Coronary artery disease screening

Dear Friend,

In the United States, someone has a heart attack every 40 seconds. 75% of the annual heart attacks are first time heart attacks. 1 in 20 adults over the age of 20 have coronary artery disease (CAD).

I’ve seen many clients who had calcium scores completed by their primary care physicians (PCP) or through corporate health evaluations and frankly, it’s not sufficient to answer the question at hand: Do you have CAD?

What is a Calcium Score?

It is a quick and dirty CT scan that looks at how much calcium is visualized around the heart, this is then quantified into categories and given a percentile risk for CAD. Many physicians will start patients on medications (statin, aspirin, etc.) based on this percentile.

So what’s the problem?

It is two-fold, the calcium score only shows calcium deposits, which means a soft plaque has matured (calcified). The calcium is your body’s way of protecting the plaque from causing a full occlusion (“heart attack”). Secondly it picks up all calcium, so some of it may not be in your coronary vessels which is where it matters.

What’s the solution?

Coronary CT Angiogram

Let’s look at 3 real-life examples from our client group?

1. 45 year old male with high genetic risk for cardiovascular disease and high cholesterol. No family history and no symptoms.

   • CCTA shows 100% occlusion of the left anterior descending artery (LAD, aka “widow maker”), partial occlusion of 2 other vessels. This process took 10-20 years to develop, allowing the heart to form "collateral" blood supply.

   • Outcome: Coronary Artery Bypass Graft (CABG-Open heart surgery) a week after CCTA, discharged from the hospital in just 3 postoperative days because of his relative youth. He maintained perfect heart function because he never suffered a cardiac event. He’s back to working out with a different perspective on life.

2. 60 year old male with high genetic risk for cardiovascular disease and high cholesterol. Had a positive calcium score years ago, no symptoms. Not on any medications.

   • CCTA shows a 25% occlusion of LAD. Considered high risk because different than the case above, no collateral blood supply formed, so if the plaque ruptures, it will completely block the blood supply causing a heart attack

   • Outcome: Started on statins and specific lifestyle changes to mitigate risk of plaque progression

3. 65 year old male with no increased genetic risk for cardiovascular disease and mildly elevated cholesterol levels. Had a positive calcium score by his primary care physician (PCP) and recently started on statins.

   • CCTA shows no plaques, 0 calcium score

   • Outcome: After a in depth discussion, stopped the statin and continues to optimize lifestyle

3 very different results, only possible with a CCTA. A calcium score was not only inadequate, but misleading. At BodyTimeMD, we carefully tailor our diagnostics to the individual. Hope this provides some insight, let’s talk if you are interested in finding out more about your body.

 This newsletter is intended for informational purposes only and does not constitute giving medical advice or endorsing any treatment. The use or application of the content herein forms no doctor-patient relationship. The information in this newsletter should not substitute for professional medical evaluation, advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.

Thanks,

Mike