Is a Heart Scan the Right Test For You?

We have heard the stories about a friend who visits his doctor and has a clean bill of health. Two days later he dies of a massive heart attack and you do not understand how or why this happened. Your friend was active, played handball regularly, he was thin, and he ate fish. His total cholesterol was a little high but his good cholesterol was very good. He was taking a low dose of medication to keep his blood pressure down for about a year and that was working. What happened?

Blood pressure and cholesterol levels are reliable gauges of how much at risk you are for heart disease. However, the amount of calcium in your coronary arteries and how it is affecting your blood flow may be an even better way of predicting who is most likely to have a heart attack unless they get on medication therapy.

The problem is that someone who is asymptomatic, in good shape, active and eats well is not sending any red flares that something is wrong. Without any symptoms such as shortness of breath or high blood pressure even with medication, there is no indication that he needs a heart scan, also known as Coronary Calcium Scans.

Heart scans use noninvasive techniques that measure the amount of calcium in the walls of your coronary arteries, the arteries that supply your heart with blood. One of the goals of cardiac CT for calcium scoring is to determine if coronary artery disease, CAD, is present and to what extent, even if there are no symptoms. It is a screening for patients with risk factors for CAD but no clinical symptoms because having calcium in the walls of your arteries could mean you have coronary artery disease, a major cause of heart attacks. CAD takes place when plaque builds up and narrows your arteries.

The plaques are made of fat, cholesterol and calcium. It is the calcium in those plaques that the CT scan detects. The CT scan obtains information about the presence, location and extent of calcified plaque in the coronary arteries. The amount of calcium that is present is used to calculate a score that, when combined with your other health information, helps to determine your risk of coronary heart disease or heart attack. The result of this test is called a coronary calcium score.

However, heart scans are still controversial. First they are not for everyone.

What’ is more, it is still unclear whether heart scans should be used widely. Routine use of heart scans on people who do not have any symptoms of heart disease is also not recommended by the American Heart Association or the American College of Cardiology.

They report that a heart scan is not useful if you have a low heart attack risk. For example, if you are younger than 55 years old, have normal cholesterol and blood pressure levels and do no’t smoke, your heart attack risk is less than 10 percent and a heart scan is not going to tell your doctor something he does not already know. On the other hand if you are at high risk because you are over 65, your cholesterol is high and so is your blood pressure, the heart scan may not do you much good either because you and your doctor already know you are at high risk.

If on the other hand, you fall somewhere between the two and have borderline high cholesterol or high blood pressure you may find having a heart scan will give you valuable information. You will be able to tell more precisely what your risk of CAD is.

The theory behind using heart scans is that the more calcification you have, the worse your heart disease. Part of the theory is that even having small amounts of calcium might indicate you could go on to develop heart disease unless you take aggressive measures to stop it such as reducing your cholesterol and living a more healthy lifestyle.

However, having calcium in your coronary arteries does not mean you have heart disease. How much do you pay attention to the dreaded false-positive results? That means there is an error on the scan. For instance, if you show heart disease your doctor may request more invasive tests that would not be necessary because there was a mistake.

On the other hand, the heart scan can show you are free of calcium and that does not mean you absolutely do not have heart disease. The plaques that build up in your arteries start out as soft and only become calcified over time. So your arteries can be clogged but the scan cannot detect them.

Ruthan Brodsky is a health writer with a special interest and expertise in healthy aging. You are invited to claim her Special Report, at no cost, about finding reliable health information on the internet. Visit http://healthyagingsuccessguide.com.

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