Daily photos by John Godbey|
With technician Ed Henry at the controls, Daily reporter Paul Huggins is wheeled into the Brilliance CT cardiac scan at Parkway Medicial Center. The prognosis was good.
Into the hole to avoid a heart attack
A little scan
will spot it
New technology detects blocked arteries other methods can’t
By Paul Huggins
I was thunderstruck by the doctor’s report.
There had to be a mistake.
I exercise three to five times a week and eat healthy most of the time, rarely stopping for fast food. I’ve never smoked. Most of the time I feel 21, not the 41 my driver license says.
But back in August, my routine physical showed my cholesterol level was high. Overall it was 242, 42 points above the risk level. The bad LDL cholesterol followed suit: 147, or 47 points above the risk factor.
The numbers disturbed me, mainly because I was doing so many things right and still had a bad report. Then my dad, who had a heart attack eight years ago, read me his history of cholesterol tests, and all were better than mine.
Every day since then, I had worried whether my arteries were clogged and whether my chest contained a ticking bomb.
My stress level nose-dived Friday, however, after receiving a Brilliance CT (computed tomography) cardiac scan at Parkway Medical Center. The new technology, which the hospital implemented six weeks ago, showed I had no growing blockages.
The scanner not only relieved my fears; it did so quickly and much easier and more accurately than the traditional diagnostic method: either a stress test or an arteriogram.
The actual scanning took less than 20 minutes, and all I had to do was lie on a table and hold my breath a few times for 20 seconds. I didn’t even have to loosen my necktie.
My arm did have to receive an intravenous needle, which the nurse used to release a dye seconds before the CT took the photos. It briefly gave me a metal taste in my mouth and a warm sensation around my groin. The nurse also gave me a drug to slow my heart rate slightly and help improve the quality of the images.
About 20 minutes after the last scan, I was sitting next to lab technician Ed Henry, looking at three-dimensional photos of my heart.
Henry pointed out the main arteries, and none showed dangerous buildup of plaque. I stayed for about an hour asking questions, but the usual process from check-in to checkout probably would last no more than an hour.
“We’re not playing catch-up with the rest of the country,” Henry said of the new technology. “We’re leading.”
Speed is the key
The Brilliance CT scanner is four times faster than the previous generation of CT scanners, and you’d have to go to Huntsville, Birmingham or Nashville to find one as fast.
Huggins’ heart, as it appeared on the computer screen.
Speed is the key to getting clear images of a beating heart, for much the same reason that The Daily’s photographers need a fast shutter speed and lens to capture sporting events.
The technology — price
tag about $2 million — has been in use for a few years, and The Heart Center in Huntsville began using it in March 2005.
It has done 3,000 cardiac CT screenings since then, the most in the Southeast, said Dr. Michael Ridner. He is director of cardiac CT and angiography for The Heart Center, which partnered with Parkway to provide doctors and technicians to operate the lab.
The training included free screenings for the hospital’s physicians.
That proved a great benefit for Dr. Michael Disney, medical director of the emergency room.
“I have a history of high cholesterol, but I’ve never had any chest pains, never had any symptoms,” the 44-year-old said. “Lo and behold, I had a couple of vessels that were blocked, and one of them was 99 percent blocked. I could have had a heart attack at any time.”
He had an angiogram to confirm the CT scan findings and received two stents to clear blood flow.
“Had I not had that test, I might not even be here now,” Dr. Disney said.
Dr. Ridner said Dr. Disney’s experience is a common tale, and that’s what makes the CT scanner so valuable.
It’s great that it’s less invasive or taxing than an arteriogram or stress test, but the real benefit is its accuracy, he said.
A stress test — typically the first stage of cardiac testing — is only 80 percent accurate, Dr. Ridner said, whereas a CT scanner is 99 percent accurate. A patient with 50 percent blockage in an artery can pass a stress test, but that blockage could become a full clot at any time, he said.
The Heart Center has already seen a 10 percent reduction in arteriograms, and Dr. Ridner said he expects stress tests to become mostly a tool for checking the therapy of heart patients.
Detecting heart problems
The CT scanner can also detect heart problems, such as mitral valve prolapse, and can be pointed at the neck and look for early signs of stroke in carotid arteries.
Dr. Ridner said the new CT scanner will change cardiac care from a reactive method of treating patients after they visit an emergency room to a proactive method: finding the problems before a patient shows symptoms, and then prescribing medicine, diet and exercise to reverse plaque buildup.
Perhaps one day, CT scans will be used with routine examinations, he said, but currently they are being used only with people who have cardiac disease symptoms. Medicare covers the scans fully, he added, and Blue Cross Blue Shield of Alabama covers them as long as the patient has symptoms.
The Heart Center does offer $99 screenings that use the CT scanner to check for calcium buildup in arteries. It doesn’t require a dye, nor will it give a full picture, but it will tell whether more testing is needed, Dr. Ridner said.
On Thursday at 6 p.m., Parkway will have a free community seminar in the Pavilion classroom to inform people how the scanner can serve them.
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