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Heart Testing, Scans Catch Disease Before It's Too Late

Posted on: Monday, 10 October 2005, 03:00 CDT

By Quinn, Jennifer

If problem detected, lifestyle can be changed

New tests and technologies are helping doctors find people who are more likely to develop heart disease. Rather than suffering a surprise and often deadly heart attack, it's now possible to catch a heart problem, which can worsen over a 10- to 15-year period, before it's too late.

Heart scans are a type CT scan that can determine if people are at risk for heart disease, giving them time to make lifestyle changes.

The scan reveals a person's calcium Agatston score, a calculation of coronary calcium, also known as plaque. The score tells patients if they have high levels of plaque, which could lead to a heart attack.

Boulder Community Hospital in Boulder uses a multi-slice CT scanner to generate an image to look at possible calcium deposit and assess the need for any follow-up. A team of radiologists and cardiologists evaluate the images for more accuracy.

Joe Mikoni, director of Imaging Services at Boulder Community Hospital, said 10 to 12 patients come in for a heart scan each week.

"The heart scan tells us about risk of suddenly forming a blockage that creates a heart attack," said Dr. Nelson Trujillo of Boulder-based Rocky Mountain Cardiology. "Plaque buildup in the arteries is a process that starts early and worsens until the day people have a heart attack. The test will show people if they are at risk and in two to 10 years could have a major problem."

Catch it early

Heart scans at Boulder Community or Longmont United Hospital cost between $300 and $495.

Early detection of heart problems is important because, according to the American Heart Association, approximately 70.1 million Americans have one or more types of cardiovascular disease, and 27 million of them are 65 or older.

In 2005 the cost incurred in the U.S. for hospital care, doctor visits, emergency room visits and recovery came to about $393.5 billion.

Each year more than 400,000 Americans die of heart disease in an emergency department before being admitted to a hospital, accounting for 60 percent of all cardiac deaths.

But a new procedure called cardiac alert can get people suffering from a heart attack help faster, said Dr. Pam Decker, noninvasive cardiologist at Colorado Kaiser Permanente. Cardiac alert allows the ambulance crew to notify the hospital when an incoming patient is suffering from heart distress. Rather than spending time getting evaluated in the emergency room, the patient goes directly to the cardiologist for necessary procedures.

Hospitals also are starting to use a new stent coated with a hormone that keeps blood vessels open, Decker said. The hormone keeps the vessel from blocking and helps prevent plaque buildup. Previously, a clot would need to be removed to keep the keep blood vessel open, and a third of those procedures would fail. The new stents have a 5 percent reoccurrence rate of blockage.

Interventional cardiologist Trujillo urges people to be aware of early signs and symptoms of heart distress including chest pain and shortness of breath. Symptoms in women vary and include fatigue, nausea and abdominal pain.

"We need to educate everybody that if you feel something new, you need to seek attention from a doctor," Trujillo said. "The first hour is really important in saving lives." Women have a tendency to wait longer than men, he said, because they think it is heart-burn or something else.

Cardiovascular disease doesn't discriminate between genders. One in four Americans, male and female, has some form heart disease. In 2002, cardiovascular disease was the primary or contributing cause of 1.4 million deaths, or 2,600 per day averaging one every 34 seconds. In 2001, Colorado ranked fifth in the nation for number of people with cardiovascular disease.

Heart disease often begins in childhood and young adulthood, Trujillo warned. An estimated 9.18 million children and adolescents ages six to 19 are considered overweight or obese, which contributes to heart problems.

"Every time a child eats a Happy Meal it is the equivalent risk of three cigarettes," he said. "Over time the risk of heart disease is astronomical."

People need to be aware that heart disease problems can be passed between generations, and anyone with a family history of heart disease could be a candidate for early testing, said Lynn Miller, supervisor of health and wellness including cardiac rehabilitation at Longmont United Hospital.

"People understanding that they need to make lifestyle changes is the biggest challenge we face," Miller said. "We try to educate people about the importance of exercising and watching their diet. Many of the folks we see have been smokers and/or bad eaters for many years, and lifestyle change can be overwhelming to them."

Margie Reynolds, a registered nurse at Longmont United, said she's treating many people in their early 50s who have suffered heart failure. She also has been seeing more cases of obesity.

"I think people have gotten lazy," she said. "Society is not making exercise a priority; instead people are watching TV rather than taking a 30- to 45-minute walk."

The Cardiac Rehabilitation Phase II at Longmont United consists of a prescription from a cardiologist, an evaluation with an RN and a review of the patient's health history. The patient is placed on an exercise routine where they are monitored electronically for heart rate and EKG rhythms.

Exercises include walking, stretching and using a treadmill, stationary bicycle or stepping stairs at various intervals. Pedometers are used to track how much a patient is exercising away from the hospital, and patients are required to log their meals. The cardiac rehab center averages 100 new patients each year.

"We are a springboard for people to make behavior changes for better wellness," Miller said. "The other component is education. We talk about smoking, diet and nutritional components of good health."

"Plaque buildup in the arteries is a process that starts early and worsens until the day people have a heart attack. The test will show people if they are at risk and in two to 10 years could have a major problem."

Dr. Nelson Trujillo

ROCKY MOUNTAIN CARDIOLOGY

Risk factors for heart disease

Uncontrollable

Male sex, older age, family history of heart disease, post- menopausal, race [Blacks and Mexican Americans are more likely to have heart disease than whiles).

Controllable

Quit smoking. Smokers have more than twice the risk for heart attack as nonsmokers and are much more likely to die if they suffer a heart attack. Smoking is also the most preventable risk factor.

Improve cholesterol levels. The risk for heart disease increases as your total amount of cholesterol increases. A total cholesterol level over 200, a HDL, or "good" cholesterol level under 40, or a LDL, or "bad" cholesterol level over 160 indicates an increased risk for heart disease.

Control high blood pressure. More than 50 million people in the U.S. have hypertension, or high blood pressure, making it the most common heart disease risk factor. One in four adults has systolic blood pressure (the upper number) over 140, and/or diastolic blood pressure (the lower number) over 90, which is the definition of hypertension.

Get active. People who don't exercise have higher rates of death and heart disease compared to people who perform even mild to moderate amounts of physical activity. Even, leisure-time activities like gardening or walking can lower the risk of heart disease.

Achieve and maintain a healthy weight. Excess weight puts significant strain on your heart and worsens several other heart disease risk factors such as diabetes. Research is showing that obesity itself increases heart-disease risk. By eating right and exercising, you can lose weight and reduce your risk of heart disease.

Manage stress. Poorly controlled stress and anger can lead to heart attacks and strokes. Use stress and anger management techniques to lower risk.

Control diabetes. If not properly controlled, diabetes can lead to significant heart damage including heart attacks and death.

Source: WebMD Inc.

BY JENNIFER QUINN

Business Report Correspondent

Copyright The Boulder County Business Report Sep 16-Sep 29, 2005

Source: Boulder County Business Report

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