By Peter M. Abel, M.D.
Medical Director,
Prevention Center for Cardiovascular Disease
Cardiocascular Institute of the South

I'm usually asked that question by men in their early 40s, who already suspect -- correctly --that the answer is "just about now."

For some, it should be even earlier. A man with a family history of early onset heart disease should start having an annual heart exam by about age 35. So should anyone with two or more of the other heart disease risk factors -- smoking, obesity, high blood pressure, high cholesterol levels, diabetes or a sedentary lifestyle.

Obviously, anyone who has experienced any symptoms suggestive of heart disease should be checked immediately. Those symptoms include a pressing type of chest discomfort during physical exertion, heart palpitations, faintness or weakness.

Women are far less likely than men to develop heart disease prior to their mid 50s. But after menopause, their heart risk increases -- especially if they have one or more of the previously noted coronary risk factors working against them.

With women, as with men, any symptoms of coronary disease should be checked out immediately. Otherwise, I would generally recommend that a woman have her first heart checkup no later than age 50, or at the onset of menopause.

What should that first checkup include? A complete medical history, to begin with Then a general physical examination, including heart rate, blood pressure, a blood test including a cholesterol level check, and an electrocardiogram (EKG). If the EKG results suggest a possible problem, your doctor may also want you to undergo a stress test to see how your heart behaves during exercise.

Assuming you have no troubling symptoms, you should repeat the physical and EKG annually.

Why bother with annual checkups if you have no symptoms? Well, think of heart disease as a rattlesnake: what makes it deadly is that sometimes it doesn't give you fair warning that it's about to strike.

1995 Cardiocascular Institute of the South

For further information, call Jane Arnette, Cardiocascular Institute of the South/Houma, 1-800-425-2565, or Jim Keyser at 1-800-848-2715. E-mail questions or comments to: jakeyser@cardio.com.

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