Heart Calcium Scan

Heart calcium scan also known as Coronary Calcium Scan is what the doctor will use to look for calcium deposits in coronary arteries. Such calcium deposits can narrow arteries and thereby increase heart attack risk. The result of this scan is called Coronary Calcium Score. Heart calcium scans are non-invasive techniques to measure the amount of calcium in the walls of coronary arteries – arteries that supply heart with blood. This is an indication that they may develop coronary artery disease.

Why heart calcium scans?

These scans show a higher risk of having a heart attack or any other problems before any symptoms of heart disease become obvious. However, the American College of Cardiology does not recommend routine heart scans on people who do not exhibit any symptoms of heart disease and who do not smoke or have cardiac risk factors such as elevated cholesterol or high blood pressure.

Heart scans is useful to whom?

In those who are in intermediate heart attack risk category, a heart scan may give information about heart attack risk. Based on risk factors, having a heart attack in the next 10 years falls somewhere between 10 and 20 %. For instance, if the patient is between ages 55 and 65 years and bordering on high cholesterol or blood pressure or a smoker, then a heart scan may be considered. As there is some evidence that people with calcium scores show risk of heart disease, many would be motivated to adopt lifestyle changes, lose weight or quit smoking than those who do not undergo heart scan.

Who do not benefit from heart scans?

If a person is younger than 55 years of age and has normal cholesterol and blood pressure levels, and does not smoke, heart attack percentage is calculated less than 10 % and falls under low-risk category. Probably, in such cases, a heart scan may not reveal anything more than what the doctor already knows.

A 20 % risk or greater risk of having a heart attack in the next 10 years means at high risk. If the person is older than age 65 with high cholesterol levels and high blood pressure and does smoke, then a heart scan will not do much good because the doctor knows the risk based on risk factors and the steps to prevent a heart attack such as taking medications and making significant changes in life style. If the person has already had a heart attack or a surgical procedure, then he is at a high risk of having a heart attack and therefore a heart scan will not provide any more information on how his/her condition should be treated.

Preparing for a heart scan

It is better to visit the doctor prior to the heart scan as this can provide additional information on the heart attack risk for a doctor to consider. The examination will include:

1. A review of the medical history and the patient's family medical history.
2. A physical examination including blood pressure.
3. A risk assessment including questions about exercise and smoking habits.
4. Blood tests including cholesterol levels.
5. The doctor has to be told if a woman is pregnant. This test is not done on pregnant woman.
Other than these, there are no special preparations to have before the heart scan.

The procedure and after

A coronary calcium scan is usually done by a radiology technologist. The pictures are interpreted by a radiologist. A team of family medical practitioner, internist, cardiologist or surgeon may also review this test. Heart calcium scans takes only a few seconds and during this procedure the patient is asked to hold their breath to obtain an accurate image. The scan shows the calcium in the heart arteries by using computerized tomography (CT).

Calcium deposits show up as bright white spots on the scan. The standard imaging technique for coronary arteries uses multi slice or helical CT. In addition to calcium, such scans also reveal the presence of any narrowing of heart arteries due to coronary artery disease. After the procedure there are no special precautions and the patient should be able to drive home and continue daily activities.

Results

If calcium score is high, it means more aggressive treatment of heart attack risk factors should be done such as life style changes or medications. The doctor may recommend more invasive tests such as coronary Angiography based on scan results. Sometimes the result of the test may not be helpful if the patient has a fast heart rate or smokes.

Risks

Heart scans such as multi slice computerized tomography and helical CT are used to see calcium in arteries. Such type of scans expose the patient to radiation. There is a slight chance of developing cancer from having coronary calcium scan. The chance is higher in those who have had many radiation. It is imperative to consult with the doctor about the amount of radiation required for this test and confirm that the test is needed. Sometimes an allergic reaction to the medication that is used during the procedure is exhibited.

The results of such scans should never be interpreted alone but should be used with information about other overall heart health and any risk factors the patient may have such as family history and high cholesterol. It is possible to have false positive results. This means that the test shows a high chance of plaque in the arteries when it is not true. Those with low chance of heart disease are most likely to have a false-positive test.

Myocardial Infarction

Myocardial Infarction (MI) is also referred to as a heart attack or coronary thrombosis. It is a condition where a part of the heart muscle suddenly loses blood supply. Typically, a heart attack occurs due to a thrombosis (blood clot) formed within a coronary artery. This obstructs normal blood flow to some part of the heart. If left untreated, myocardial infarction can cause damage to the heart. Besides a severe myocardial infarction can be fatal. There is shortness of breath and profuse sweating. It is essential to seek immediate medical help if you feel that you are suffering a myocardial infarction. Sudden overwhelming stress or laborious exertion or physical activity might bring on a myocardial infarction.

A heart attack is felt as a sudden and severe chest pain that may also travel up and down both arms. The pain felt during myocardial infarction lasts longer than that felt during an angina. In rare cases, a person does not feel any noticeable symptoms and is even unaware that he has suffered a heart attack. Smoking, diabetes, hypertension, high cholesterol and obesity puts a person at increased risk of heart attacks. Heart attacks are more noticed in older men and women, though there is an increasing trend for younger persons to suffer heart disease too. Female sex hormones protect women from heart disease till menopause. Heart ailments and coronary heart disease is sometimes genetic.

An ECG (electrocardiograph) can help trace your heart activity and whether you have suffered a heart attack. A Doppler ultrasound helps examine the heart valves, muscles and blood flow. A coronary angiogram is a special x-ray procedure that tests the severity of the blood vessel block with the help of a dye. The presence of certain enzymes like Troponin-I and Creatinine Kinase (CK) are indicative of a heart attack.

Hospital treatment is essential for a person suffering from a MI. The nature of the treatment hinges on the extent of damage of the heart muscle as well as the blockage of the blood vessels. Medication for dissolving the blood clot is administered. The patient is given drugs to reduce the pain and breathe easier. Beta-blocker drugs may be given to reduce the chances of another heart attacks. ACE Inhibitors may be prescribed to prevent heart failure. Balloon Angioplasty may be recommended to improve blood flow to the heart.

Congestive Heart Failure

Congestive Heart Failure or CHF is a condition where there is weakening in the pumping action of the heart due to fluid buildup in the body. The term 'congestive' is indicative of the blood backing up into the liver, abdomen, lungs or lower extremities. This medical condition develops over a period of time and leads to enlargement of the heart. Due to the inability to pump enough blood, the heart compensates by becoming larger. This leads to enlarged heart chambers and thicker heart wall muscles. Persons suffering from coronary disease or arrhythmia are more at risk for CHF.

Persons suffering from hypertension and heart valve disease are more susceptible to congestive heart failure. If you have suffered a heart attack or congenital heart defect, you are more likely to be prone to CHF. Congestive heart failure is characterized by backing up of the blood from both one or both the lower chambers of the heart.

Symptoms of Congestive heart failure include shortness of breath and weakness. A person suffering from CHF may notice weight gain on account of body fluid accumulation. This shows up as water retention and edema in the ankles, feet and legs. The fluid buildup leads to frequent urination, especially at night. Chest pain, irregular pulse and restlessness are other symptoms of CHF. Decreased alertness and inability to pursue exercise are signs of congestive heart failure. There is weakness and extreme fatigue due to reduced blood flow to the major organs. Dizziness and confusion is noticed due to inadequate oxygen supply to the brain. Persistent cough and wheezing can also be noticed.

Diagnostic tests such as chest x-rays and ECG can aid in detecting any stress on the heart. During a physical examination, a doctor can detect fluid buildup in the chest. Imaging tests such as angiography and nuclear ventriculorgraphy help in clear diagnosis of the heart's pumping condition. EKG and echocardiogram aids in detecting any possible heart enlargement and fluid buildup. Blood tests can indicate any kidney or thyroid malfunction that may affect heart's functioning. BNP test or B-type natriuetic peptide Test is conducted to assess heart failure.

Medications for congestive heart failure include ACE inhibitors that keep the blood vessels open and inotropics to strengthen the heart's pumping capacity. Diuretics may be prescribed to get rid of excess body fluids. Vasodilators and Calcium channel blockers open up narrowed blood vessels. Angioplasty is done to open up narrowed arteries. This is resorted to in cases where there is fatty plaque buildup. Surgery to repair existing defects such as heart valve repair and coronary artery surgery are sometimes resorted to. Lifestyle changes can go a long way in keeping CHF at bay. CHF is a progressive condition; it cannot be cured but lifestyle changes can go a long way in slowing the progress of the disease. These include quitting smoking and controlling diabetes, cholesterol and high blood pressure. Control alcohol consumption and embark on a fitness regimen that includes aerobic exercise.