the risks at a young age is helpful.”

Gordon said people with a family history of heart disease, that smoke or have other contributing conditions such as diabetes, hypertension or high cholesterol should consider having the screening performed at an earlier age.

The CT scanner used for the screening is a large, box-like machine with a hole or short tunnel. You slide into the tunnel for the scan. Prior to this, electrodes are attached to your chest.

“It takes pictures at 360 degrees in between heartbeats,” Morales said. “Calcium or objects look white and the black is air. We’re trying to detect the calcium buildup in the artery of the heart.”

The calcium is calcified plaque that starts forming in childhood, according to Gordon.

“It’s inflammation in the arteries, and that inflammation leads to the buildup of plaque,” he said. “As the scar from the inflammation matures, calcium starts to develop. That’s the hardening of the arteries. It shows up on the CT scan.”

The screening is simple, patients do not need a prescription, and there’s no invasive IV or need to fast. You are asked not to ingest caffeine the day of the screening. The cost is $99.

“It’s a great type of test that’s going to change how we practice medicine,” Gordon said. “It’s cheap. You don’t need a prescription, and there’s no IVs. It also gives you an enormous amount of information.

“Our bodies are like a black box, and this opens the black box,” he said. “Within minutes, you’re looking at X-rays of the heart. It’s imaging the blood vessels, and it’s definitive. You get to see the disease.”

As Gordon said, within minutes I was looking with the techs at images of my heart on the screen. And fortunately, I didn’t see any of the white deposits.

Within days, I received my results with a perfect score of 0, meaning that for my age and gender, I currently am at a very low risk for coronary artery disease. No other abnormalities were found.

Scores can range from 0 to up into the thousands, and the higher the number for your age, the more care is needed.

“If you had a 30-year-old and an 80-year-old with scores of 100,” Gordon said. “In the 80-year-old, there’s a good chance that they are developing calcium in their arteries. But if the 30-year-old has a score of 100, they will want to watch it closely.

“Experts say if the score is over 400, you are several times more at risk for a heart attack,” he continued. “That is the cutoff. Those patients will be watched closer with more frequent doctor visits and closer monitoring of their blood pressure and cholesterol. They will be more motivated to change their lifestyle.”

After the screening, patients with elevated risks can make lifestyle changes, including increasing exercise, changing to a healthier diet and taking medication as prevention of a heart attack.

While my score came back at zero, Gordon said it’s not a free pass to quit trying to maintain healthy habits.

“If it comes back a 0, the patient has an excellent prognosis if they maintain a heart-healthy lifestyle,” he said.

He warned there still may be soft plaque that has not calcified. The key is early detection and prevention, with which this technology assists.

“People need to be informed,” Gordon said. “People and primary care doctors need to be educated that this technology is available.”

For information about the screening, visit the Wise Regional Health System website, www.wiseregional.com. To schedule an appointment, call (940) 626-1232.

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