Tag Archives: heart attack

Scan for heart-disease risk before symptoms

The coronary calcium scan is a screening test to evaluate risk for future coronary events. It uses a state-of-the-art computerized tomography (CT) scan to detect calcium deposits found in atherosclerotic plaques in the coronary arteries. It is a sensitive way to detect atherosclerosis before symptoms develop.

Main risk factors for coronary artery disease are:

  • Personal/family history of coronary artery disease
  • Males over the age of 45, females over 55
  • History of smoking (past or present)
  • Overweight
  • High cholesterol
  • Diabetes
  • High blood pressure
  • Inactive lifestyle

Your doctor can use the results of the scan to help make treatment decisions on how to lower your risk for heart disease. This test is most helpful for patients who do not have known heart disease but are at medium risk for disease after evaluating the main risk factors listed above.

Some studies have shown that a cardiac calcium scan might be a motivational factor for people at moderate risk to follow treatment plans and to make lifestyle changes.

The screening test is NOT for you, if

  • you don’t have any risk factors for heart disease
  • you are at high risk for heart disease
  • you have already been diagnosed with heart disease – since the information obtained from the scan will not impact your recommended treatment.

The result of the test is a number called the cardiac calcium score, or Agatston score.

The score is calculated from the total area of calcium deposits and the density of the calcium.

  • A score of zero means no calcium is present in the coronary arteries, which suggests a low likelihood of having a heart attack in the future.
  • A score of 100-300 is indicative of moderate plaque deposition in the arteries and is associated with a relatively higher risk of heart attack or heart disease over the next three to five years.
  • A score greater than 300, is considered very severe with high risk of heart attack or heart disease.

What are the concerns of getting a scan?

  • You are exposed to a low dose of radiation.
  • False positives are possible leading to further testing or treatment that you don’t need.
  • Not all arteries with heart disease have calcium “soft plaque atherosclerosis,” so it is possible to get a low score and still be at risk.
  • The scan is not covered under most insurance plans and Medicare, so the cost is out-of-pocket.

Many people do not know that they have heart disease until they have a heart attack. A coronary calcium scan is one way to find out if you have early heart disease, but other risk factors must be evaluated along with the score to give you a truer assessment of your cardiac risk. Your doctor can use your score to help you make lifestyle changes and/or to decide to treat high cholesterol or high blood pressure with medication.

SUSAN LOCKE is Healthnetwork Foundation’s medical director

Symptoms of a woman’s broken heart

Susan Locke writes that women have different symptoms for heart trouble than men . . .

healthnet

Research from the National Institutes of Health compared the symptoms of heart attack for men and women and reached two important conclusions.

One: Women are more likely than men to have “atypical symptoms” during a heart attack, and two: Women often experience new or different physical symptoms as long as a month or more prior to the heart attack.

Most people are familiar with the “classic symptoms” of a heart attack. These include a crushing, squeezing or burning pain, pressure or fullness in the center of chest. The pain may radiate to the neck, one or both arms, shoulders, or the jaw. The pain usually lasts more than a few minutes, but it may go away and then return later. Other symptoms may include shortness of breath, sweating, nausea, or cold and clammy skin.

Atypical symptoms, which were found to be more common in women include: Back or neck pain, vomiting, indigestion, weakness, fatigue, dizziness and lightheadedness

The NIH study found that women often do not experience severe pain during an attack; therefore, they should take milder chest pain seriously. In fact, 43% of the women studied did not experience any chest pain at all, and about one third described chest discomfort but not severe pain. Shortness of breath was more common in women, and sweating was more common in men experiencing heart attacks.

The second significant finding was that 95% of the 515 women studied experienced symptoms for weeks or even months before the attack. The “pre-attack” or early symptoms included unusual fatigue (70%), sleep disturbance (48%), shortness of breath (42%), indigestion (39%), and dizziness (39%).

Life-saving heart attack treatments are time sensitive — the earlier they are initiated, the better the out come. Delay can result in long-lasting heart damage or death. So learning to recognize early symptoms and atypical symptoms can be vital to getting the treatment you need fast. Every second counts.

SUSAN LOCKE, MD, is Healthnetwork Foundation’s medical director.

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