Facts about Heart Scans (EBCT)

As advances are made in the treatment of heart disease, a variety of tests have been developed to detect these problems. Echocardiography that views the heart in motion. Another of these heart tests recently getting wide, if perhaps confusing attention, is the ultra-fast (electron beam) computed tomography scan (EBCT), more popularly known as a "heart scan". The test has become a heavily advertised procedure for the early detection of coronary heart disease. Promoted by extensive marketing campaigns, this test is touted to be both painless and accurate and does not require a physician's order to be scheduled. But what is this new test? How accurate is it? Will insurance cover the procedure? Is it truly cost-effective? Does it play any role in the management of coronary heart disease.The EBCT "heart scan" is an elegant, sophisticated x-ray[coro angio] that very accurately identifies and quantifies the presence or absence of calcium deposits, both in or around the coronary arteries (arteries that feed the heart). Strong statistical correlation exists between the presence of these calcium deposits and the presence of coronary heart disease. It should be noted, however, the statistical correlation is heavily age dependent, as calcium deposition appears to be a natural phenomenon of aging.Therefore, the predictability of an individual with coronary calcium deposits for having significant heart disease is higher for those in younger (40's - 50's) than in older age groups. Likewise, the predictive accuracy for individuals without coronary calcium deposits being free of significant disease is lower in younger test subjects. Unfortunately, this test is being marketed as a self diagnostic test for the presence or absence of coronary heart disease. Any person experiencing warning cardiac symptoms, who then undergoes a "heart scan" and gets a favorable result, may erroneously forego medical consultation and miss the real diagnosis.However, following a low fat diet, exercising regularly, avoiding tobacco products, maintaining regular contact with one's personal physician, and obtaining prudent consultation with a cardiologists, remain the best ways to prevent, detect and treat coronary heart disease.

The Old Tests Were Wrong

If the means to turn off heart disease are already within our grasp, why don’t most doctors tell you about it? Surely, if there were some medicine like calcium or health practice that could stop heart disease in its tracks, he/she would tell you about heart attack. Think about your heart for a moment: Coronary heart disease is the number one cause of death, and most physicians do not know how to screen a seemingly well person for hidden heart attack. You may, in fact, know of friends or acquaintances who passed their annual physical exam from their family physician, only to die or have a heart attack shortly afterwards.

What is coronary risk?

In order to assess the implications of your calcium score , it is important to understand your risk profile for the development of coronary artery disease (CAD). There are several specific and predictive risk factors for the development of CAD, including: (1) cigarette smoking; (2) abnormal blood lipid profile, including an elevated LDL cholesterol and/or a low HDL cholesterol; (3) a strong family history of CAD at relatively young ages; (4) the presence of high blood pressure (hypertension); and (5) the presence of diabetes mellitus. In addition, with advancing age, the likelihood of developing CAD increases, particularly past the age of 65. Finally, if the patient is having symptoms consistent with CAD (e.g., chest pain), has already survived a heart attack, or has had coronary artery angioplasty and/or bypass surgery, there is already evidence of significant underlying CAD. If these factors are present, there is no need for a screening test such as a heart scan for underlying calcium . In these patients, who already have symptoms suggestive of CAD or who have already had documented CAD, doctors perform physiologic tests, such as exercise stress tests. These tests assess whether there is a severe blockage that may place the patient at significant risk for cardiac events. The results of these physiologic tests may indicate the need for further, more aggressive evaluation and treatment. The important point is that the heart scan is a screening test and is designed for use in patients without known CAD but who are at risk. In patients already known to have CAD, such a test is unnecessary and will not affect appropriate management.

What does heart-related chest pain feel like

By William R. Ladd, M.D., Director of Nuclear Cardiology
If you suffer chest pain, particularly while exercising, you will almost certainly wonder whether it might be heart-related - and well you should. Heart muscle pain - angina - is likely to be the first warning of blocked coronary arteries, the cause of most heart disease.
While there are no infallible guidelines about whether a chest pain is heart-related, it generally takes a particular form. Heart discomfort is rarely a sharp, stabbing pain. Even a heart attack may not be unbearably painful at first, permitting its victim to delay seeking treatment for as much as four to six hours after its onset. By then, the heart may have suffered irreversible damage. It is not unknown for patients to drive themselves to emergency rooms with what proved to be very serious and even fatal heart attacks.
Angina is a protest from the heart muscle that it isn't getting enough oxygen because of diminished blood supply. A heart attack is simply the most extreme state of oxygen deprivation, in which whole regions of heart muscle cells begin to die for lack of oxygen. If the blockage in the arteries serving the heart muscle can be cleared quickly enough - within the first few hours of the onset of the attack - the permanent damage can be held to a minimum.
Pain is the only warning you are likely to get of a potentially lethal condition. Ignoring this sort of pain can cause heart disease. Heed it! Consult a cardiologist immediately.

The Definition of Heart Disease

Heart disease is any condition that causes your heart to malfunction. When the words "heart disease" are used generically, what people are usually referring to is Coronary Heart Disease which leads to heart attacks and angina, ultimately caused by Atherosclerosis. But there are a wide range of other diseases of the heart. For example:
1) Congestive Heart Failure
2) Valvular Heart Disease - Diseases of the heart valves
3) Cardiac Arrhythmias - Irregular heartbeats
4) Diseases of the Pericardium
5) Diseases of the Myocardium
6) Congenital Heart Disease - birth defects of the heart
7) Endocarditis (infection of a heart valve)