What Happens If Something Is Detected On My Screening Exam
If screening tests reveal coronary artery disease, there are steps you can take to lower your risk for having a heart attack or worsening heart disease. Your doctor may recommend lifestyle changes such as a healthier diet, exercise and smoking cessation.Medications may also be necessary. Medicines can treat coronary artery disease risk factors such as high cholesterol, high blood pressure, an irregular heartbeat and low blood flow. In some cases, more advanced treatments and surgical procedures can help restore blood flow to the heart.
A negative cardiac CT for calcium scoring means no calcification was found within your coronary arteries, suggesting that coronary artery disease is absent or so minimal it cannot be seen by this technique. Under these circumstances, your chance of having a heart attack over the next two to five years is very low.
A positive cardiac CT for calcium scoring means that CAD is present, regardless of whether or not you are experiencing any symptoms. The amount of calcification is expressed as the calcium score. A score of 1 to 10 indicates minimal evidence of CAD, 11 to 100 indicates mild evidence, 101 to 400 represents moderate evidence of disease and a score of over 500 indicates extensive evidence of disease.
If coronary artery disease is present, steps to reduce the individual’s risk of heart attack and to manage symptoms include lifestyle changes, medications and if necessary, medical or surgical procedures such as:
Anxiety And Depression After A Heart Attack
After a heart attack, many people worry about having another heart attack. Sometimes they feel depressed and have trouble adjusting to new lifestyle changes.
Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you’re very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.
Joining a patient support group may help you adjust to life after a heart attack. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical center.
Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.
Returning To Normal Activities
After a heart attack, most people who don’t have chest pain or discomfort or other problems can safely return to most of their normal activities within a few weeks. Most can begin walking right away.
Sexual activity also can begin within a few weeks for most patients. Talk with your doctor about a safe schedule for returning to your normal routine.
If allowed by state law, driving usually can begin within a week for most patients who don’t have chest pain or discomfort or other disabling problems. Each state has rules about driving a motor vehicle following a serious illness. People who have complications shouldn’t drive until their symptoms have been stable for a few weeks.
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What To Do If You Or Someone Else May Be Having A Heart Attack
- Don’t ignore or attempt to tough out the symptoms of a heart attack for more than five minutes. If you don’t have access to emergency medical services, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only as a last resort, and realize that it places you and others at risk when you drive under these circumstances.
- Chew and swallow an aspirin, unless you are allergic to aspirin or have been told by your doctor never to take aspirin. But seek emergency help first, such as calling 911.
- Take nitroglycerin, if prescribed. If you think you’re having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else’s nitroglycerin, because that could put you in more danger.
- Begin CPR if the person is unconscious. If you’re with a person who might be having a heart attack and he or she is unconscious, tell the 911 dispatcher or another emergency medical specialist. You may be advised to begin cardiopulmonary resuscitation . If you haven’t received CPR training, doctors recommend skipping mouth-to-mouth rescue breathing and performing only chest compressions . The dispatcher can instruct you in the proper procedures until help arrives.
- If an automated external defibrillator is available and the person is unconscious, begin CPR while the device is retrieved and set up. Attach the device and follow instructions that will be provided by the AED after it has evaluated the person’s condition.
Heart Tests That Could Save Your Life
Your physician has you come into his office and run on a treadmill while you’re hooked up to an EKG. For the next 8 to 12 minutes, he’ll evaluate your heart rate, breathing, and blood pressure as the intensity of the workout increases. When the stress test is over, he’ll tell you whether you have coronary artery disease.
Sounds simple enough, right? Well, here’s news that might make your heart skip a beat: For women, there’s a 35% chance the test results will be wrong. Most often, the test reveals false positives, meaning healthy women are told they have heart disease. Less frequently, but obviously far more dangerous, is when the test fails to detect clogged arteries that could, in fact, cause a heart attack.
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For decades, doctors had nothing more sophisticated than a stress test to offer, but not anymore. Cardiologists now have access to advanced imaging and blood tests that give a much more accurate assessment of heart attack risk. “These tests are the best ways to tell who is in danger because they can catch cardiovascular disease 20 to 30 years before it gets severe enough to cause a heart attack or stroke,” says Arthur Agatston, MD, an early champion of many of them.
The “new and improved” heart tests listed below are available at most major medical centers and hospitals. If your doctor doesn’t request them for you, demand the ones that are recommended for women in your age group and risk category.
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What Are The Early Signs Of A Heart Attack
There are heart attack symptoms in women that are different from heart attack symptoms in men. But the common signs and symptoms they usually share are as follows:
- Chest pain or discomfort: The discomfort usually lasts for more than a few minutes or it may go away and come back. The discomfort may feel like pressure, squeezing, fullness or pain at the center of the chest.
- Discomfort in other areas of the upper body: This may include pain or discomfort in the back, jaw, stomach or in one or both arms.
- Shortness of breath: This may occur with, before or without chest pain or discomfort.
- Breaking out in a cold sweat
- Nausea or light-headedness
Meanwhile, heart attack symptoms in women sometimes go unnoticed. These include the following:
- Back pain
- Dizziness
- Fainting
- Pressure, fullness, squeezing pain in the center of the chest, spreading to the neck, shoulder or jaw
- Unusual fatigue
- Treating or managing conditions that can be a risk factors of heart attack such as diabetes
Who Should Have Their Cardiovascular Health Risk Assessed
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All adults aged 30 or more.
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Adults of any age who have:
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A strong family history of early cardiovascular disease. This means if you have a father or brother who developed heart disease or a stroke before they were aged 55, or in a mother or sister before they were aged 65.
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A first-degree relative with a serious hereditary lipid disorder. For example, familial hypercholesterolemia or familial combined hyperlipidemia. These diseases are uncommon.
If you already have a cardiovascular disease or diabetes then your risk does not need to be assessed. This is because you are already known to be in the high-risk group.
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Who Should Get An Ultrasound Screening
Individual ultrasound screening tests may be helpful for certain people. For example, a one-time ultrasound of the abdominal aorta is recommended at age 65 to 75 for men who have smoked to look for an abdominal aortic aneurysm.
Similarly, screening the legs and ankles may be recommended for someone diagnosed with cardiovascular disease or at increased risk for it, particularly if they have leg cramps.
An ultrasound of the carotid arteries will be performed immediately in someone who reports symptoms of transient ischemic attack , a mini-stroke that resolves spontaneously. TIAs are warning signs that a full-blown stroke is imminent.
It is important for anyone who receives this warning to go immediately to the emergency room for treatment to prevent a stroke from occurring, says M. Shazam Hussain, MD, Director of Cleveland Clinics Cerebrovascular Center. The highest risk for stroke is within two day after the TIA, so no one should wait to get checked.
In all these cases, testing will be reimbursed.
Ask The Doctor: How Should I Be Screened For Cardiovascular Disease
Q. I have a family history of cardiovascular disease. Although I don’t have high blood pressure, high cholesterol, diabetes, or any other risk factor, I’m concerned about how my cardiologist is screening me, because women can have small-vessel disease and not necessarily arterial disease. How should I be screened?
A. In general, the decision to screen a woman for cardiovascular disease depends on her risk for the disease and whether she has symptoms. The risks include some things that are out of our control, such as a strong family history . But we can prevent or lessen many other risks through lifestyle changes, or, if necessary, medications. Major risk factors include obesity, smoking, physical inactivity, high blood pressure, high cholesterol, and diabetes. All of these affect both genders, but several have a greater impact on women. For example, diabetes raises the risk of heart disease in women more than in men.
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How Is The Lipid Panel Used
The lipid panel is used to help determine your risk of heart disease and to help make decisions about what treatment may be best if there is borderline or high risk. The results of the lipid panel are considered along with other known risk factors for heart disease to develop a plan for treatment and follow-up. Depending on the results and other risk factors, treatment options may involve lifestyle changes such as diet and exercise or lipid-lowering medications such as statins.
The lipid panel measures cholesterol, triglycerides, high density lipoprotein cholesterol as well as calculates low density lipoprotein cholesterol . Triglycerides are a form of fat and a major source of energy for the body.
According to 2002 guidelines from the NCEP Adult Treatment Panel III, the desirable ranges for the components of the lipid panel are:
- Cholesterol < 200 mg/dL
- HDL-cholesterol > 40 mg/dL
- LDL-cholesterol < 100 mg/dL â this is considered optimal levels will depend on the number and type of risk factors present and reason for testing.
- Triglycerides < 150 mg/dL
Some other information may be reported as part of the lipid panel. These parameters are calculated from the results of the tests identified above.
How Does Your Doctor Check Your Risk
Your doctor looks at things that put you at risk for a heart attack and stroke. Your doctor might check:
- Your cholesterol levels.
- Your age, sex, and race.
- If you smoke.
- If you have a family history of early heart disease. Early heart disease means you have a male family member who was diagnosed before age 55 or a female family member who was diagnosed before age 65.
- Results of tests such as C-reactive protein, coronary calcium scan, or ankle-brachial index.
Calculators. Your doctor might use a tool to calculate a risk score for you. There are different tools that doctors use. These tools are not perfect. They may show that your risk is higher or lower than it really is. But these tools give you and your doctor a good idea about your risk.
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About Coronary Heart Disease
According to the National Institutes of Health, heart disease is the leading cause of death in the United States and a major cause of disability. Of the many different forms of heart disease, coronary artery disease is the most common and a major cause of myocardial infarction .
CAD occurs when plaque collects and forms along the walls of the heart’s arteries, a condition called atherosclerosis. As the plaque builds up, the heart’s arteries narrow and blood clots may form, limiting blood flow and creating a risk for the vessel to become completely obstructed resulting in a heart attack.
Risk Factors You Can Control
The major risk factors for a heart attack that you can control include:
- High blood sugar due to insulin resistance or diabetes
Some of these risk factorssuch as obesity, high blood pressure, and high blood sugartend to occur together. When they do, it’s called metabolic syndrome.
In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesn’t have metabolic syndrome.
For more information about the risk factors that are part of metabolic syndrome, go to the Health Topics Metabolic Syndrome article.
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Heart Tests Your Doctor Might Order And What They Mean
Heart disease patients and those suspected of having heart disease often face a battery of tests. Find out what you should expect if one of these noninvasive heart tests is in your future.
This post is part of a mini blog series dedicated to bringing awareness about your heart health during the American Heart Association’s national #HeartMonth. Miss the other stories? Catch up on 5 Eating Tips for a Healthy Heart, How To Check Your Blood Pressure at Home, How to Know If You’re Having a Heart Attack and Getting Heart Healthy with a Mediterranean Diet.
MRIs. CT scans. ECGs. There are a lot of test names you may hear when you visit your cardiologist, but what are all these tests and why do you need them?
If you have heart issues or are suspected of having a heart condition, your doctor may order an array of tests. But whats their purpose and what should you expect? Michigan Medicine cardiologist Venkatesh Murthy, M.D., offers a guide to the various noninvasive tests your doctor may order, including what theyre designed to do.
1. Echocardiogram: Uses sound waves to produce images of your heart. This common test allows your physician to see how your heart is beating and how blood is moving through your heart. Images from an echocardiogram are used to identify various abnormalities in the heart muscle and valves. This test can be done while youre at rest or with exercise to elevate your heart rate .
Reasons for the test:
Reasons for the test:
Reasons for the test:
The Heart Test You May Needbut Likely Havent Heard Of
How’s your coronary artery calcium? What’s that, you ask? Like the more familiar tests used to assess your risk of future heart problemscholesterol, blood pressure and blood sugar tests, for examplecoronary artery calcium testing helps reveal your risk of heart disease, often before other warning signs appear.
Also known as a calcium score, it’s one of the newerand more accurateassessment tools being used. “A coronary calcium scan isn’t for everyone, but it’s the finest way for those who are uncertain about their heart disease risk to make better decisions about treatment and medications,” says Michael Blaha, M.D., M.P.H., director of clinical research at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins.
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Checking Your Blood Pressure
Blood pressure is the force of the blood against the walls of your arteries as your heart pumps it around your body. There are two ways it’s measured:
Systolic blood pressure. This is the pressure in your arteries when your heart squeezes.
Diastolic blood pressure. It’s the pressure in your when your heart is relaxed, between heartbeats.
Normal blood pressure for an adult, when you’re at rest, is less than 120 over less than 80. The 120 is the systolic pressure. The diastolic pressure is 79.
High blood pressure, also called hypertension, is a blood pressure reading of 130/80 or higher.
Years of high blood pressure can stiffen and narrow your artery walls, which blocks the blood flow to your heart. It can lead to heart disease or heart attack.
Your blood pressure may go up or down depending on your age, heart condition, emotions, activity, and the medications you take. One high reading doesn’t mean you have high blood pressure. You need to measure it at different times while you’re resting to find out your typical numbers.
Heart Screenings: Why And When You Need Them
The best way to prevent heart disease is understanding and managing your risk factors. For many people, this can be as simple as scheduling an annual checkup with your primary care physician to screen for things like:
- weight and body mass index
- blood pressure
- cholesterol
- fasting blood glucose
Knowing those numbers can help determine if you need to make lifestyle modifications or seek further treatment for potential heart conditions.
But when should you ask for a more comprehensive heart screening?
For patients with two or more risk factors who are experiencing symptoms such as chest pain, shortness of breath or irregular heartbeats, we would consider additional cardiac tests, says Beaumont cardiologist Chandrakant Pujara, M.D.
Dr. Pujara said these tests could include:
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