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Contact: Paul Lindsley; 615/222-6859; plindsley@stthomas.org
NEW HEART TESTS COULD SAVE YOUR LIFE
NASHVILLE, Tenn. – Feb. 22, 2010 – "Let's run a few tests." As a cardiologist at Saint Thomas' Heart Failure Clinic, Mark Aaron, M.D., knows that this phrase can provoke anxiety. Sorting out the slew of new tests for diagnosing heart disease – the nation's leading cause of death among men and women – can add to the apprehension.
Along with these new tests comes a host of questions: Which tests provide useful information? Which give new doctors new data, and which repeat what another test has already shown? And most important, who should get which tests?
"These new tests can help catch the killer and intervene before it strikes," said Dr. Aaron. "With the right test and more specific information, we can better assess how aggressive a treatment is needed. For example, we can accurately determine whether a patient needs an interventional procedure, statins or just to watch his or diet. The goal is to prevent heart attacks and preserve heart muscle."
So which tests do you need? Dr. Aaron says that, in treating heart disease, the key word is risk: the patient's odds of having a heart attack. The higher the risk, the more aggressively doctors seek to lower it with drugs, diet and exercise.
If you don't already know whether your risk of a heart attack is low, medium, or high, your doctor can help calculate it using measurements such as blood pressure and cholesterol levels. Your cardiologist can also recommend whether any of the following tests are right for you:
- C-reactive protein (CRP). Blood test for protein that accompanies inflammation; high levels could indicate heart disease. For people at medium risk of heart disease, especially those with an inflammatory disease, such as arthritis or autoimmune disorders.
- Fibrinogen. Blood test to check protein that is essential to normal clotting. Excess fibrinogen may cause blood clots in arteries or be a sign of atherosclerosis. High levels are associated with heart disease. Recommended for people with a medium risk of heart disease.
- Homocysteine. Blood test for the amino acid homocysteine. Elevated levels are sometimes associated with heart disease and stroke. For those at high risk, especially those whose close relatives had heart disease at a young age.
- Lipoprotein (a), Lp(a). Blood test for a fat, or lipid. Lp(a) contributes to atherosclerosis and may increase the risk of blood clots. This lipid can be elevated even if other cholesterol levels are normal. For those with a family history of heart disease, suggesting they may carry a gene for high cholesterol.
- Ankle-brachial index. Measures the ratio of the blood pressure in the ankle to the blood pressure in the arm's main artery. An index of less than 0.9 indicates a blockage in a vessel in the legs, which can suggest blockages in the coronary arteries. Recommended for those at medium risk, especially smokers and diabetics.
- Carotid ultrasound. Uses sound waves to measure thickness of the walls of the carotid arteries in the neck; thicker walls suggest a higher risk of heart disease. For those at medium risk for carotid artery stenosis.
- Magnetic Resonance Imaging (MRI). Uses radio waves and magnetic field to show motion of the heart or images of blood vessels. In the future, it may be used to show atherosclerosis. For those with suspected congenital heart disease, irregular heart rhythms, chest pain or a potential aortic aneurysm.
- Ultrafast CT scan, or Electron Beam Computed Tomography (EBCT). Imaging test used to detect calcium in the arteries, which indicates the degree of atherosclerosis. For those at medium risk, especially smokers.
Dr. Aaron says that as promising as these new tests are, an estimated 90 percent of heart attacks occur in people who have at least one of the known risk factors: high cholesterol, high blood pressure, diabetes or smoking.
"Even though the tools for discovering and understanding heart disease may be rapidly expanding, the most effective treatment is prevention," Aaron said. "The prescription for protecting your heart is the same: keep your 'bad' cholesterol level and your blood pressure down, reduce your risk of diabetes by watching your weight and exercising and do not smoke."
To learn more about heart health, call Saint Thomas Heart at 615-269-4545, or visit www.heartasone.com.
