Could You Have Heart Disease And Not Know It?

July 26, 2019

Heart disease – also commonly called coronary artery disease (CAD), hardening of the arteries, or atherosclerosis – is a leading cause of death for men and women. As with all diseases or chronic conditions, the early detection and clinical diagnosis of CAD is key to a successful treatment plan, which may include lifestyle changes, medicines, certain medical procedures and, in some cases, surgical interventions.

One important diagnostic tool available for the early detection of CAD is coronary artery calcium scoring. Before we talk about the test, let’s understand a bit about the disease.

What is Heart Disease?

The coronary arteries are the large blood vessels that supply your heart muscle with oxygen-rich blood.

If blood flow is interrupted or constricted, serious consequences such as a heart attack can result. CAD is the narrowing or blocking of these arteries by the buildup of plaque – a waxy substance that can accumulate over many years due to a variety of factors. It is this plaque that blocks the blood flow to the heart and can lead to serious health problems. Over time, the plaque may harden or rupture, resulting in a blood clot, which may cause additional narrowing or a complete blockage of the artery.

Many people with CAD do have symptoms. Many do not. Not to be overly dramatic, but for many people the first sign of CAD is sudden death from a heart attack or life-threatening arrhythmia.

Symptoms of Coronary Artery Disease

With that sobering thought, what are some symptoms of CAD?

Angina is discomfort or a feeling of pressure or squeezing in your chest. It may also be experienced as pain in your shoulders, arms, neck, jaw or back and is often mistaken for indigestion. Angina tends to get worse with activity or emotional stress and lessens when you rest.

Arrhythmia is when the rate or rhythm of your heartbeat is irregular. Many describe the sensation as a “fluttering” in their chest. Some arrhythmias can cause your heart to suddenly stop beating, which can cause death if not treated immediately. When this happens, it is called sudden cardiac arrest.

A heart attack happens when one or more coronary arteries become completely blocked, cutting off blood flow to a section of the heart. Until blood flow is restored, the affected section of heart muscle begins to die. Immediate medical care is required, as once heart muscle has died, it cannot be restored and will be replaced by scar tissue, further weakening the heart. Heart attack symptoms are similar to those of angina but may last longer, be more severe, and be accompanied by shortness of breath, nausea, vomiting, light-headedness and a clammy feeling. The pain may go away and come back and may not be relieved during rest as with angina. If you or a loved one experiences any of these symptoms, call 9-1-1 immediately.

Heart failure is when your heart is weakened and cannot pump enough blood to meet your body’s needs. It doesn’t mean your heart stops working completely as the name suggests; it just doesn’t work efficiently. As a result, you may feel short of breath and very tired. Heart failure can cause your body to retain fluids, causing swelling of the feet, ankles, stomach area and veins in the neck.

How Calcium Scoring Can Help

So, what is coronary artery calcium scoring? Numerous studies in medical literature cite coronary artery calcium scoring as a valuable tool to predict future risk of heart attack.

Coronary artery calcium scoring is a noninvasive computed tomography (CT) scan that takes a series of very thin pictures of your heart and the vessels that supply blood to your heart. These pictures are used to measure the amount of calcium in the plaques built up in the walls of your coronary arteries. Based on these CT images, you will be assigned a coronary artery calcium score. The higher your level of calcium, the greater your risk for heart disease or CAD.

“Although coronary artery calcium scoring is widely available, its use by patients has been limited due to the high cost of the test and the fact that most insurances will not pay for it,” says Avirup Guha, MD, a cardiologist at UH Harrington Heart & Vascular Institute.

Your doctor will determine if calcium scoring is right for you based on your medical history, risk factors, age, gender and ethnicity. If it is determined that you would benefit from a calcium scoring test, your doctor will write an order or prescription for the scan. This order will be required when either you or your doctor call to schedule the test.

Steven Baldridge, RN, is a staff educator at University Hospitals Samaritan Medical Center.

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