Did you know that every year approximately 600,000 individuals with no symptoms or warning signs die from a sudden heart attack or stroke? Many people know about the common risk factors for heart attack: obesity, smoking, drinking, high blood pressure, high cholesterol, fatty diet, old age, diabetes, and lack of exercise. However, many individuals who don’t clearly exhibit these behaviors or health issues still develop atherosclerosis and die from heart attack or stroke.
The Crux of the Matter: Asymptomatic Atherosclerosis
In these individuals, the condition is often known as “asymptomatic atherosclerosis.” But in many cases, asymptomatic atherosclerosis isn’t detected until after the fatal event. Atherosclerosis is a condition in which arterial walls thicken due to a buildup of calcium and fatty deposits within the arterial walls. As a result, less blood flows through the arteries, and plaque buildup continues.
In many patients, atherosclerosis produces a set of classic symptoms, such as pain or tightness in the chest (in the case of coronary arteries), intermittent claudication (peripheral arteries), and numbness or weakness on one side of the body (carotid arteries). Patients who have plaque buildup – but no symptoms – have asymptomatic atherosclerosis. Of course, the catch-22 is that most people with atherosclerosis do not become aware of their condition until they start having symptoms. If those symptoms are heart attack or stroke, then it may be too late.
Dr. Thomas Perry discusses heart warning signs and the reasons why a primary care provider may refer a patient to a cardiologist.
Can A Heart Attack Be Prevented?
Quite possibly. At Advanced Heart and Vascular Institute, cardiologists are working to detect asymptomatic atherosclerosis and prevent heart attacks before they occur by following the S.H.A.P.E. Guidelines, published by the Society for Heart Attack Prevention and Eradication.
How Cardiologists Evaluate Patients
Following the S.H.A.P.E. Guidelines, your cardiologist will test for atherosclerosis, determine your risk level, and then provide treatment according to your risk level. This process is recommended to most men over the age of 45 and most women over the age of 55. (“Very low risk” individuals who meet all of the following criteria may be excepted from the screening process: non-smoker, no family history, no history of any type of diabetes, cholesterol lower than 200 mg/dL, and blood pressure lower than 120/80 mmHg.)
In order to calculate your atherosclerosis risk, your cardiologist may use the following information from your medical history (based on the Framingham Heart Study):
- Total Cholesterol
- HDL Cholesterol
- Smoker (Y/N)
- Systolic Blood Pressure
- On Blood Pressure Medication (Y/N)
This data can be used to calculate a patient’s 10-year cardiovascular risk.
If a patient has a 10-year risk <6%…
Then he or she may be recommended to follow low-risk preventative measures. (If this patient is a diabetic over the age of 40 or has a family history of premature coronary artery disease, see the 6% to 20% range below.)
If a patient has a 10-year risk of 6% – 20%…
Then he or she may be recommended an atherosclerosis test.
If a patient has a 10-year risk >20%…
Then he or she may be advised to follow high-risk preventive measures. An atherosclerosis test may also be recommended.
From the Atherosclerosis Test to Prevention
If your 10-year cardiovascular risk score indicates that you need an atherosclerosis test, here’s what you can expect:
- Carotid IMT. This test, known as a carotid intima-media thickness test, is a safe, noninvasive procedure that measures thickness of the arteries (and plaque buildup) in the neck. During the procedure, the health professional uses a small handheld transducer to bounce sound waves off the carotid (neck) arteries. Test results have been shown to correlate with patients’ future risk of heart attack and stroke.
- Coronary Artery Calcium Scan (CACS). This brief, affordable procedure is another noninvasive method for detecting plaque buildup. During the procedure, the patient is scanned by a 64-slice CT scanner, which creates detailed images of the heart. When evaluating your scan, the cardiologist will look for the presence of calcium in the coronary arteries.
Using the results of your test(s), your cardiologist may be able to classify your risk level. Based on how you’re categorized (very low risk, low risk, intermediate risk, high risk), your physician may make certain recommendations to prevent heart attack and stroke.
Why This Approach to Cardiology Is Revolutionary
In many primary care and cardiology practices, you’ll find that heart attack prevention doesn’t start until (1) symptoms have already appeared or (2) a heart attack or stroke has already occurred. At Advanced Heart and Vascular Institute, cardiologists are dedicated to uncovering these hidden health problems before the patient starts experiencing atherosclerosis symptoms. This pro-active approach to heart care is starting to pick up steam in the United States, thanks to the work of S.H.A.P.E.
However, the responsibility to get screened falls on the patient. Take your healthcare into your own hands, and schedule a screening with a board certified, fellowship-trained cardiologist in Phoenix, Globe, or Tempe, AZ, by calling 602-507-6002. You can even schedule your appointment online. Stroke and heart attack can be prevented in your family – starting with you.