Heart Disease

About Heart Disease

Heart Disease Statistics: Every 60 seconds, someone in this country suffers a fatal heart attack. Two out of every three first time heart attack victims had no prior warning symptoms. For one out of every three first time heart attack victims, that heart attack was their last. Don’t let appearances fool you. A recent medical study found that 88% of new heart attack victims would have been classified as low to intermediate risk according to their pre-event risk factors.

Every day, seemingly healthy individuals with low cholesterol, who maintained a healthy diet and exercise program and who passed annual physical exams and treadmill testing suffer fatal or debilitating heart attacks. Heart disease is by far the number one killer of both men and women in the U.S., causing 43% of all deaths.

Why EBT?

The theory behind the heart scan is very simple. Heart disease is caused by a build-up of plaque in the arterial walls, which blocks the flow of blood to the heart muscle. Plaque growth is a slow process that takes years. Plaques are composed of deposits of cholesterol and fatty acids. As plaques grow and age, bits of calcium are deposited into the plaque. These calcium deposits are present in the arteries of 96% of all heart attack victims and can be detected years before any symptoms, such as chest pain or shortness of breath, appear. By finding people with calcium in their arteries, doctors are finding the people who need to be treated for early heart disease.

If the test is so simple, why has it taken so long for this test to become available to the public? The answer is that it is not so simple to image the beating heart. Until recently, it has not been possible to accurately assess the coronary arteries with CT technology. Because the heart is in constant motion, images have to be acquired very rapidly. Conventional CT scanners operate by mounting an X-ray source and detectors in a doughnut that rotates about the patient. Because the speed of rotation of the doughnut is limited to two rotations per second, the resulting heart images are blurred.

The introduction of the GE-Imatron™ Electron Beam CT (EBT) scanner was the breakthrough that enabled the detection and quantization of even miniscule amounts of coronary calcium. EBT scanners utilize an electron gun to acquire 20 images every second, fast enough to “freeze the heart”, making assessment of coronary calcium possible. EBT scanners are the only FDA approved CT scanners for the coronary calcium exam.

The only heart test you need

Just how good is this test? When the EBT coronary calcium score is zero, when no calcium is detected, the probability of developing symptomatic heart disease during the next 10 years is 1% or less. The odds ratio; the ratio of events in an interest group to events in a base population, of developing symptomatic heart disease is 3 to 1 for people with scores of 1 – 80 (the base population is people with zero scores), 8 to 1 for people with scores of 81-400 and 25 to 1 for people with scores above 400. Compare those numbers to the odds ratio’s for the traditional heart disease risk factors: 1.8 to 1 for total cholesterol above 240mg/dl; 1.8 to 1 for HDL cholesterol below 35mg/dl; 5.4 to 1 for diabetes, 3.6 to 1 for smoking; and 2.6 to 1 for high blood pressure. Your calcium sore is more predictive of future events than all traditional risk factors combined!

And anyone who has ever passed a treadmill test as part of their annual physical thinking that they were free of heart disease should know this. A treadmill test can only detect heart disease after a blockage has reached 85% or greater. That’s right! This test only tells us who needs surgery or angioplasty. If you are comfortable waiting until then that’s OK but most of us would prefer to know before the disease gets this severe. What’s even scarier is that half of all heart attacks occur in individuals whose blockages are 30% or less, when the plaque suddenly ruptures and completely occludes the coronary artery. All of these individuals would have passed a treadmill right up until the moment their heart attack occurred.

Cross Sections of
Atherosclerotic Arteries

The best news today is that heart disease is treatable and reversible. Your physician now has medications which both lower your cholesterol and stop and reverse plaque formation. Electron Beam CT (EBT) heart scanning was developed to detect early heart disease so that heart attacks and heart surgery could be avoided. All men over age 35 and women over age 45 should undergo EBT scanning. You should consider earlier testing if you have: a family history of early heart disease, diabetes, elevated cholesterol, high blood pressure, obesity, current or former smoker, or prolonged exposure to second hand smoke. Once heart disease is established, your calcium score should be checked on an annual basis, the calcium score gives you critical information as to how you are responding to therapy. The fact is, EBT the only technology that is FDA approved to successfully find the early signs of heart disease while it is at it’s most treatable stage.

Mammogram of the Heart

Recently called the ‘Mammogram of the Heart’ the GE-Imatron™ Electron Beam CT (EBT) Heart Scan is a breakthrough in Early Detection and Cardiac Risk Assessment. In a 5-minute test, the electron beam scanner takes forty pictures of your heart, between beats, while you remain fully clothed. These images show the early calcium plaque build-up, which appear as white specs on the walls of your arteries. At the end of the test, you will be given a calcium score for each of your coronary arteries and a total score for your heart. This score directly correlates with your risk for heart attacks and can be used by your doctor to guide your treatment program.

Who should consider getting a EBT Heart Scan?

  • Men over age 35
  • Women over age 45
  • Younger age if there is a history of premature heart disease in the family.
  • Current or Former Smoker
  • Diabetic
  • Elevated Cholesterol
  • High Blood Pressure
  • Overweight

All individuals being considered for conventional coronary angiography as a result of either symptoms (chest pain or angina) or positive or inconclusive exercise (treadmill) testing.

Individuals who have had bypass surgery, angioplasty or atherectomy, and need a re-evaluation of the condition of the revascularization(s) (bypass graft or stent patency).

Individuals who have had bypass surgery, angioplasty or atherectomy, and are experiencing new symptoms (chest pain, shortness of breath, fatigue, etc.).

All Individuals with an unexplained cardiomyopathy

For localization of the coronary sinus prior to pacemaker placement.

Other indicators: Evaluation of Congenital Heart Disease, annual follow-up of patients after heart transplant, Coronary vein assessment, pacemaker placement.