Heart & Cardiology/tetsing
Hi Doc. By the way, thanks for your service on here. I have two pretty straight forward questions. Although I know an echocardiogram is the best tool but can cardiomyophies/ heart muscle problems be seen on a 12 lead EKG read by a cardiologist? Last question. Is cardiac calcium scoring a legit test? Due to my father having early heart disease, I had one at age 40. I’m now 42. My score was “0”. Again, thanks for providing a service here
Hi, there some reading on stress testing etc at http://blog.myheart.net/2014/03/17/do-i-need-a-stress-test/
The EKG is a useful tool. its most useful for heart rhythm disorders and in patients having acute chest pain its useful for seeing if there is compromised blood supply to the heart. It is less useful when done at rest in patients without symptoms. It can be useful in detecting heart muscle damage and sometimes muscle enlargement but it is not as sensitive as an echocardiogram. If your baseline echo is ok then indications for a repeat study would be development of symptoms or other clinical change. Routine surveillance echo isn't typically useful in surveillance of asymptomatic patients with family history of heart disease.
I've written about CT calcium before and here is a summary. The coronary artery calcium score uses CT scanning to indicate the presence or absence, and the extent of calcium in the coronary artery and thus in general the degree of coronary atherosclerosis. It has been well established that low scores are associated with a low risk of future events and high scores are associated with an increased risk, as would be expected. The aim of CT calcium scoring in asymptomatic patients is to improve the risk assessment process, and so allow identification of patients who require intensification of preventive strategies such as lifestyle, blood pressure, cholesterol etc. Its important to note that the calcium score should not be used to identify coronary stenoses (blockages). In those patients that are high risk, there should already be maximum attention paid to those risk factors and therefore the a high risk calcium score would not be of use and a low risk calcium score would not negate the presence of factors that made the person high risk and who will require intensive risk factor modification anyways.
In your case, you have a history of premature heart disease. Your attention, in order to give you the best outcome, should be focused on preventative measures. Surveillance testing searching for blockages, although attractive, isn't of much use without the development of symptoms or clinical change.
Hope that was helpful,