The search for the Holy Grail in cardiology has been the
ability to obtain high quality pictures of the coronary arteries without the
need to enter the body. CAT scans are specialized x-rays that have been used to
obtain images of many body parts. The ability of CAT scans to obtain pictures
of the heart has been limited by one unique property of the heart that
distinguishes it from any other organ in the body…it continuously moves! The
latest generation of high speed x-ray imaging systems and computer processors
now enable exactly this. Using “multiple slice, multiple detector” technology,
external images of the beating heart of sufficiently high quality to be
comparable to coronary angiograms can now be obtained. The latest generations
of scanners obtain coronary CT angiograms (CCTA) that reliably show the level
of plaque inside coronary arteries just like a cardiac catheterization, and so
much more. The CCTA does all of this in a painless, 14 second examination that
requires the patient to simply lie inside a hollow chamber and briefly hold
their breath. The greatest value of the CCTA examinations is to exclude, or
“rule-out” CHD. In patients with suspected coronary heart problems, the CCTA
has nearly 100% accuracy in the ability to detect any level of plaque. Since
nearly one out of three patients in the U.S who have a cardiac catheterization
turn out to not have any serious blockages, a CCTA potentially could eliminate
many of these unnecessary invasive catheterizations.
A European Collaborative study has found that individuals
who lived in areas where they breathed in large concentrations of particles of
polluted air over a long period had a marked increase in the risk of having
heart attacks. The study further supports previous research that environmental
pollutants can contribute to the risk of heart disease. The ESCAPE trial found
that just a 5ug/m3 level increase in pollutants corresponded with a 13%
increased risk of heart events. This risk was independent of the effects of
other heart risk factors, such as age, sex, smoking and socioeconomic status. Take
an increasing level of individual responsibility to modify those heart risk
factors that are under your direct control. Avoid tobacco exposure, exhaust
fumes and maintain a healthy lifestyle for yourself. Take a pro-active role in
evaluating and modifying your heart risk in partnership with your health care
Dr. Sheikh is featured in the February/March, 2013 issue of Space Coast Medicine & Active Living. On pages 98-100, Dr. Sheikh discusses lipids and the value of having a lipid expert, otherwise known as a lipidologist provide an opinion about an individual's heart risk, and what can be done to further lower that risk. Also featured in the same issue are articles on pages 112-113 about emotional stress and heart disease, as well as an overview of Dr. Sheikh's new heart wellness book, "Don't Let Your Heart Attack!" on page 32.
Go to the following link and search for the page numbers as above:
The U.S. Attorney’s Office in Pittsburgh, Pa. reached a settlement with Westmoreland Hospital in Greensburg, Pa. to repay the federal government nearly $2 million in Medicare payments it received for unnecessary heart angioplasty procedures. The case is another in a familiar line of fraudulent, unnecessary and inappropriate heart angioplasty procedures that have recently become public. In August, 2012 an appeals court in Louisiana upheld the conviction of cardiologist Mehmood Patel for 51 counts of health care fraud related to unnecessary angioplasty procedures. In 2009, Baltimore cardiologist Mark Midei, who earned a seven-figure salary, resigned from St. Joseph’s Medical Center when an investigation revealed that he had falsified records and performed unnecessary angioplasty procedures in roughly 600 patients.
Nearly one million coronary angioplasty and stent procedures are done each year in the U.S. to treat coronary artery blockages. Coronary artery stents are the most common medical device used in the U.S. A recent clinical study published in the Journal of the American Medical Association found that nearly half of all of these procedures, when done in non-emergency situations were unnecessary.
Another prominent celebrity died prematurely of sudden cardiac death. Davy Jones, who was the lead singer for the popular rock group in the 1960’s and 1970’s died at the age of 66. An autopsy confirmed he had a heart attack caused by atherosclerosis, leading to a blockage of cholesterol and blood clot in his coronary arteries. This led to a sudden deprivation of blood supply to the heart muscle leading to a a catastrophic arrhythmia, called ventricular fibrillation.
K. H. Sheikh, MD, MBA, FACC
Dr. Sheikh directs a cardiology practice specializing in lipid management and cardiovascular disease prevention, treatment and reversal in Cocoa Beach, Florida. He was a Professor of Cardiology at Duke University before entering private practice, and is currently on the clinical faculty at the...
Heart disease affects 17 million Americans, with another 100 million more who are at-risk because of abnormalities in blood cholesterol. With the proper knowledge and an understanding of the tools for proper diagnosis and treatment, atherosclerosis and coronary artery disease can be prevented and reversed...