Obesity, smoking, lack of exercise. These are all things that can contribute to the risk factors for heart disease. But, what if you've already developed it and the damage is done?
Kristie Vermulm: Dr. Artang we have now been talking about the risk factors for coronary artery disease over the past few months, including obesity, smoking, lack of exercise and so on. What if the person has already developed coronary artery disease and the damage has occurred. How would we know if the disease is present and if it is significant?
Dr. Artang: As I mentioned before the disease process starts relatively early in all of us. The big difference however is between a person that is curious about his heart condition without any symptoms, and a person who is experiencing actual chest pain or shortness of breath with physical activity.
Kristie Vermulm: What if the person is without any symptoms?
Dr. Artang: For an asymptomatic person then we divide that into low risk and intermediate to high risk category. A low risk person is usually young female or male with no medical issues. We usually do an electrocardiogram, blood pressure measurement and cholesterol. There are also other screening tests available such as vascular screening where the vessels of the neck are looked at by ultrasound. And lastly coronary calcium score where the amount of hardening of the coronary artery is measured.
Kristie Vermulm: How would you know if the person is intermediate to high risk. ?
Dr. Artang: Things start to change once you reach above age of 45-50 for males and 55-60 for females. Then another point for smoker, another point for high cholesterol, another point for high blood pressure and a big point for person with diabetes regardless of the age. Then strong family history adds to the risk as well.
Kristie Vermulm: What would you do with a high risk person or person with symptoms. ?
Dr. Artang: We would do a stress or exercise test. The idea is to increase the activity and provoke possible symptoms if there is a true narrowing. We usually place the person on a treadmill and have them walk up to 9 minutes with increasing speed and incline. We also image the heart either with ultrasound or nuclear scan before and after the exercise to evaluation the heart function. Person with true narrowing would have a different image after exercise as compared to the image before exercise.
Kristie Vermulm: What if a person has a knee or hip problem and cannot exercise on treadmill.?
Dr. Artang: In that situation we use a chemical stress test, by using an intravenous medication that can resemble an exercise situation for the heart. Usually the person is sitting or laying down, and receiving the medication. We again obtain images before and after the chemical stress.
Dr. Ramin Artang is always ready to answer your questions about your heart and your health. If you'd like to submit a question that may be featured on an upcoming show. Visit the heart health page and look for Do you have questions for Dr. Artang?
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