Assessing Your Risk Factors for Heart Disease

Here is some advice from Dr. Stephen Sinatra, who is a highly respected and sought-after cardiologist. Dr. Sinatra has an integrative approach to treating cardiovascular disease. He combines traditional cardiology with natural alternatives.

Here are 4 important tests that Dr. Sinatra says to consider, when assessing arterial health and heart-disease risk:

1. Electron-Beam Computed Tomography (EBCT) - Electron-beam computed tomography, or EBCT, is a sophisticated, noninvasive screening procedure for measuring hardened plaque in coronary arteries. EBCT is also proving to be a reliable way to assess heart attack risk factors in people with no (or few) other known risk factors.

Dr. Sinatra considers any EBCT scan score over 100 to be a concern. A person with a score of 100 is at three times higher risk of sudden death than someone with a score of zero. A score of 1,000 or more raises your risk to 12 times that of someone with a score of zero. This test is invaluable for people who have heart disease symptoms or who could benefit from some improvement in lifestyle habits. Insurance may or may not pay for the scan, which costs approximately $400 to $500.

2. 64- or 128-Slice Coronary CT Scan - A test for detecting arterial plaque that is even more advanced than EBCT is called the 64- or 128-slice coronary CT scan. This new technique is the noninvasive equivalent of putting a camera inside the coronary arteries and assessing plaque and calcification status. (Note: “Slice” refers to a particular viewing angle, not actual slicing of the arteries.) The slice method provides previously unobtainable visualization of the coronary arteries, with much less radiation and risk than the former gold standard—the coronary angiogram (see angiogram below). If your cardiologist orders a standard, invasive angiogram for you, ask if a 64- or 128-slice coronary CT scan can be done instead.

3. Intimal Medial Thickness (IMT) Analysis - One of the latest and greatest screening tools available to cardiologists today is ultrasound imaging of the carotid artery. The measurements obtained from pictures of these crucial arteries to your brain are expressed as carotid artery intimal medial thickness, or IMT for short. Increased IMT is now considered a reliable, independent risk factor of heart disease and stroke.

4. Angiogram - A coronary angiogram, or cardiac catheterization, is the “gold standard” for evaluating the presence and extent of obstructive coronary heart disease. This invasive procedure is done while you‘re awake after local anesthetic is injected into the groin area (to access the femoral artery) or the bend in the arm (if the brachial artery is used). Usually, we only use this test after a noninvasive procedure indicates the need. Angiograms are also used to evaluate heart valves, especially if surgery is being considered.

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