By: Dr.
Jonathan Lebowitz,
University Medical Center at Princeton
July 20, 2001
According to the American Heart Association, each year 1.5 million
Americans have heart attacks, and the number is rising. For 20 to
40 percent of these people, a heart attack is the first symptom
of heart disease, and one in three people does not survive a first
heart attack.
To help reverse this trend, it is important to take sensible steps
to ensure a healthy heart before a tragedy occurs. In addition to
making smart choices regarding nutrition, exercise and lifestyle,
there is an exciting testing tool that can help you and your doctor
assess your heart health — the coronary artery CT scan.
Coronary arteries are blood vessels that supply oxygen to your heart.
Deposits called "plaque" can build up in your coronary
arteries, which may eventually cause blockage. Over time, calcium
can accumulate in part or all of the plaque. The more plaque that
is present, the more calcium can accumulate. High levels of calcium
may indicate that at least one major heart artery has a blockage,
which can cause heart attacks.
The coronary CT scan evaluates the presence of — and quantifies
— calcified plaque in the coronary arteries, generating a coronary
artery calcification (CAC) score. This score reflects a broad estimate
of cardiac risk and can be compared to average scores of people
in the same age and gender category.
Regardless of the total score, it is imperative that your doctor
evaluate all your risk factors. After discussion, your doctor may
recommend lifestyle changes, medications, or other tests that would
be appropriate.
Please note: You should not schedule this test if you are experiencing
acute chest pain or other acute cardiac symptoms. Instead, call
your doctor immediately.
The calcium cardiac scoring scan has been available for about 10
years, but it is only quite recently that the equipment has become
faster and more accurate. The scan is done using fast spiral CT
technology, without contrast, and takes less than five minutes to
perform.
Another benefit is that patients may remain fully clothed, making
this a comfortable and non-invasive procedure. The radiation exposure
is less than that of a routine CT scan and has not been associated
with harmful biological effects.
To better understand your overall heart health, familiarize yourself
with the risk factors for heart disease and identify any you may
have. Some risk factors,
including age, gender, family history and personal history cannot
be changed.
• Age/Gender: In the middle decades of life, the risk of heart
disease is three to four times higher for men than for women. For
both men over 45 and women over 55, the risk gradually increases
with age.
• Family History: A family history of early heart disease increases
your risk.
• Personal History: The risk of a heart attack is five to seven
times higher for people who have had a heart attack or stroke than
for people who have not.
Controllable risk factors include:
• Smoking: Smokers are twice as likely to have a heart attack
than nonsmokers.
• High Blood Pressure: High blood pressure (140/90 or higher)
weakens the heart, contributing to heart disease. Reducing your
blood pressure in turn reduces your risk of heart disease, stroke,
kidney failure and blindness.
• High Cholesterol: Too much cholesterol in the blood can lead
to clogged arteries and eventually to coronary heart disease. Opt
for foods low in saturated fat and cholesterol.
• Weight: Being overweight increases your risk of high blood
pressure, diabetes and heart disease. You can significantly reduce
your risk by losing even 10 or 15 lbs.
• Diabetes: A person with diabetes has a two to three times
higher risk of heart disease than a person who does not have diabetes.
Maintain proper weight, keep active and eat a healthy diet, high
in fiber and low in refined foods.
• Sedentary Life Style: Regular physical activity can cut your
risk of heart disease in half and help prevent obesity, high blood
pressure, high cholesterol levels and high blood sugar. It will
also improve your energy level and your ability to cope with stress.
Although you may have some or all of these risk factors, modifying
them will reduce your overall risk of developing heart disease.
If your risk factors warrant a closer look, you can either call
your hospital directly or ask your doctor to set up a cardiac calcium
scan appointment for you.
The test, currently available from University Medical Center at Princeton,
costs $450 and is not yet covered by insurance. Test results are
mailed to both you and your doctor, at which point you can discuss
appropriate treatment options, if necessary.
To be heart smart, assess your risk factors, control those you can,
keep an open dialogue with your doctor, and put medical advances
to work for you. Copyright © 1996-99
The Princeton Packet, Inc.
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