A new service available at Tidelands Health can help you understand your risk for coronary artery disease and heart attack.
Called Heart Scan, the test measures the amount of calcified plaque build-up in coronary vessels, which is an accurate predictor of heart attack risk.
Candidates for Heart Scan typically have no known heart disease but do have at least one of the following risk factors: between the ages of 45 and 85, smoke, are living with high blood pressure, diabetes or high cholesterol, have a family history of heart disease, are overweight or obese and are physically inactive.
Christopher Daub, MD., is here to explain the benefits of early screening for calcified plaque build-up.
Calcium Scoring Scan: How it Works and Benefits/Importance
From the Show: Tidelands Health - Better Health Radio
Summary:
Air Date: 5/1/16
Duration: 10 Minutes
Transcription:
Bill Klaproth (Host): There’s a new weapon in the fight against heart disease and heart attack that measures the amount of calcified plaque build-up in coronary arteries which is an accurate predictor of heart attack risk. It’s called a “calcium scoring scan” or “heart scan”. Here to tell us more is Dr. Chris Daub, a physician and radiologist at Tidelands Health and is subspecialty trained in body imaging. Dr. Daub, thank you so much for your time today. We really appreciate it. So, let’s jump in. What is a calcium scoring scan?
Dr. Chris Daub (Guest): Okay, Bill. Essentially, a calcium scoring scan is the CT scan of heart. It acquires some high resolution images of the heart at rest based on EKG gauging. It shows the coronary arteries in great detail. After that, we have some software that basically identifies the calcified coronary artery plaque, if there is any, and it creates something called a “calcium score”. With this score, we then can compare that to people of similar ages, ethnicity and gender. Basically, the higher the calcium score number is, it puts the patient at greater risk for underlying heart disease and risk for future heart attack. For example, a score of over 400 would be quite high and it would signify a high likelihood of at least one significant coronary artery narrowing. We actually had a patient come in who was a volunteer when we were first kicking this off and we found that she had a calcium score of over 1,000. She was referred to a cardiologist and was found to have a severe stenosis and received a life-saving stent because of that.
Bill: The more calcium – that’s bad then? More calcium equals bad.
Dr. Daub: Yes. It shows up bright on the CT scan and we circle it in each vessel and the computer software can then calculate a number and compare it with, again, patients with similar age, ethnicity and gender.
Bill: What causes this calcium buildup?
Dr. Daub: Basically, it’s a process called “atherosclerosis”. It’s where lipid and inflammation are accumulated within the wall of an artery, such as the coronary artery. Over time, this can result in narrowing of the lumen of the coronary artery. There’s different kind of plaque. Some are called “soft”, some are called “hard” plaque. The hard plaques actually have calcification actually within the plaque and they are usually associated with older plaque, more complex plaque. Plaques can also be stable or unstable. The unstable plaques are more prone to rupture and cause acute ischemia and heart attack. The risk factors for developing atherosclerosis include diabetes, hyperlipidemia, smoking, aging, family history of coronary disease, obesity, high fat diet, sedentary lifestyles and hypertension. These all can contribute to coronary heart disease. It’s kind of a multi-factorial disease.
Bill: There are a lot of things out there that are causing this calcium buildup. Which symptoms should we watch out for?
Dr. Daub: Actually, the heart scan or coronary calcium scoring exam is not for symptomatic patients. It’s for asymptomatic patients who are at intermediate risk for developing coronary heart disease and they have no known heart disease at the time of the exam. It doesn’t really benefit people who are symptomatic. People who are symptomatic--who have chest pain, angina or shortness of breath with exertion--they need to go ahead and see their primary care physicians immediately and get appropriate treatment. This is more for asymptomatic patients who are at intermediate risk for having coronary artery disease.
Bill: So, should we ask for this test just during normal checkups?
Dr. Daub: It’s something that you should consider. Basically, Tidelands Health provides a screening form to providers and patients and you can go through that with your primary care physician and determine if this exam is likely to be of benefit to you. If so, then the patient’s provider can put in an order to the hospital and we’ll get that scheduled.
Bill: Is there an age range that we should start thinking about this? I know with colonoscopies, when you get over 50 you should think about having one of these. Same thing with a heart scan, or no?
Dr. Daub: Yes, usually in middle age – mid 50’s, early 50’s – earlier if you have a family history or any of those other risk factors, maybe in your mid 40’s. But, sometime between your mid 40’s to early 50’s is something that you might want to consider if you have any of the risk factors that I mentioned previously.
Bill: If the calcium scoring scan shows a buildup of calcium, how much higher likelihood of heart disease or heart attack is there?
Dr. Daub: It’s based on the score itself and it’s broken down into a table that basically will give you that risk level. Anything over 10, you probably want to start to consider seeing a cardiologist or performing some sort of lifestyle type changes. When it gets to be over 400, that usually indicates there could be at least a significant coronary artery narrowing – at least one. You’ll probably want to get referred to a cardiologist at that point for further workup which could include stress test, cardiac cath, etc.
Bill: Is there a way to reverse this, then?
Dr. Daub: Atherosclerosis is not generally considered reversible. Usually, the thing you want to do is try to prevent progression of the atherosclerotic disease and that’s done in various ways. It usually starts out with lifestyle modifications, dietary modifications and then can progress onto medical treatments such as statins. If those things don’t work or if the disease is too much, then cardiac catheterization and stent placement or bypass grafting are usually more indicated.
Bill: It’s a very good test to get. It’s very good to know. Talk about the test a little bit. Is it an invasive procedure? What’s the procedure like to get a heart scan?
Dr. Daub: Basically, it’s a noninvasive procedure. You’ll come into the radiology department once the order is in place and scheduled. You’ll have a CT technologist greet you. You’ll be asked to change into a gown. The CT technologist will apply EKG leads to your heart so that we can monitor heartbeat. The CT will acquire the images just during the rest phase of the heart. The scan itself takes about 30 seconds. Once it’s over with, you’ll be done and you can leave. There’s no IV dye. Again, it’s not invasive and there’s no recovery time. It’s really a great study.
Bill: It’s probably a good idea to get it and then you have a baseline, too, right? That seems like it would make sense.
Dr. Daub: Right. Exactly. If you look at the risk factors, a lot of people have them and you just don’t know because coronary heart disease is usually asymptomatic until the vessel lumen reaches a critical stenosis. If you can catch it early and do something about it, whether it be lifestyle modifications or medical treatments, then obviously patients are much better than finding out than when they actually have a heart attack.
Bill: That makes a lot of sense. So, what haven’t I asked you? What else do we need to know about a heart scan that you want to tell our listeners right now?
Dr. Daub: The heart scan is new at Tidelands Health. We just kicked it off. You can see your primary care physician about it if you have any of these risk factors or have them go over the screening form with you that we provide. If it does seem like you’ll meet all these criteria and there be a benefit for the exam, then we can get that scheduled right away. There’s no wait period for that. We can get it done and get your calcium score and hopefully it’s low and you won’t need any further intervention. But, if it’s high, it’s better to know up front so you can do something about it, again, before you have some sort of complication from coronary disease.
Bill: Dr. Daub, to wrap up, then, why should someone choose Tidelands for all their heart health needs?
Dr. Daub: Sure, Bill. Tidelands is dedicated in providing quality health care service to its’ patients at an affordable price. They have invested a lot of resources in the latest technology – CT, MRI, heart scan--and providing this cutting edge technologies and diagnostic procedures to patients at affordable prices. Tidelands has also brought in experienced primary care physicians all the way to subspecialists who can quickly and accurately get patients with risk factors from heart disease or known heart disease the appropriate diagnosis and treatment.
Bill: That sounds great. Dr. Daub, thanks so much for your time today. We really appreciate it. For more information about Tidelands Health physicians, services and facilities visit TidelandsHealth.org. That’s TidelandsHealth.org. This is Better Health Radio. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): There’s a new weapon in the fight against heart disease and heart attack that measures the amount of calcified plaque build-up in coronary arteries which is an accurate predictor of heart attack risk. It’s called a “calcium scoring scan” or “heart scan”. Here to tell us more is Dr. Chris Daub, a physician and radiologist at Tidelands Health and is subspecialty trained in body imaging. Dr. Daub, thank you so much for your time today. We really appreciate it. So, let’s jump in. What is a calcium scoring scan?
Dr. Chris Daub (Guest): Okay, Bill. Essentially, a calcium scoring scan is the CT scan of heart. It acquires some high resolution images of the heart at rest based on EKG gauging. It shows the coronary arteries in great detail. After that, we have some software that basically identifies the calcified coronary artery plaque, if there is any, and it creates something called a “calcium score”. With this score, we then can compare that to people of similar ages, ethnicity and gender. Basically, the higher the calcium score number is, it puts the patient at greater risk for underlying heart disease and risk for future heart attack. For example, a score of over 400 would be quite high and it would signify a high likelihood of at least one significant coronary artery narrowing. We actually had a patient come in who was a volunteer when we were first kicking this off and we found that she had a calcium score of over 1,000. She was referred to a cardiologist and was found to have a severe stenosis and received a life-saving stent because of that.
Bill: The more calcium – that’s bad then? More calcium equals bad.
Dr. Daub: Yes. It shows up bright on the CT scan and we circle it in each vessel and the computer software can then calculate a number and compare it with, again, patients with similar age, ethnicity and gender.
Bill: What causes this calcium buildup?
Dr. Daub: Basically, it’s a process called “atherosclerosis”. It’s where lipid and inflammation are accumulated within the wall of an artery, such as the coronary artery. Over time, this can result in narrowing of the lumen of the coronary artery. There’s different kind of plaque. Some are called “soft”, some are called “hard” plaque. The hard plaques actually have calcification actually within the plaque and they are usually associated with older plaque, more complex plaque. Plaques can also be stable or unstable. The unstable plaques are more prone to rupture and cause acute ischemia and heart attack. The risk factors for developing atherosclerosis include diabetes, hyperlipidemia, smoking, aging, family history of coronary disease, obesity, high fat diet, sedentary lifestyles and hypertension. These all can contribute to coronary heart disease. It’s kind of a multi-factorial disease.
Bill: There are a lot of things out there that are causing this calcium buildup. Which symptoms should we watch out for?
Dr. Daub: Actually, the heart scan or coronary calcium scoring exam is not for symptomatic patients. It’s for asymptomatic patients who are at intermediate risk for developing coronary heart disease and they have no known heart disease at the time of the exam. It doesn’t really benefit people who are symptomatic. People who are symptomatic--who have chest pain, angina or shortness of breath with exertion--they need to go ahead and see their primary care physicians immediately and get appropriate treatment. This is more for asymptomatic patients who are at intermediate risk for having coronary artery disease.
Bill: So, should we ask for this test just during normal checkups?
Dr. Daub: It’s something that you should consider. Basically, Tidelands Health provides a screening form to providers and patients and you can go through that with your primary care physician and determine if this exam is likely to be of benefit to you. If so, then the patient’s provider can put in an order to the hospital and we’ll get that scheduled.
Bill: Is there an age range that we should start thinking about this? I know with colonoscopies, when you get over 50 you should think about having one of these. Same thing with a heart scan, or no?
Dr. Daub: Yes, usually in middle age – mid 50’s, early 50’s – earlier if you have a family history or any of those other risk factors, maybe in your mid 40’s. But, sometime between your mid 40’s to early 50’s is something that you might want to consider if you have any of the risk factors that I mentioned previously.
Bill: If the calcium scoring scan shows a buildup of calcium, how much higher likelihood of heart disease or heart attack is there?
Dr. Daub: It’s based on the score itself and it’s broken down into a table that basically will give you that risk level. Anything over 10, you probably want to start to consider seeing a cardiologist or performing some sort of lifestyle type changes. When it gets to be over 400, that usually indicates there could be at least a significant coronary artery narrowing – at least one. You’ll probably want to get referred to a cardiologist at that point for further workup which could include stress test, cardiac cath, etc.
Bill: Is there a way to reverse this, then?
Dr. Daub: Atherosclerosis is not generally considered reversible. Usually, the thing you want to do is try to prevent progression of the atherosclerotic disease and that’s done in various ways. It usually starts out with lifestyle modifications, dietary modifications and then can progress onto medical treatments such as statins. If those things don’t work or if the disease is too much, then cardiac catheterization and stent placement or bypass grafting are usually more indicated.
Bill: It’s a very good test to get. It’s very good to know. Talk about the test a little bit. Is it an invasive procedure? What’s the procedure like to get a heart scan?
Dr. Daub: Basically, it’s a noninvasive procedure. You’ll come into the radiology department once the order is in place and scheduled. You’ll have a CT technologist greet you. You’ll be asked to change into a gown. The CT technologist will apply EKG leads to your heart so that we can monitor heartbeat. The CT will acquire the images just during the rest phase of the heart. The scan itself takes about 30 seconds. Once it’s over with, you’ll be done and you can leave. There’s no IV dye. Again, it’s not invasive and there’s no recovery time. It’s really a great study.
Bill: It’s probably a good idea to get it and then you have a baseline, too, right? That seems like it would make sense.
Dr. Daub: Right. Exactly. If you look at the risk factors, a lot of people have them and you just don’t know because coronary heart disease is usually asymptomatic until the vessel lumen reaches a critical stenosis. If you can catch it early and do something about it, whether it be lifestyle modifications or medical treatments, then obviously patients are much better than finding out than when they actually have a heart attack.
Bill: That makes a lot of sense. So, what haven’t I asked you? What else do we need to know about a heart scan that you want to tell our listeners right now?
Dr. Daub: The heart scan is new at Tidelands Health. We just kicked it off. You can see your primary care physician about it if you have any of these risk factors or have them go over the screening form with you that we provide. If it does seem like you’ll meet all these criteria and there be a benefit for the exam, then we can get that scheduled right away. There’s no wait period for that. We can get it done and get your calcium score and hopefully it’s low and you won’t need any further intervention. But, if it’s high, it’s better to know up front so you can do something about it, again, before you have some sort of complication from coronary disease.
Bill: Dr. Daub, to wrap up, then, why should someone choose Tidelands for all their heart health needs?
Dr. Daub: Sure, Bill. Tidelands is dedicated in providing quality health care service to its’ patients at an affordable price. They have invested a lot of resources in the latest technology – CT, MRI, heart scan--and providing this cutting edge technologies and diagnostic procedures to patients at affordable prices. Tidelands has also brought in experienced primary care physicians all the way to subspecialists who can quickly and accurately get patients with risk factors from heart disease or known heart disease the appropriate diagnosis and treatment.
Bill: That sounds great. Dr. Daub, thanks so much for your time today. We really appreciate it. For more information about Tidelands Health physicians, services and facilities visit TidelandsHealth.org. That’s TidelandsHealth.org. This is Better Health Radio. I’m Bill Klaproth. Thanks for listening.
