Greg, a 51-year-old pharmaceutical representative, was proud of his healthy lifestyle. At 5 feet, 8 inches, he weighed a slender 147 pounds, not much more than he weighed as a champion high school boxer. He felt wonderful and engaged in his work and home life with enthusiasm and energy. He was also proud of his cholesterol numbers, which had been under control for the past 10 years since he worked in the pharmaceutical industry and paid more attention to his health. His last group: HDL 55 mg / dl, LDL 94 mg / dl, triglycerides 123, everything is fine according to his family doctor. Greg's mom and dad lived in the early 80s without a meeting with heart disease, and Greg was sure that he was risk free.
Suddenly, Greg's elder sister informed him that she had recently had unstable symptoms of chest pain requiring hospitalization. She underwent cardiac catheterization and received two coronary stent, which hardly prevented the open heart procedure. This is Greg's unsettled feeling, and now he began to worry about his health. He underwent a heart scan, which gave a rating of 1387, in the 99th percentile for men of his age. This assessment showed that the risk from Greg was at least a low risk, apparently an alarming 25% per year for heart attack and death.
Can cholesterol tell you if you have a hidden lining superimposed on your coronary arteries?
No. Cholesterol does not tell you whether a coronary plaque is present. It is simply blood fat, which is one of the many causes of coronary plaque, and provides an indirect statistical assessment of the likelihood of heart disease. Can you have a heart attack with low cholesterol? Absolutely. Can you have high cholesterol but survive to 95 years old with 18 great-grandchildren and never have stitches of heart disease? There is no doubt about it.
Does the ECG show a hidden coronary plate? No. An EKG is simply electrical measures that can manifest a heart attack while it is in process or a lot after the fact.
What about stress tests? Don't they discover a hidden coronary plate?
No, again. Stress tests are an indicator of blood flow to the heart, abnormal, only when the flow is significantly reduced. For example, locks that occupy 80-90% of the diameter of contracts will be detected during the stress test. The problem is that 90% of people with hidden (asymptomatic) coronary plaque will have completely normal stress tests, but are still at risk of heart attack. In fact, most people who are threatened with a heart attack next year have normal stress tests.
So, how can you easily and inexpensively detect and measure a hidden coronary plaque? We do not need invasive procedures that include scalpels and catheters. We need a test that accurately detects a hidden plate without pain, with virtually no risk that almost anyone can get.
This can especially make a heart scan. And he does it better, faster and easier than any other test available.
"Now we know that 95% -99% of heart disease occurs on sites WITHOUT arteries that narrow attacks."
Dr. Steve Nissen
Cleveland Clinic
What is a heart scan?
If you have gone through a heart scan, you already know that this is one of the easiest and quickest health tests: hold your breath for 30 seconds and you did it. This is about as simple as any test. No gouging, pushing or pushing, no IV, no pretreatment, no preparation. Most people are surprised at how simple it is. The most common comment after the scan is “Is that it?” With this small effort, you will be given the most powerful information you can get about your heart.
Cardiac scan is really a 30-V40 cross-sectional image (varying according to your height) of the heart from top to bottom, all you got in a few seconds you hold your breath. (Holding the breath eliminates the movement of the heart due to the expansion of the auxiliary lungs). In each of the 30 or so images you can easily see the “slice” of your three coronary incisions. Since each slice overlaps with the inscription above and below, the scan provides, in fact, a three-dimensional survey of the contents of the chest.
Each scan examines specific criteria for computer applications to help decide whether a selected area in your coronary arteries is really a coronary plaque. The area (in square millimeters) is multiplied by the density of the plaque, and this gives an "estimate" for this particular plaque. All plaques in each fragment of the image are clogged, and all assessments are added. This gives the total score reported to you. Sometimes you will hear a total score called Agatston, named after Dr. Arthur Agatston from the University of Miami, who first developed this scoring method. Agatston's account is now one of the standard calculations performed on all heart scans. (This is the same Dr. Arthur Agatston, by the way, who created the extremely successful South Beach Diet.)
If you have not yet had a heart scan, how do you decide whether you should get it first?
In many permits, it is recommended to check men over 40, women over 50. It is based on a simple observation among tens of thousands of people that a significant number of men begin to show a hidden sign (points> 0) aged 40 years and older, women 50 and older. Up to these ages, estimates above zero for any gender are unusual. Women are recommended to undergo a scan later than men, because the development of a plaque is about 10 years behind men.
Besides age, there are no useful criteria for determining who should and who should not be scanned. We could, for example, use LDL cholesterol to decide what to scan. If we chose someone with LDL cholesterol> 130 mg / dl, we would have missed half of people with heart disease. (In other words, about 50% of people with a measurable coronary plaque have LDL cholesterol 300, smoking - then you might consider scanning 5 years ago (35 for men, 45 for women).
What is the best rating of heart scandal? Zero or no detectable plaque in any of your scan images. What is terrible? Just like playing golf, the higher your score, the worse it is. But just like asking “what a terrible golf score?”, The answer to what makes up a terrible heart rate is “It depends.” Of course, the higher your score, the more memorial plaque in your coronary arms, the greater the risk of heart attack. Estimates of 1,000 or higher (this is a lot of plaque!) Save the risk of a heart attack at 25% per year (if preventive treatments have not started), as this is unexpected for Greg. Ratings between 0 and 1000 are much more common and have varying degrees of risk.
Why is it called "calcium evaluation"?
What exactly is measured when scanning the heart?
The arteries of children are flexible thin-walled tubes, without bloom, with a lining that is a millimeter thick or so. Years take place, especially if there are genetic causes or harmful factors, such as smoking, high cholesterol, high-fat fats, high blood sugar levels, etc. D. Lining tissue of arteries is sensitive and easily injured and reflects this trauma due to thickening . The thickened lining also accumulates fibrous structural material, calcium (as in bone) and inflammatory cells. The resulting lumpy material is called an “atherosclerotic plaque.”
Many of the components of plaques cannot be measured in a living person, such as inflammatory cells or structural tissues. Remember, we are trying to accurately measure plaque without scalpels, catheters or other invasive methods. Collections of calcium are inside the plaque and can be measured accurately and easily. Interestingly, microscopic studies of atherosclerotic plaque showed that calcium consistently takes up 20% of the total plaque. This proportion remains true for women, men, young, old, and whether you already have a heart attack. In other words, calcium provides indirect, albeit accurate, measurements of total plaque volume. For example, if we measured 2 cubic millimeters of plaque, then you had a total of 2 x 5 = 10 cubic millimeters of total scale.
The rule to evaluate coronary calcium is easy: the higher your score, the more plaques your coronary arteries build.
Coronary calcium evaluation predicts your risk of heart attack.
A study after the study showed that the higher the heart scan rate, the higher the risk of heart attack. This is due to the fact that the more plaque forms your coronary agreements, the more opportunities for rupture of dental plaque and heart attack, even if the plaque is only a blockage of 20%. This remains true, even if you feel great, your cholesterol is low, you are a distant runner, etc. The heart scandal score is certainly the most powerful predictor of your heart. Of course, this does not mean that you cannot change your future. In fact, exactly what the knowledge of your heart check tells you. If you find that you have a high score, the next step is to start or improve your prevention program. Your goal: to reduce the risk of a heart attack as close to zero as possible.
Unlike cholesterol, your indicator is a combination of factors that contribute to the growth of coronary plaque right up to the day of your scan. For example, suppose you spend years between 30 and 40 years of overweight, sitting, smoking, and indulging in unhealthy eating habits. A cholesterol panel during these 12 years may have reflected your unhealthy lifestyle. But, at the age of 41, you lose 60 pounds. Start an exercise program, follow a healthy diet and quit smoking. The cholesterol panel after you have achieved all of this would be greatly improved, even if you had an intense plaque in your coronary arteries. However, a heart scan at this stage is likely to reveal a high score, as it reflects the totality of the influences in your life. Your score will not falsely reassure you, like a cholesterol panel.
Is it a hard or soft board?
A common misconception is that, since calcium is a solid substance, the coronary calcium assessment obtained by scanning the heart provides only a measure of a solid plaque. Not true. Calcium measured is a reflection of total plaque, both soft and hard.
In fact, the vast majority of people with coronary plaque have a mixture of hard and soft plaque, and this can even change from day to day, week by week, as the plaque is a dynamic living tissue. In other words, a soft board today can develop heavy elements tomorrow, and a hard board today can evolve to develop soft parts in the future. Most plaques are both. That is why the assessment of heart scandal is such a big measure of a hidden, general, memorial plaque.
The most important health test you can get
Heart scan is simple and inexpensive. However, they show the number one killer among men and women in the United States with great accuracy. This is a very accurate, simple 30-second test that makes detect heart disease. The key is getting your “grades” before the danger comes. Heart scan is primarily a tool for prevention. If you know your assessment, you know that evil prevention efforts are in order.
Selected Links
Rationale for measuring coronary calcium as a measure of total coronary plaque
Detrano R, Tang W, Kang X, Mahaisavariya P, McCrae M, Garner D, et al. Accurate measurements of coronary calcium phosphate mass using electron beam electron beam diagrams. Am J Cardiac Imag 1995; 9: 167-173.
Janowitz WR, Agatston AS, Kaplan G, Viamonte J Jr. Differences in the prevalence and prevalence of coronary artery calcium found by ultrafast computed tomography in asymptomatic men and women. Am J Cardiol 1993; 72: 247-254.
Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS. Coronary artery calcium areas using electron beam computed tomography and coronary atherosclerotic plaque area: a histopathological correlation study. Circulation 1995; 92: 2157-2162.
Simons DB, Schwartz R.S., Edwards V.D., Shidi P.F., Brin Y.F. Non-invasive determination of anatomic coronary artery disease using ultrafast computed tomographic scanning: a quantitative study of pathological comparison. J Am Coll Cardiol 1992; 20: 1118-1126.
