Simple Scan for Blockage May Identify Problems, Save Lives

Mitch Campbell thought he was in good health. “My blood pressure was normal, my cholesterol was good, and I exercised regularly. I felt great,” said the 60-year-old banker who often played golf, carrying his own bag. But little did he know he was also carrying a time bomb inside his chest.
At the urging of a friend last August, Campbell took a simple test for heart blockage that may have saved his life, a CT (computed tomography) heart scan. The overall effectiveness of heart scans is an area of controversy; however, a December 2013 study by Johns Hopkins School of Medicine in Baltimore found the scan an effective tool in identifying more people at serious risk of heart attack.
February is Heart Month, when the American Heart Association shines a spotlight on heart disease, a stealthy killer. Like Campbell, 40 percent of heart attack victims were feeling just fine the day before the “event,” according to Centers for Disease Control and Prevention.
And the numbers don’t get any better:

• About 600,000 people die of heart disease in the United States every year, or about 1 out of every 4 deaths, making it the leading cause of death in this country.
• Each year 715,000 Americans have heart attacks, with some 500,000 of those being first heart attacks.
• Heart disease costs American industry more than $100 million a year in health care services, medications and lost productivity.

Campbell’s discovery of his own heart condition began with the death of his neighbor and friend, Joe Williams, an executive for Pinnacle Airlines. Williams had recently died of a sudden heart attack, completely unaware he had any type of heart problem.
Several days after the funeral, Williams’ wife, Kathy Kelley, still reeling from the death of her husband, asked their good friend Campbell to undergo a CT heart scan, to make sure that he didn’t have a hidden heart problem too.
“I’d never even heard of the test,” Campbell said. “So I took it, and was I in for a surprise.”
The scan, a simple, relatively quick, noninvasive test that looks for calcium buildup in the arteries, raised a red flag that said there was blockage. Further tests showed that three arteries were 90 percent blocked, and a triple bypass was performed.
The scan, an imaging method that uses X-rays to create detailed pictures of the heart and its blood vessels, has had its share of skeptics over the years but more and more doctors are turning to it as a key diagnostic test.
“It’s a very good screening test to determine if a patient is at risk of having coronary artery disease,” said cardiologist Dr. Lisa Young of Memphis’ Sutherland Cardiology Clinic. “It’s not a regular part of a heart checkup but it’s being recommended by some of the more enlightened general practitioners.
“One of the reasons it hasn’t been used more than it has probably has to do with the fact that many insurance companies wouldn’t pay for it, but I believe that’s changing too.”
Dr. David Wolford, an interventionist cardiologist with the Stern Cardiovascular Clinic in Memphis, also points to the CT heart scan’s effectiveness, saying patients need to take the test in order to know their calcium score.
The test is relatively inexpensive, as low as $99 in some hospitals and clinics.
“The calcium score has been shown to be more valuable than the cholesterol score in finding coronary risk,” he said. “Some physicians had rather see your calcium score than your cholesterol numbers.”
The overall effectiveness of heart scans is an area of controversy and many doctors and some health organizations do not suggest a CT heart scan as a primary tool for diagnosing heart attacks.
However, the study last year by Johns Hopkins determined that the CT heart scan and its calcium score proved its effectiveness.
“Calcium tests trump cholesterol levels, high blood pressure and other risk factors historically used in preventing heart attacks and deaths. We showed that by using only the traditional risk factors, we miss a significant percentage of individuals at high risk.”
Dr. Young points out, however, that the CT heart scan, as effective as it may be, isn’t foolproof. She said a patient can have a calcium buildup without a major blockage and a patient can have a major blockage that doesn’t have calcium in it.
“But it really is a great screening tool, particularly in cases where there are already risk factors present such as high blood pressure, high cholesterol or a family history of heart problems,” she said. “It’s relatively inexpensive and can be very valuable. So why not take it?”
A key part of the fight against heart disease is awareness, Dr. Young said, and that means knowing when you’re having a heart attack. The classic symptoms include chest pain radiating to the left arm, sweating, shortness of breath, and a feeling of pressure and tightness in the chest.
Women tend to not have as much chest pain as men but have more shortness of breath, and if they do have pain, it mostly occurs in the back and shoulder.
“If you’re having pain and you can point right to the spot of the pain, then you’re not having a heart attack,” she said. “It doesn’t hurt in just one place.
“I’ve also seen weird symptoms. I knew of a patient who had his pain in his jaw.”
Stomach problems can be a symptom of a heart attack and victims may think they simply have acid reflux, heartburn or perhaps a stomach virus.
So how can you tell if you’re having stomach problems or a heart attack?
“That’s a problem, but I think most people know when something just isn’t right, particularly when there’s nausea or vomiting,” she said. “They may think ‘this isn’t like the other stomach viruses I’ve had’. It’s listening to it that can make a difference.”
Dr. Dharmesh Patel, cardiologist with Stern Clinic and president of the Memphis area American Heart Association, said heart disease is preventable and that the AHA wants to reduce heart disease by 20 percent by 2020. They’re more than halfway there, he said.
Lifestyle factors such as diet and exercise remain at the center of heart disease prevention, and Memphis and North Mississippi are unusually unhealthy.
“I call this the Lard-belt of America,” he said. “There is so much obesity in this region. When a patient comes to me I first check out everything about their lifestyle. As far as I’m concerned, they’re guilty until proven innocent.”
Kathy Kelley said her husband’s death drove home a message to her that everyone is ultimately responsible for their own health.
“We’ll never know whether or not if Joe taking the test would have made a difference,” she said. “But it might have given him a better chance.”
In Mitch Campbell’s case, a little test he didn’t even know existed may have saved his life because a friend told him to give it a chance.
“I guess you could say that Joe Williams saved my life,” he said. “People need to know about these things.”
Written by Brown Burnett, a freelance writer in Memphis, Tenn.