Calcium heart scan: Knowledge is power

Calcium heart scan: Knowledge is power

Randy E. Cohen, MD, Cardiologist, Mount Sinai Roosevelt

Diane has lived a healthy, active life. But when the Manhattan resident turned 60 — the same age her father died of a heart attack many years ago — she decided to take a more proactive approach to heart health. “I was watching a TV show with my husband, whose father also died of a heart attack at the young age of 57. The show featured a heart scan that can be used to determine the presence of calcium buildup on the walls of the arteries,” Diane says.

Her husband, Jose, 62, has been managing high blood pressure and high cholesterol for years. He decided to get a heart scan, too. The couple found Dr. Randy Cohen, Medical Director of University Medical Practice Associates at Mount Sinai St. Luke’s and Mount Sinai Roosevelt, online and booked appointments for coronary calcium scans.

Diagnosing early-stage heart disease like never before

The traditional approach to heart disease screening has involved entering numbers — like age, blood pressure, and cholesterol — into an equation that estimates the risk of having a heart-related event in the next 10 years. “We have learned that risk prediction tools like that equation could be improved upon,” Dr. Cohen says. “A good number of people either had their risk overestimated and went on to have unnecessary follow-ups, or they had their risk underestimated, creating missed opportunities to intervene from a prevention standpoint.”

The coronary calcium scan, which has been available for about 15 years, is a low-radiation CAT scan that indicates the presence of calcified plaque in the arteries of the heart. Research indicates there is a strong relationship between the amount of calcium plaque and the risk of a future heart disease event, Dr. Cohen says. Now, instead of just using calculators to predict risk, patients are able to get a much more accurate indication of whether or not they have early-stage heart disease.

Quick test, long-lasting takeaways

The test itself was very quick — Diane spent about 20 minutes at the doctor’s office, including wait time — and wasn’t invasive. There is no IV or dye injection, and for those who are claustrophobic, the time spent in the digital scanner is minimal. “You go in feet-first, lying down, and once you’re in the machine, you hold your breath for 10 seconds, we take pictures of your heart, then it’s done,” Dr. Cohen says.

For some patients, the scan can awaken them to the reality that they need to make lifestyle changes to prevent the onset or progression of heart disease. “Other than borderline high cholesterol, Diane didn’t have any significant history that would suggest heart disease,” Dr. Cohen says. “So this was a useful test for her, because her calcium scan indicated she was at much higher risk than we would have otherwise thought, diagnosing early-stage heart disease.”

Diane’s calcium score was 328. That score places her in the 97th percentile as compared to other women of similar age and ethnicity. By traditional risk assessment methods, Diane has a 2.5% 10-year risk (low risk, in other words) for a significant cardiac event. Adding her coronary calcium score of 328 to the equation substantially elevated that 10-year risk, placing her in a moderate- to high-risk category, Dr. Cohen says.

“It made me more aware that I need to continue to watch my diet and exercise regularly, and to adopt a healthier lifestyle whenever possible,” Diane says. Dr. Cohen recommended taking aggressive measures to prevent the progression of heart disease, including daily aspirin and statin medications.

Jose’s calcium score was also high. Both Diane and Jose then underwent nuclear stress tests to determine how well their hearts were performing — and both passed with flying colors. “Our hearts are working well,” Jose says.

“Even though our calcium scan results were a bit of a shock, Dr. Cohen was so friendly and willing to take as much time as we needed to talk to us and answer any questions we had.”

Scan a powerful motivator

The calcium coronary scan is an important test for people over 40 to consider, as it helps adequately classify risk and direct better treatments for patients, Dr. Cohen says. “Prevention, screening and early detection of heart disease is powerful because this is where we can make positive changes,” he says. “When patients get this scan and see these pictures, they walk away motivated in a more profound way then they have perhaps been before. It’s a powerful tool.”

For more information about coronary calcium scans, call 1-855-411-LWNY (5969) or visit United Medical Practice Associates’ website.

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