Heart diseases affect a major chunk of the adult population in India. Food habits, lifestyle and stress are major causes of heart diseases. Key symptoms of heart disease include crushing pain near the heart, difficulty in breathing and nausea. Almost all heart ailments require some or the other form of surgical intervention. Therefore diagnosis, treatment and recovery can be long and sometimes complicated. The risk of heart diseases can be reduced by maintaining healthy food habits, regular exercise and less stress. However it is important to look out for symptoms and get regular checkups done to avoid any unpleasant situation.
There are various methods to diagnose different kinds of heart ailments like Electrocardiogram, Stress Tests, Echocardiography, and Nuclear Imaging etc. An ECG uses electrodes on skin to record the movement of electric impulses through the heart. The deviation in impulses helps to identify problems in heart muscles. Heart function if monitored in stress tests like walking, exercise etc can also help to detect abnormalities. Echocardiography is also used to monitor heart rate and valve function to identify defects. Nuclear imaging includes injecting radioactive material into veins to trace and identify blockages in path of blood flow.
One of the most important methods is Cardiac Calcium Scoring Test. This method uses an X ray Imaging system to check blockages in arteries caused by calcium build up. These blockages can hinder the normal pumping of blood and lead to heart diseases and increase the risk of heart attacks.
The test is usually carried out for adults in their 40s who are considered to be at high risk. Calcium build up in arteries usually increases with age and hence younger people are at little or no risk. This test will also be carried out by the doctor considering other factors such as age, blood pressure, sex, other complications such as cholesterol and diabetes etc.
The individuals are considered high risk in case of the following:
- High blood pressure and cholesterol levels
- Overweight or obesity
- Family history of heart diseases
- Bad food habits and sedentary lifestyle with little or no exercise
Before the test
The cardiac calcium scoring test does not need any special preparations and can be taken as a walk-in test. The doctor may review your medical history and your family medical history. A physical examination may also be undertaken. Blood tests may be done to check cholesterol, diabetes etc. You may also be asked about your exercise regimen and smoking habits.
It is advised to avoid taking caffeine in any form before the test. Pregnant women are not allowed to take the test due to the harmful rays of the imaging machines. You may be asked to remove jeweler, piercings, or any other objects that may affect the CT scan imaging. The test is usually carried out by a radiologist and the results can be reviewed by a doctor or specialist.
During the test
The entire procedure may take around 30 minutes. The doctor will attach electrodes to your chest to monitor cardiac activity during the CT scan. The machine itself is box like with a tunnel in the middle. You will be asked to lie down on a table that slides into the opening of the tunnel. The scanner then moves around your body taking CT scan images. You may be asked to remain completely still when the images are being taken. The images taken are processed on the computer workstation in a separate room.
During the procedure, no one is allowed inside the scanner room. However the doctor will communicate steps of the process to you via an intercom. Although the CT scan will be absolutely painless, some patients do experience anxiety and nausea due to nervousness. Reach out to the radiologist in case you feel extreme discomfort and require help. In some cases the doctor may also administer some medication to make you feel relaxed and at ease.
Once the imaging is done, the radiologist may ask you to continue lying down while they verify if CT scan images required have been taken. The test result of the imaging will be your calcium score. It may range from 0 to above 400. A result of 0 indicates no presence of calcium. Anything from 1 to 100 indicates minimal or mild evidence of calcium. Any result of from 100 to more than 400 is an indication of higher risk of heart attack or stroke. Depending on the results follow up check up may be scheduled by your doctor.
Advantages and Risks
Cardiac CT scan is a simple test to take with no prior preparation or medication necessary. It is non invasive and does not require hospitalization. You can resume routine activity immediately after taking the test. There is a slight risk of over exposure to radiation which increases the risk of cancer. However over exposure is almost negligible. The CT scan sometimes provides a false negative result if it fails to detect soft calcium build up. Soft calcium is the earliest form of the build up and may go undetected in a CT scan. Sometimes a higher than normal heart rate may interfere with the test results. This may also lead to a false positive. Similarly smoking or caffeine intake before test can also lead to misleading results. However any deduction of the CT scan should be made only by a specialist after considering other factors such as age, sex, blood pressure, cholesterol etc.
A cardiac calcium scoring test is carried out at all major radiology centers as well as super specialty hospitals. However not all medical insurers cover this particular test. The cost of the procedure may range from Rs 4000 – 6000 depending on city and hospital. It is a highly recommended procedure for patients in medium and high risk categories for heart disease. The cost of CT scan is negligible to the risk of developing serious heart conditions like heart attack, stroke, hypertension or even blockages. Early identification of a heart problem can help save later emergency costs of costly procedures like angiography, angioplasty or even by pass surgery.