Show #539 Airing Sunday, 9/5/10
Let’s get right to the heart of the matter – today’s testing for a cardiac condition is clear-cut and uncomplicated. Dr. Anthony Vlastaris is here to help us understand these matters of the heart. Dr. Vlastaris is a Cardiologist with Fairview Hospital.
Question: Do all of us need to be checked for heart disease?
Answer: Not necessarily. However, if there’s heart disease in your family – or you notice any symptoms like chest discomfort, shortness of breath, you're increasingly tired or even doing your regular chores is becoming more difficult - you should have a discussion with your doctor and get checked out.
Question: Do we start with basic blood tests? Can they help identify potential problems?
Answer: Yes – even for those who don’t have any symptoms. We know that we need to check cholesterol levels on an annual basis. But we also need to know not just our cholesterol level – but our numbers for good and bad cholesterol. Something new we’re finding is that there are a lot of people with blocked arteries who don’t have high cholesterol. So we want to do a blood test that also checks for inflammatory markers in the blood stream. Inflammatory markers could indicate damage or blockage to arteries. If they are present, the patient has a high risk of having a heart attack within six months to a year. This lets us know we need to do more aggressive evaluation and treatment.
Question: Let me guess - then my doctor will have me jump on a treadmill for a stress test!
Answer: We do still use stress tests to check out the heart and how it’s working - and we’ll see that on the ECG – electrocardiogram. But if for some reason you are unable to walk on a treadmill – maybe you have a balance problem or arthritis or a bad hip or knee – we now have medication that will simulate in your heart what it would do if it could be on the treadmill. We just put a small IV in your hand and inject a radioactive tracer. You lay under a nuclear camera and we can see what your heart does before, during and after the effects of the “exercise medicine.”
Question: But there are other ways to look at our ticker, too, right?
Answer: Absolutely. We now use Echocardiography –otherwise known as an ultrasound machine. This is similar to looking at how well a baby is moving in mom’s tummy.
Instead we can look at how well your heart squeezes and if the valves are opening and closing properly.
Like many of the tests we now have, it’s non-invasive and can be done outside a hospital setting.
We also can use a 64 slice Cat scan where you lay under a CT machine and hold your breath for 6 seconds and get a quick picture of the arteries.
This will show any calcium buildup in the arteries and blockages.
Question: If these more non-invasive kinds of tests show there's a problem, what's next?
Answer: Then we may need to move to performing a cardiac catheterization to look closer at the heart. This is typically done in a hospital. A cardiologist actually injects dye into the arteries that supply blood flow to the heart muscle. And the results of all of the tests will indicate what kind of further evaluation may be needed – and/or what kind of treatment we should provide.
Take this information to heart and be sure to be screened and evaluated for heart disease. My thanks to Dr. Vlastaris for joining us today.
