Advanced technology to detect heart disease is helping move cardiac medicine from a let's-fix-it mentality to one of prevention. And imaging tools can now detect signs of heart disease at earlier stages before chest pain and other symptoms, at a stage when lifestyle and diet changes, along with medications, can alter the future.
That's the topic of Saturday's Deseret Morning News/Intermountain Health Hotline. From 10 a.m. to noon, Dr. Christopher McGann and Dr. Brent Wilson, both advanced diagnostic cardiologists at LDS Hospital's Cardiac Imaging Center, will take phoned-in questions from 10 a.m. to noon. The confidential hotline can be reached at 1-800-925-8177.
"It's not that all of a sudden in the 21st century we decided that early diagnosis is a good thing. We've really just gotten to the point where we can pick up disease noninvasively earlier than before. Now we are able to do it in a way that's safe and effective and, in many cases, the tests are substantially better than what we'd done before invasively," says McGann.
Often, when heart disease is found early enough, it can be managed medically, without additional procedures. And when the tests are done later, after symptoms have developed, the two say, they can help sort out whether symptoms are due to developing cardiac disease or not. So the tests are not just used for early screening.
But that early screening is particularly important if there's a family history of premature coronary artery disease or when a person has risk factors like high cholesterol, hypertension (even mild) or a history of smoking. People with diabetes are at greater risk, as well, as are those who are overweight. Smoking is as significant as hypertension, cholesterol and diabetes. Smokers are more likely to develop heart disease whether or not they are hard-wired genetically, Wilson says.
The advanced diagnostic tests include cardiac CT to get a coronary calcium score (a definite sign of coronary artery disease), coronary CT angiography and cardiac MRI.
The two are also working with other Intermountain researchers to see if the tools can be used to risk-stratify diabetics. "We want to see if we can change treatments in a way that changes outcomes." McGann says they hope to identify people with diabetes who are asymptomatic but at high risk of or in the early stages of coronary artery disease to see if treatment decisions can allow patients to live longer, healthier lives.
Because the tests, with the exception of the coronary MRI, deliver radiation, however, they say it's not recommended for just everyone. "The decision needs to go hand-in-hand with the physician, performed at an optimal time."• Tomorrow: The tests and what they tell you.
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