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What are CT Heart Scans and Why are They Important

Guest Bio: Amit Zachariah, MD , Interventional Cardiologist
Dr. Amit Zachariah received his Doctor of Medicine from University of Cincinnati College of Medicine in Cincinnati, Ohio. He then completed his residency at Baylor College of Medicine in Houston, Texas and went on to complete a fellowship in cardiology at University of Cincinnati and an interventional cardiology fellowship at University of Illinois at Chicago.
    What are CT Heart Scans and Why are They Important
    Amit Zachariah, MD, explains what a CT Heart Scan is, who should receive this scan, and what steps are taken once results from the scan are determined.

    Alyssa Diaz (Host):  And it’s the Well Within Reach Podcast with Riverside Healthcare. I’m your host Alyssa Diaz and today we are talking about CT heart scans, what are they, and why are they important? Our featured guest today is Dr. Amit Zachariah, an Interventional Cardiologist at the Riverside Heart and Vascular Institute. Dr. Zachariah, thank you so much for joining us. Welcome to the podcast. And let’s go ahead and start with a quick introduction to you as a physician and your specialty as an interventional cardiologist. And tell us a little bit about yourself.

    Amit Zachariah, MD (Guest):  Yeah, thank you. So, I actually grew up in the Kankakee area and I went to high school in the area. I then did my training in Cincinnati and I traveled back to Chicago at the University of Illinois at Chicago. And then I came back to Riverside to start my job as an interventional cardiologist.

    Host:  Let’s jump right into the topic of CT heart scans which is something that’s very near and dear to your heart if I might say. And let’s start with the most basic. What is a CT heart scan?

    Dr. Zachariah:  Yes, so a CT heart scan is a x-ray based test which helps determine if there’s calcification in the arteries that supply blood to the heart. The heart is a muscle; just like any other muscle, it needs a blood supply and the coronary arteries are the arteries that supply blood to the heart.

    Host:  Okay and basically when you say it measures the calcium; is that also something that we would understand as plaque build-up in your arteries?

    Dr. Zachariah:  Yes, you can get plaque in the coronary arteries and those plaques that we see there have different characteristics. Calcified plaque has been shown to be associated with an increased risk of cardiovascular outcomes that are negative. And by looking at how much calcified plaque there is, we can determine if a patient is a higher risk to have those bad outcomes.

    Host:  Okay. And so when somebody decides that they are ready to get this scan; they go in and get a CT of the chest; is that correct?

    Dr. Zachariah:  That is correct. The whole test takes about 15 to 20 minutes to do. There’s very minimal radiation. It is a noninvasive test. It’s pretty straightforward and easy to do.

    Host:  Okay. And then the results are given in a quantified measure so basically the higher the score you receive, is the great risk for heart disease. Is that correct?

    Dr. Zachariah:  That is correct. And usually what we say is zero to 100 is a very low risk of having a bad cardiovascular outcome, 100 to 400 is a moderate risk and then greater than 400 is a high risk.

    Host:  So, let’s dive into who could be at risk for heart disease and what it takes to qualify for the CT heart scan. We know that general rule of thumb you need to be 35 years or older before you receive this scan and not already previously diagnosed with heart disease. What are some of the other qualifications to take into consideration?

    Dr. Zachariah:  Yeah, what we noticed is that patients that are older, tend to be the ones that develop calcified plaque so, that’s why we say there’s a sort of an age cutoff where we don’t scan people that are in the young range less than 35. And some of the guidelines even say less than 45. So, what we typically say is there are certain risks that we can use to justify getting a CT heart scan and some of those include being a man with an age over 45, a woman with an age over 55, having a family history of heart disease, high blood pressure, high cholesterol, physical inactivity, diabetes, and obesity. The key thing to remember here is that in most of these patients; the reason to get the scan is if you have no symptoms but you have some of these risk factors.

    If you do have symptoms, the CT heart scan is probably not the test to order. A stress test might be the best test to order.

    Host:  Okay so yeah, so reiterating the beauty of a test like this is to catch heart disease in an early stage, maybe even before someone’s experiencing signs or symptoms to prevent a possible cardiac event in the future.

    Dr. Zachariah:  That’s exactly right. What we have seen is that even low to intermediate risk patients can develop heart attacks, can develop strokes and even those patients need to be risk stratified even further and the CT heart scan is the best tool to do that.

    Host:  Right and we know that heart disease is the number one killer in the United States. So, this seems like a really simplified way to go about your journey to heart health and kind of staying on top of your risk factors to hopefully get out in front of something bad happening down the road.

    Dr. Zachariah:  That’s exactly right. It’s a great screening tool.

    Host:  So, once somebody has the CT heart scan and the results are determined; what are the next steps as far as monitoring or treatment?

    Dr. Zachariah:  Yeah so, this is where the score comes in and you had mentioned it was a quantifiable score and if you have a low to moderate risk score so between zero to maybe 100 or 100 to 400; you can do things like making lifestyle changes. That would be things like increasing your level of exercise or adjusting your diet. If you have a score above 400; you may want to talk to your physician or your cardiologist and usually what would happen is we would do some sort of noninvasive testing, usually a stress test. The other option is if you have a very high score; you can actually go straight to an angiogram where we actually look at the arteries supplying blood to the heart and using dye to see if there are any blockages there.

    Host:  Treatment options that are tailored to each patient’s results and hopefully helps get out in front of anything bad that might happen in the future. So, at Riverside, you can call and schedule your CT heart scans. There’s one phone number for scheduling. It’s 815-935-7531 and Doctor, how might individuals seek care for this or even other cardiovascular conditions or get in touch with somebody on your team?

    Dr. Zachariah:  Yeah, they can talk to their primary care physician and they can also go online at www.riversidehealthcare.org or call 844-404-HRTS.

    Host:  Thank you Dr. Zachariah for joining us on today’s podcast. And thanks for tuning in. for more information on this topic or any other at the Riverside Heart and Vascular Institute visit www.riversidehealthcare.org/heart. This has been the Well Within Reach podcast.