Greg, a 51-year-old pharmaceutical agent, was proud of his healthy lifestyle. When he was 5 feet 8 inches, he had a slim body weight of 147 pounds and was emphasized as a champion's high school wrestler. He worked on work and family life with great feelings, enthusiasm and energy. He was also proud of his cholesterol value that he checked in the past ten years since he worked in the pharmaceutical industry and paid more attention to his health. His recent panel: HDL 55 mg / dl, LDL 94 mg / dl, triglyceride 123, all according to his doctor. Greg 's mother and father were alive even if they did not encounter heart disease in the early' 80s. Greg was confident that he was released from danger.
Surprisingly, Greg 's older sister informed me that she had developed an unstable chest pain symptom that required hospitalization recently. She underwent cardiac catheterization, received two coronary artery stents, narrowing open heart surgery. Satisfaction of this unstable Greg was worried about his own health. He received a cardiac scan that brought a score of 1387, with a 99th percentile of men of his age. This score is not low risk, but in fact it shows that the risk of Greg is 25% per annum of heart attacks and deaths.
Can you tell if cholesterol is hiding the backing plate of your coronary artery?
No, cholesterol does not tell if coronary plaque exists. It is just blood fats which is one of many causes of coronary plaque and provides an indirect statistical measure of the possibility of heart disease. Can you cause a heart attack with low cholesterol? definitely. You are high in cholesterol, but you are 18 years old grandchildren and live to 95 years old, do not you have heart disease stitches? no mistake.
Does EKG show hidden coronary plaque? No, EKG is a simple electrical procedure that actually indicates a heart attack in progress or later.
How is the stress test? They do not detect hidden coronary plaque?
No, once again. Stress testing is a measure of blood flow to the heart and is abnormal only when the flow is substantially reduced. For example, blocks that occupy 80 to 90% of the diameter of the Convention can be detected by stress testing. The problem is that 90% of the hidden (asymptomatic) coronary plaque is absolutely subject to a normal stress test but is still at risk of a heart attack. In fact, most of the people suffering from a heart attack next year are undergoing regular stress tests.
So how can we easily detect hidden coronary plaque plaque easily, cheaply and safely and measure it? We do not want invasive procedures involving scalpels or catheters. It is necessary to have a test that accurately detects hidden dental plaque with virtually no risk and pain that most people can get.
What you can do with heart scan, in particular, it is superior, faster and easier than any other test.
"Currently, 95% to 99% of cardiac diseases are known to occur in areas without arterial stenosis.
Dr. Steve Nissen
Cleveland Clinic
What is a cardiac scan exactly?
If you receive a cardiac scan, you know that the heart scan is taking place in the easiest and quick health checkup. Please hold your breath for 30 seconds. You can easily get any test. Without stabbing, you can not prepare for IV, premedication, or preparation without sudden or pushing. Most people are surprised at how easy it is. The most common comment after the scan is completed is "Is that so? Through such efforts, you can get the most powerful information about the future of your mind.
Heart scan is the actual 30-V 40 cross-sectional image from the top to the bottom of the heart (it varies according to the height) and can be acquired in seconds. (If you hold your breath, there will be no movement of the heart due to lung expansion.) You can easily see the "slices" of three coronal sections with each of over 30 images. Each slice overlaps with the slices above and below it, so we actually survey the contents of the chest in three dimensions.
Each scan is reviewed with computer application-specific criteria, which helps to determine whether the selected area within the coronary artery is really coronary plaque. The area (square millimeters) is multiplied by the density of the plaque, which results in a "score" for this particular plaque. All plaques within each image slice are scored and all scores are added. This will bring you the total score reported to you. You may hear the total score of the "Agatston" score named after Dr. Arthur Agatston of the University of Miami. This scoring method was developed for the first time. The Agatston score is currently one of the standard calculations performed on all cardiac scans. (This is the same as Dr. Arthur Agatston who wrote a very successful South Beach diet.)
If you have not yet received a cardiac scan, how will you decide if you need to get it first?
Many permits are recommended to scan men over the age of 40, women over the age of 50. This is based on a simple observation that tens of thousands of men started showing hidden spots (score> 0) over the age of 40, women over 50 years old. Prior to these ages, scores above 0 are unusual for both sexes. Women are advised to undergo scans later than men because the development of plaque is about 10 years behind the male.
Beyond age, there are no useful criteria for deciding who should scan, who should not scan. For example, you can use LDL cholesterol to decide what to scan. If you choose LDL cholesterol> 130 mg / dl person, half of cardiac patients will escape. (In other words, about 50% of people with measurable coronary plaque smoking LDL cholesterol 300 - you may consider to scan 5 years earlier (35 males, 45 females) .
What is the score of heart scan? Detectable plaques are zero or none detected for any scanned image. What is terrible? Just like playing golf, the higher your score is, the worse it is. But just as asking "What is a terrible golf score?" The answer to what constitutes a bad cardiac scan score is "it depends." Indeed, the higher your score, the more plaque in your arterial arms the higher the risk of heart attack. It has a risk of heart attack of 25% per year (unless prophylactic therapy has been started), as unexpected due to the above Greg the score of 1000 or more (It is plenty of dental plaque!). Scores between 0 and 1000 are much more common and have different degrees of risk in between.
Why is it called "calcium score"?
What exactly is measured by heart scan?
A child 's artery is a lining tissue with a thickness of about 1 mm, which is a flexible thin walled tube without plaque. Especially, if there are harmful factors such as genetic reasons, smoking, high cholesterol, high fat diet, hyperglycemia, it will take a year. The inner layer tissue of the artery is delicate and easily injured, reflecting injury due to thickening. Within the thickened lining, fiber structural material, calcium (such as in bone), and inflammatory cells also accumulate. The resulting atheromatous material is referred to as "atherosclerotic plaque".
Many plaque components can not be measured in living humans such as inflammatory cells or structural tissues. We are trying to measure plaque accurately without invasive methods such as females and catheters. The collection of calcium in the plaque can be accurately and easily measured. Interestingly, microscopic examination of atherosclerotic plaques shows that calcium consistently accounts for 20% of the total volume of plaque. This percentage is true regardless of whether female, male, young, old, and you are already suffering a heart attack. In other words, calcium provides an indirect but accurate means of measuring total plaque mass. For example, measuring 2 cubic millimeter plaque yields a total of 2 x 5 = 10 cubic millimeter plaques.
Rule of coronary calcium scoring is simple: the higher your score, the more plaque will be in the coronary arteries.
Coronary arterial calcium score predicts the risk of heart attack
Studies after the study have shown that the higher the score of the heart scan, the higher the risk of heart attack. This is because plaque ruptures with a high probability that a heart attack will occur, even if the plaque is occluded by only 20%, the more plaques along the coronary artery treaty are. Even if there are low cholesterol values, long distance jogging etc, this is the truth. Cardiac scan score is the most powerful predictor of the future of the heart. Of course, this does not mean that you can not change the future. In fact, you should encourage you to know your heart scan knowledge. If you find that your score is high, it is to start or improve the preventive program. Your goal: To minimize the risk of heart attacks to zero.
Unlike cholesterol, your score represents the sum of factors contributing to the growth of coronary plaque by the day of scanning. Let's say you spend between 30 and 40 years of age who are overweight, comfortable to sit, smoke, unhealthy eating habits. Those 12 year cholesterol panels may reflect your unhealthy lifestyle. However, I lose 60 pounds at the age of 41. Start the exercise program, smoking according to a healthy diet. If you have a strong plaque in the coronary arteries, the cholesterol panel will be much improved after achieving all this. However, cardiac scanning at this point reflects the total impact in your life, so it may indicate a high score. Your score does not reassure you lying, as the cholesterol panel does.
Is it "hard" or "soft" plaque?
A common misunderstanding is that because the calcium is a hard substance, the coronary calcium score obtained by cardiac scan only provides a measure of hard plaque. wrong. The calcium measured is the reflection of both soft and hard total plaques.
Indeed, the vast majority of coronary plaque has a mixture of hard plaque and soft plaque, the plaque is dynamic and living tissue, so it can be changed every day, every week. In other words, today's soft plaque can develop hard elements of tomorrow, today's hard plaque can develop to develop soft parts at any time. In fact, most plaques are both. Therefore, the score of your heart scan is a big measure like a hidden, whole, plaque.
The most important health examination you can get
Cardiac scanning is simple and cheap. Still, in the United States, we are revealing the greatest killers between men and women. It is a very accurate and simple 30 second test that quickly detects heart disease. Their key point is before risking your "score". Cardiac scanning is primarily a tool for prevention. If you know your score, you know that prevention evil effort is correct.
Selected reference
Theoretical rationale for coronary calcium measurement as a measure of total coronary artery plaque
Detrano R, Tang W, Kang X, Mahaisavariya P, McCrae M, Garner D, et al. Accurate coronary artery calcium phosphate mass measurement from electron beam computed tomography. Am J Cardiac Imag 1995; 9: 167-173.
Difference in the prevalence and abundance of coronary calcium detected in super fast computed tomography of pregnant men and women. Am J Cardiol 1993; 72: 247-254.
Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS. Coronary artery calcium region by electron beam computed tomography and coronary atherosclerotic plaque region: histopathological correlation study. Circulation 1995; 92: 2157-2162.
Simons DB, Schwartz RS, Edwards WD, Sheedy PF, Breen JF. Noninvasive Definition of Anatomical Coronary Artery Disease by Ultrafast Computed Tomography Scan: Quantitative Pathological Comparative Study. J Am Coll Cardiol 1992; 20: 1118-1126.
