Heart for life

Coronary Artery Disease (CAD) or Heart Disease and resultant Heart Attack is by far the leading cause of death in Western adult males and females (60%), far exceeding deaths due to all cancers and strokes combined.

CAD is caused by a process called atherosclerosis or “hardening of the arteries”. As we grow older, cholesterol deposits accumulate in the walls of our blood vessels (arteries). This gradual build-up of cholesterol creates plaques. When plaque in the coronary arteries gets large enough, it can reduce blood flow to the heart muscle causing angina or heart failure. If the plaque is large and a clot (thrombus) develops with it, or a plaque breaks off (ruptures), it results in clotting and closure of the artery with death of the heart muscle – a Heart Attack. This process of forming plaque occurs in everyone as we age, often starting as early as the teen years. However it usually takes many years before the plaques are large enough to be significant. Over time the original non-calcified or “soft” fatty plaques becomes calcified or hard. The risk for Coronary Artery Disease climbs exponentially in middle age, yet most people with significant CAD have no symptoms and many have a normal cardiac examination and ECG test.

Unfortunately in up to 80% of people the first symptom of CAD is a Heart Attack. 85% of Heart Attacks can be prevented if the CAD is diagnosed early enough to treat medically and prescribe lifestyle changes. In women, the benefits of Hormone Replacement Therapy for Cardiovascular Disease are unproven, and women account for 49% of CAD deaths.

So, CAD is by far the most likely cause of adult death, it is silent in 80% of cases, and it can be effectively treated if diagnosed early on. The only non-invasive way of accurately diagnosing early CAD and narrowings is with the Heart For Life Scans. In the USA, the NIH (National Institute of Health) has endorsed the use of Coronary Artery Scanning.

Other heart examinations, such as the treadmill stress ECG test, may only detect significant lack of blood flow to the heart muscle, whereas the CT Angiogram Scan detects early coronary artery narrowings and wall plaques before the heart muscle is actually deprived of blood flow. Unlike traditional invasive (tube) Coronary Angiograms, no groin incision or insertion of catheter tubes into the coronary arteries themselves are required, and thus these invasive risks are now excluded.

The Coronary Artery Calcium Score Scan (CACS)

We have entered the age of personalized medicine; we can individualize treatment on the basis of disease detection rather than treat all 70-year-olds as if they were the same. The CAC score affords the patient and physician with valuable knowledge regarding the presence or absence of coronary artery disease. Moreover, the CAC score quantifies plaque, allowing us to more precisely determine the patient’s specific level of risk. Using calcium scores to guide decision-making regarding medications such as statins and aspirin is based on extensive literature (>2000 published papers related to clinical CAC score use).

There is ample evidence that not all intermediate-risk patients are created equal. CAC equals atherosclerosis, and there is no stronger predictor of cardiovascular events. The American College of Cardiology/American Heart Association Guidelines state: “Assessing CAC is likely to be the most useful of the current approaches to improving risk assessment among individuals found to be at intermediate risk after formal risk assessment.”[1] Given the plethora of additional therapies beyond statins now available for prevention of heart attack and stroke (cholesterol-lowering treatments such as PCSK9 inhibitors, ezetimibe, and therapeutic lifestyle changes), doctors can refine their treatments based on CAC results.

This is a non-invasive screening CT Scan of the coronary arteries for calcium deposits.  Calcium deposits are markers for the Coronary Artery plaque load or burden, and typically appear years before the development of symptoms. It is a proven technology for the early detection and quantifying of the degree of Coronary Artery Disease (CAD) and a good predictor for the risk of acute coronary events (Heart Attack). It does so by measuring the amount of calcified plaque (deposits) in the coronary arteries and provides a numeric score that evaluates the risk of Coronary Artery Disease relative to the patients age. High scores are predictive of significant CAD. The Calcium Score is now rated as the most significant risk factor assessment for a future Heart Attack.

It is completely non-invasive, safe, painless and rapid. The entire process takes less than 15 minutes.

It does not however provide the accuracy and artery narrowing information that the Coronary CT Angiogram Scan does.

Preparation for the Scan:

  • If you have a known allergy, particularly an Iodine allergy (X-ray contrast ), please notify the doctor.
  • Please bring any previous cardiac related information, including appropriate blood tests and medication, with you.
  • Please adhere to the following guidelines so that your heart rate (pulse) will be low for the scan, which will ensure an accurate examination.

THE EVENING BEFORE THE SCAN :

  • No cardiac stimulants:
    • NO CAFFEINE, COFFEE, TEA, ENERGY DRINKS.
    • NO SMOKING.
    • NO “COLD / FLU “ MEDICATION / SPRAYS.
    • NO EXERCISE.
  • No erectile dysfunction medication (Viagra etc) for 24 hours before your scan.
  • Take your pulse for 1 minute in the evening around 6 – 10 pm.
  • Take ONE supplied tablet. This is a safe Beta Blocker to lower, your heart rate (Metoprolol – Lopresor – 100mg).Do NOT take a tablet if :
    • Your pulse is less than 55 beats per minute.
    • You have had an Asthmatic attack previously or Obstructive Airways Disease.
    • You have partial Heart Block.
    • You have uncontrolled Heart Failure.

 

THE MORNING OF THE SCAN :

  • No cardiac stimulants:
    • NO CAFFEINE, COFFEE, TEA, ENERGY DRINKS.
    • NO SMOKING.
    • NO “COLD / FLU “ MEDICATION / SPRAYS.
    • NO EXERCISE.
  • Do not eat for 3 hours prior to your appointment.
  • Take your pulse for 1 minute.
  • Take ONE supplied tablet. This is a safe Beta Blocker to lower your heart rate (Metoprolol – Lopresor – 100mg). Do NOT take a tablet if :
    • Your pulse is less than 55 beats per minute.
    • You have Asthma or Obstructive Airways Disease.
    • You have partial Heart Block.
    • You have uncontrolled Heart Failure.

Requirements for the Scan:

None.  It does not require contrast (“dye”) or even an IV line (needle).

The Coronary Angiogram Scan

This scan is appropriate in the diagnostic (referral) setting, where occlusive Coronary Artery Disease is suspected, or patency of Bypass Grafts / Stents, require assessment.

This is a non-invasive CT Scan of the coronary arteries and heart. It  is the most accurate non-invasive test available, with close to 100% rate of excluding significant coronary artery narrowings or blockages. The scan visualises the inside of the actual coronary artery channel (lumen) for narrowings (stenosis) caused by plaque (cholesterol deposits). The walls of the arteries are also assessed for early plaque, particulalrly the dangerous fatty plaques which are not yet causing significant narrowings, but are prone to rupture and coronary artery blockage (occlusion).

In addition, the Scan diagnoses other serious chest abnormalities such as Aortic Aneurysms and Pulmonary Embolisms.

The resolution of the CT Angiogram Scan, and therefore accuracy for the coronary arteries, is far superior to MR (Magnetic Resonance) Angiogram performed on an MRI (Magnetic resonance Imaging) Scanner.

The scan is non-invasive, safe, rapid and painless. The entire process takes less than 30 minutes.

Preparation for the Scan:

  • If you have a known allergy, particularly an Iodine allergy (X-ray contrast ), please notify the
  • Please bring any previous cardiac related information, including appropriate blood tests and medication, with you.
  • Please adhere to the following guidelines so that your heart rate (pulse) will be low for the scan, which will ensure an accurate examination.

 

THE EVENING BEFORE THE SCAN :

  • No cardiac stimulants:
    • NO CAFFEINE, COFFEE, TEA, ENERGY DRINKS.
    • NO SMOKING.
    • NO “COLD / FLU “ MEDICATION / SPRAYS.
    • NO EXERCISE.
  • No erectile dysfunction medication (Viagra etc) for 24 hours before your scan.
  • Take your pulse for 1 minute in the evening around 6 – 10 pm.
  • Take ONE supplied tablet. This is a safe Beta Blocker to lower, your heart rate (Metoprolol – Lopresor – 100mg).Do NOT take a tablet if :
    • Your pulse is less than 50 beats per minute.
    • You have had an Asthmatic attack previously or Obstructive Airways Disease.
    • You have partial Heart Block.
    • You have uncontrolled Heart Failure.

 

THE MORNING OF THE SCAN :

  • No cardiac stimulants:
    • NO CAFFEINE, COFFEE, TEA, ENERGY DRINKS.
    • NO SMOKING.
    • NO “COLD / FLU “ MEDICATION / SPRAYS.
    • NO EXERCISE.
  • Do not eat for 3 hours prior to your appointment.
  • Take your pulse for 1 minute.
  • Take ONE supplied tablet. This is a safe Beta Blocker to lower your heart rate (Metoprolol – Lopresor – 100mg).Do NOT take a tablet if :
    • Your pulse is less than 50 beats per minute.
    • You have Asthma or Obstructive Airways Disease.
    • You have partial Heart Block.
    • You have uncontrolled Heart Failure.

Requirements for the Scan:

You will receive an injection of safe IV Contrast during the Scan. This is known as x-ray “dye” and contains Iodine. It is administered via a standard IV line (“drip”). Scan for Life™ uses the latest contrast agent which is extremely safe.

Cardiovascular Disease (CVD) / Heart Disease:

CVD is the number one killer of men and women, accounting for 60% of total mortality.

Claims more lives than the next 5 leading causes of death.

The probability of dying of a CVD event at birth is 47%.

One in five Males and females have CVD.

The majority of CVD deaths are due to Coronary Artery disease.

50% of men and 64% of women who died suddenly of a heart attack had no symptoms of Coronary artery Disease.

Only 20% of heart attacks are preceded by symptomatic angina.

From 75 yrs the prevalence of CVD is higher in women than men.

First major CVD events occur in women 10 years after men.

Coronary Artery Disease is the leading cause of premature permanent disability.

About two thirds of heart attack victims do not ever make a complete recovery.

After a heart attack, 18% of men and 35% of women will have another heart attack; 22% of men and 46% of women will be disabled with heart failure; 7% of men and 6% of women will experience sudden death.

Source: The American Heart Association

Who should consider the Heart for Life Scans?

From age 40 in males, and age 45 – 50 in females, if there are 3 or more further risk factors:

  • Positive Family History, particulalrly where a parent or sibling has suffered a Heart Attack before the age of 55.
  • Smoker or previous significant tobacco history.
  • High Blood Pressure. More than 30% of Hypertensive adults do not now they have high blood pressure.
  • Diabetes.
  • High Cholesterol, Homocysteine and / or Ultra-sesnsitive CRP levels.
  • Significantly overweight (more than 20%).
  • Inactive sedentary lifestyle.
  • High stress lifestyle. Most business executives, male and female, attribute much of their success to their competitive and motivated natures, but this drive to succeed can jeopardise their health.
    Type A personality traits may increase Coronary Artery Disease by as much as 200%.

How often must the Heart For Life Scans be performed?

In the vast majority of people, it is a once off Scan.

Occasionally it may be repeated after 5 to 10 years.