Those of you reading the Heart Scan BlogI hopehave come to appreciate the power in measuring atherosclerotic plaquethe stuff of coronary artery diseaseand not relying on indirect potential "risk factors," especially the fictitious LDL cholesterol.
Howeverlike all thingseven a great thing like heart scans can be misused. Here's a story of how a heart scan should NOT be usedsubmitted by a reader.
First of alllet me start out by commending you on all of the work you are doing with your websiteblogsetc. You are truly a breath of fresh air at a time when conventional medicine is no longer making any sense. In the last 3 years or soI have spent a lot of time using the internet to try and find answers . . . and just about every timewhen I find things that make "sense," it coincides which the recommendations you provide. Thank You!!
I am 56 years oldand roughly 5 years ago I bought your bookTrack Your Plaqueprimarily because I had asked my then Internal Medicine physician about why we weren't more "proactive" about determining the state of our cardiovascular health...since the means to do so existed (scans). He was trying to get me to go on a statin because my cholesterol #'s were a little high and at the time I smoked. Other than thatI was in perfectly good health with no side effects or issues. The following year at my annual physicalwe again discussed this and he gave me a few options and I ended up having a calcium score donewhich showed some blockagebut againI never had any painssweatsor any other symptoms whatsoeverand I am a very active former athlete. This is when I bought your book to try and set a course of plan that wouldn't just include pharmaceuticals.
At the same timemy father was in his last months of life dealing with prostate cancer and the multiple radiation and chemo treatmentsso I was making many trips from my home to be with him . . . a 4 hour driveand very disruptive to familyas I still have 3 kids at home. At what I thought was going to be my last visit with himI stopped at the cemetery he had planned on being buried to confirm details and such and then started home.
As I was drivinga symptom hit me which I was unfamiliar with (pretty sure it was an anxiety attack now) and I stopped at a friend's house in Chicagoas I didn't want this to be a heart attack while I was driving. This is when I began thinking about the heart scan and the blockageand ended up driving back later that night and went right to the ER....not because I had any chest painsbut thought it best to be checked out because I did not want to go before my dad did. I ended up staying the night. In the morning the cardiologist PA [physician's assistant] came in with a copy of my calcium scoring and said it was best to have a heart cath...which I was in total agreement with since it would definitively tell me the current condition of my coronary vessels. As I was getting ready to be wheeled into the cath labthey approached me with a form that would allow them to treat (stent). This is where I became very uncomfortablein that I had never even met the cardiologist . . . and I didn't like this. No one ever had asked if I was experiencing pains or anything else . . . but I buckled and signed the form.
Before you knew itI was awake watching my heart being cathed and the cardiologist angry because they did not have all the right sizes of stentsso he had to use a couple extra and I ended up w/5 total . . . and my life changed forever! In looking backI can't necessarily argue the need for interventionbut in hindsightit would have been nice to have tried an alternative method of reversing my plaqueespecially since I had never experienced any symptoms and didn't appear to be in any imminent danger.
Upon release from the hospital I was put on a cocktail of drugs that typically follow and I then began to search and research. No one talked to me about lifestyle changes other that smoking....but nothing on diet or other means of cholesterol controletc....in factwhen I had to pick out my meals in the hospitalthey wouldn't let me have cheese....but the rice crispy treat was fine....how stupid! They originally told me the Plavix had to last 6 months....and then 12....and then 2 years....I stayed on it for 1-1/2 years and it was the only thing other than a baby aspirin. I went to another cardiologist out of town and he wanted me back on 5 or 6 medications and said that now I had the stents....I would have to be on these for life.....and he was the expert that talked at several main conferences.....my last trip to him.
Nowfast forward to about 6 months ago: I was participating in a father-son soccer scrimmage and was playing goalie. It was wet out and I couldn't catch very well. So being the competitive person I amI resorted to using my chest on several of the saves and also took a direct blow to my eye ( I wear glasses) and the eye started swelling up pretty good. We then finished and went inside to have pizza and everyone was concerned about my eye. About 30 minutes later I excused myself as i felt some pretty significant sweats and subsequently a pretty severe pain directly in the middle of my chest....I was having a heart attack! Called 911 and went to hospital (2-1/2 years since original stents) and my local cardiologist removed the blockage that was at the anterior portion of my 1st stent causing the blockage. The huge disappointment to me is that I had taken many steps to improve my overall health. But now that I have foreign bodies in my vesselsthe chance of further clotting is something that i will most likely always have to live with.
This is an example of how heart scans should NOT be used. They should NEVER be used to justify a procedureno matter how high the score or where the plaque is located. The "need" for procedures is determined by symptoms (BU's symptoms were hardly representative of heart disease)blood findingsEKGstress testingand perhaps CT coronary angiography. "Need" for procedures can never be justified simply on the basis of the presence of plaque by a heart scan calcium score.
Unnecessary procedures like the one BU underwent are not entirely benignas his experience at the soccer game demonstrated.
Heart scans are truly helpful things. Butlike many good thingsthey are subject to misuse in the hands of the uncaring or greedy.