Silent heart disease diagnosis by CT scan of the coronary arteries. It gains acceptance in clinical practice. Silent heart disease is widespread. It kills patients. How diagnose and reduce a silent heart disease risk?
At the time of his fatal first-time heart attack, TV anchor Tim Russert had excellent cholesterol profile. But post-mortem showed extensive coronary artery disease. His silent heart disease likely formed before he started to take medications to lower cholesterol and blood pressure. Cardiac CT scan could have diagnosed his silent heart disease earlier. People with risks for silent heart disease have to take preventive measures early to decrease risks of heart attack. Leading CT and MRI radiologist discusses calcium score CT scans and CT angiography. Silent heart disease CT scan diagnosis. Using CT Scan to diagnose heart disease in patients who have no symptoms of heart disease today. Video interview with leading expert in radiology, CT and MRI specialist. Detecting and treating silent heart disease is difficult. Diagnosing coronary heart disease with cardiac computed tomography is one option for patients with family history of heart disease and presence of other risk factors. There are few effective ways to detect silent heart disease today. Cholesterol lipid profile testing and coronary calcium scan. Cardiac CT for calcium scoring is a quick and effective method to establish baseline. Coronary artery calcium scoring does not require intravenous contrast injection. Medical Second Opinion after cardiac CT test can confirm and clarify results. Medical Second Opinion also helps to choose the best strategy to lower risks of coronary artery disease progress. Seek medical Second Opinion after cardiac CT scan and be confident that your decisions are the best. Cardiac CT angiogram offers a more direct way to detect heart disease. Cardiac CT angiography and calcium scoring can predict risk of heart disease progress in patients without symptoms. Dr. Kent Yucel, MD. CT scans may predict heart disease better than existing lipid profile levels. Using CT scan to diagnose silent heart disease. Dr. Anton Titov, MD. What is the opportunity for using CT scan of the heart to screen for heart disease? Dr. Anton Titov, MD. Especially using cardiac CT for a person with silent heart disease, who is totally asymptomatic? Dr. Anton Titov, MD. Because today cholesterol profile is the only heart disease screening tool available. Dr. Kent Yucel, MD. CT and MRI specialist, Tufts Medical Center. When we talk about CT screening we are talking about coronary artery disease, and to prevent heart attacks. Right now, the only treatment that is available to prevent atherosclerosis is lipid lowering medications (statins). Atherosclerosis is the hardening of the coronary arteries. It causes heart attacks. So, therefore, cholesterol measurement and lipid measurements are the mainstay of heart disease screening. Because treatment is directed at lowering cholesterol. But there are patients in whom coronary CT, computed tomography study of the heart, may be helpful as additional information. There are patients who clearly do not need lipid-lowering therapy. And there are patients who clearly need treatment to lower cholesterol. Because their medical history, their family history and their lipid profile indicates they need lipid-lowering treatment. But there is also a fairly large group of patients who are at intermediate risk. They may have problems with the medications. Or maybe the patient and the doctor have difficulty to decide how aggressive lipid lowering therapy should be. Or if they should use lipid-lowering medications at all. And those are the patients who may benefit from cardiac CT scan to further refine their heart disease risk. And that is done primarily today without a coronary CT scan. All we do is a quick heart CT scan ("cat scan") without x-ray dye. This CT has low radiation dose. Such heart CT tells us how much calcium is in the coronary arteries. And the degree of coronary calcification is an additional factor that can help the doctor and patient. They can assess the coronary artery disease risk going forward. They can decide how aggressive they should be at lipid lowering therapy. Dr. Anton Titov, MD. This is very important to know because there is a sizable proportion of first time heart attacks that are severely debilitating and potentially fatal. (So many patients have silent heart disease). So using more advanced imaging (cardiac CT scan) perhaps is helpful to identify someone at high risk for heart disease. A person with silent heart disease. Who might not have any signs of heart disease now. But at the same time who has risks for a potentially fatal heart attack in the future. Dr. Kent Yucel, MD. Cardiac CT can help. Again, I would say that - still - a primary screening for heart attack risk is medical history: smoker, diabetes, family history and lipid profile. So heart CT scan we reserve for the next level. Dr. Kent Yucel, MD. We do cardiac CT if we don't know, if we don't have enough information about what to do with the patient at the first pass. Silent heart disease CT scan diagnosis. Video interview with leading expert in radiology, CT and MRI specialist. Indications for CT angiogram, calcium scoring.