Discovering Heart Attack in Advance

Hi,

Is there a single best non-invasive test to detect potential causes of getting a heart attack in the future? I see discussions about C64-CT with merits and demerits. Is there any thing better out there?

[NTB]

besides an image, you can add in blood tests for inflammation markers, which might very well have predictive power for plaque rupturing

[erijon]

I still think that a nuclear profusion stress test is about as close as you can come for what you're looking for. Yes, there is a small amount of tracer used to help determine if your heart muscle is oxygen deprived, but is a good, safe way to see if you have any potentially blocked arteries. I've had two, no complaints..........

Good Luck!

Jon

[kenkeith]

The ct 64-slice angiogram is the only test that calculates the degree of calcification in the four main arteries.  Soft calcification is the formation of plaque between the inner vessel lining and the outer lining.  It is this soft plaque that presents the highest risk for a heart attack by rupturing through the inner layer into the lumen.  The scan shows images of the complete anatomy of the vessel and quantifies the degree of plaque numerically and statistics provide information to the prognosis.

The risk with ct is the radiation and the risk of cancer.  May not be suitable for a young individual because of the cancer risk.  Because it takes about 10 years to develop an older individual is a better candidate...heart rate can be lowered with medication to below 60, and one is able to hold their breath for several seconds.

The plaque within the vessel (lumen) is what a the other tests assess, and that is potential for ischemia and angina, but very few lesions cause a heart attack...it is the soft plaque that presents the highest risk.

[NTB]

and keeping in mind the famous case of Tim Russert, who underwent (and 'passed') some sort of treadmill stress test roughly a week before his fatal heart attack.

The small soft plaque that he had inside his heart presented no problem during the test, but later it ruptured, after which the body very quickly "healed" it over just like forming a scab on the surface of the skin after a cut - but that scab blocked off the blood flow inside the artery. Atherothrombosis.

[erijon]

True enough, Tim Russert passed a standard stress test just before his heart attack. Let's face it, we all face that risk. As Kenkeith said, it's the soft plaque that usually ruptures and causes approx 70% of heart attacks. The only way to be 100% sure is with a cath, which is very invasive. You need to weight the affects of the test to the peace of mind and accuracy of the results. I have read both good and bad things about a 64 slice CT, my cardiologist is still not convinced it is accurate enough for her practice, I can't really say. If you want to know for sure, get a cath.
Good luck!
Jon

[kenkeith]

The new scan picks up on artery blockage BEFORE it can affect blood flow. In short, this test seems most useful for patients, who, after clinical evaluation, appear to be at moderate risk of having coronary disease....more effective evaluation of the individual's cardio-vascular hearlth  

Many patients with chest pain are given a simple stress test, a nuclear chemical stress test, or a stress echo. These tests assess blood flow and can therefore be normal even when a patient has mild to moderate blockage.

CT angiography scans does become valuable emergency room tools. There, they can
be used to determine exact reasons for chest pain. “Typically, if someone
comes to the ER with chest pain, it could be a number of things – blockage
of an artery, a tear in the aorta, or a blood clot to the lungs. The CT scan
can rule out all of the above,” said Dr.Hundley.