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.
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.
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 (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.
Aspirin - Acetylsalicylic Acid
Developed by German chemist Felix Hoffmann in 1897, acetylsalicylic acid or Aspirin as it is popularly known is a safe and effective treatment for many an ailment ranging from moderate fever to swelling or even blood clotting. This over-the-counter medication is probably one of the widest selling drugs.
Aspirin: Interestingly, Aspirin is a medicine that has found its way into the Guiness Book of Records. In the year 1950, aspirin recorded entry into the Guinness Book of Records as the highest selling drug product. People are familiar with a common adage which says 'take aspirin at bed time to cut heart attack risk in the morning'. This is a finding of a research that is popular amongst people but has not been published in a peer-reviewed medical journal.
World over, millions of people are familiar with Aspirin as a medicine to relieve pain, aches, fever and inflammation. In such instances, Aspirin is an anti-prostaglandin. Aspirin is also antiplatelet blood thinner medicine. It restricts the ability of the platelets to stick together which in turn reduces the risk of formation of blood clots.
Aspirin is used to treat headache, migraine, muscular pain, neuralgia and sore throat. Aspirin or acetylsalicylic acid has anti-coagulant properties as well as analgesic and antipyretic properties. This drug is a NSAID - non steroidal anti inflammatory drug. Prostaglandins - a family of chemicals are produced within the body's cells by the enzyme cyclo oxygenase (COX).
Further there are 2 kinds of COX enzymes - COX 1 and COX 2 which produce prostaglandins which in turn promote pain, inflammation and fever. Non steroidal anti inflammatory drugs - NSAIDS act by blocking the COX enzymes and reduce prostaglandins thereby reducing the pain, fever and inflammation. In this process of reducing the prostaglandins, NSAID promotes bleeding and may contribute to stomach ulcers. Aspirin is an unique NSAID in the sense that it inhibits clotting of blood for prolonged period - up to 4 to 7 days. It is used to reduce temperature and is commonly recommended for pain relief as in the case of dental pain. Aspirin works as a pain killer by working on the sensitivity of the nerves both at the site of the pain as well as the central nervous system. FDA has approved the use of aspirin in the following conditions:
Heart conditions : The FDA has approved the use of aspirin to reduce the risk of fatality in the event of a heart attack. Aspirin taken during a suspected heart attack can also lessen the damaging effects of the heart attack. Persons who have already suffered a heart attack or unstable angina are put on a course of aspirin to reduce the risk of another heart attack. Aspirin is also recommended for use in people who have suffered transient ischemic attack (TIA or mini-stroke). FDA has endorsed the use of low dose aspirin (75 and 325 mg) for lowering the risk of heart attack and strokes. Aspirin helps in improving blood flow through narrowed blood vessels.
Side Effects of Aspirin: Side effects from aspirin are relatively rare. If you are prone to heartburn or indigestion, ensure that you take aspirin after food. Some people experience rashes or vomiting or stomach pain after taking aspirin. Rarely are side effects such as ringing in the ears, dizziness or mental confusion noticed. In such a case, consult a doctor immediately. Recent research indicates that regular intake of Aspirin on a daily basis can increase the risk of age related Macular Degeneration. Rarely some men have reported blood in the semen - a condition called as Haematospermia.
Contraindications: Aspirin must not be taken on an empty stomach. Persons suffering from peptic ulcer must consult the doctor for the recommended dosage. Aspirin must not be taken along with alcohol. Aspirin and other salicylates should not be taken during the last 3 months of pregnancy or while breast-feeding. It is essential to keep the doctor informed if you are allergic to aspirin If you are taking medications for high blood pressure, diabetes or any anticoagulants, you must inform your physician before he prescribes aspirin.
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Bibliography / Reference
Collection of Pages - Last revised Date: April 1, 2020