Cardiovascular disease is the number one health-related killer of both men and women - often times claiming lives that simple testing and the right screening could have spared.
Coronary artery disease presents itself one-third of the time with “exertional” chest discomfort, one-third of the time with acute chest pain and some variation of a heart attack and one-third of the time with sudden death.
While physicians continue to underscore that a nutritious diet and regular exercise are the primary deterrents, simple tests available to cardiovascular specialists and primary care physicians alike could provide diagnostic information indicating the need for specific treatment - and also dramatically altering the outcome for many suffering from undiagnosed coronary artery disease. This screening could reduce the number of “sudden events” in those seemingly healthy individuals.
Standard cardiovascular screening is generally recommended for those individuals with known coronary artery disease and/or experiencing some symptoms. These tests are designed to identify abnormalities in those with severe disease and include echocardiogram, Holter monitor, carotid duplex study, or a nuclear stress test.
But for those individuals who are asymptomatic (experiencing no symptoms), they are often inappropriate and may provide false reassurance. Those individuals with mild or moderate disease often times receive a normal result with these standard screenings and remain unaware of their risk for a sudden event. In fact, individuals can have significant plaque in their coronary arteries, but unless the ruptured plaques (causing blood clots and narrowing of the blood vessel) result in a narrowing of 70% or more in the blood vessel, they may go undetected. These individuals may pass a nuclear stress test yet remain extremely vulnerable without realizing or taking the proper steps to reduce their risk.
More effective screening for identifying coronary artery disease in those individuals experiencing no symptoms includes; assessment of family history, physical exam observations (such as checking leg and feet pulses and BMI), and evaluation of specific lab factors (such as two-hour glucose after a sugar drink and triglycerides/HDL ratio). This evaluation is inexpensive and easily performed in a doctor’s office.
If from these screenings abnormalities are found to exist, there are two non-invasive tests capable of effectively identifying coronary and carotid disease in those currently experiencing no symptoms. These include Coronary Calcium Scoring and Carotid IMT - the best test dependent on availability and age. These tests are simple, inexpensive and safe.
Coronary Calcium Scoring and Carotid IMT are able to identify the presence of cardiovascular disease in those with only mild to moderate disease - often otherwise missed by standard cardiovascular screening. This gives them the opportunity to change the course of the disease.
Dr. Dale Allen Faulkner is a fellowship trained cardiovascular and internal medicine physician who specializes in primary and secondary prevention of cardiovascular disease.
Formerly Chief of Staff at Fort Bend Hospital and Chief of Internal Medicine at Memorial Hermann Fort Bend and OakBend Medical Center as well as Chief of Cardiology at Memorial Southwest, Dr. Faulkner has lead the direction in cardiovascular care as the Medical Director for the Cardiopulmonary and Coronary Care Unit at OakBend where he currently serves as an active member of the staff.