Understanding Health Risks

Are You in Danger of a Heart Attack?

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By Henry Ford Health System Staff

The unexpected deaths of Fox 2 Detroit news anchor and firefighter Ron Savage and actor Bill Paxton, along with “Biggest Loser” trainer Bob Harper’s recent heart attack, have people asking themselves ‘Could that be me?’

Bob Harper’s career is based on a good diet and exercise. Ron Savage told his fire chief in Milford that he got a clean bill of health at a check-up a few months ago. He regularly worked out and was two days from doing the American Lung Association’s Fight for Air Climb at the Renaissance Center in Detroit. And Paxton was planning another movie, post-surgery.

“It is always important to remember that bad things happen to good people all of the time,” says Henry Ford cardiologist Deirdre Mattina, M.D. “It is unfortunate to lose someone unexpectedly, but there are limits to our ability to detect and prevent illness with science and technology.”

Of course, no single test or exam can definitively predict whether you’ll have a heart attack. But there are options for testing that can help determine your heart health—and what you can do to improve it.

“The first thing is, beyond the age of 20, at least once every three to five years, to go in and have a formal assessment with your primary care doctor – get checked out,” says Karthikeyan Ananth, M.D., a Henry Ford cardiologist who specializes in cardiac imaging. A routine physical should include a blood pressure screening, cholesterol test, blood test to measure your sugar levels, an evaluation of your weight and cardiac symptom check along with the non-cardiac assessments typical of a check-up.

Beyond a routine physical, a combination of factors should determine what types of additional testing is right for you.

“People who don’t have symptoms, that’s the biggest challenge,” says Dr. Ananth. “Stress tests (or a treadmill test) are primarily designed to detect significant blockages. Many times the heart attacks are from blockages that are not significant. So the cardiology community has moved away from routine stress testing assessment to determine risk, and now look at a combination of factors.”

What Types of Heart Screening Tests Are Available?
The simplest tests of heart health are online and typically free. These risk assessments analyze information you input about your health history, then predict how likely you are to suffer a heart attack in the future. Most, like the Henry Ford Heart Health Quiz, are based on guidelines set by the American Heart Association and the American College of Cardiology. They typically look at your body mass index, family history, smoking history, cholesterol numbers (if you know them), activity level and eating habits to predict the likelihood you’ll have a heart attack.

“These tests help assess lifetime risk and what can you do to improve your long-term risk,” says Dr. Ananth. “However, we know many of these tools we use are predictions, but predictions are not 100 percent.”

More involved tests are available for people who either have had heart issues – or their scores add up to a higher risk of a cardiac event.

The most insightful test regarding the risk of heart disease is a Coronary Calcium Scan, says Dr. Ananth. The test is targeted to people with a strong family history of heart disease, borderline or early diabetes, high cholesterol and borderline high blood pressure, and a physician referral is often required, as it is at Henry Ford, Dr. Ananth said.

“In those patients, it may be reasonable to have a calcium scan if we want further clarification,” says Dr. Ananth. “We don’t blindly offer this to everybody. You want to target a population rather than blindly have people exposed to small amounts of radiation.”

Patients lay under a CT scanner, and doctors are able to see the accumulation of calcium in the arteries of the heart. No contrast agent is needed for this test and everything is completed in less than 15 minutes.

“It is probably the best test we have beyond the risk assessment to determine if cholesterol buildup is happening in the arteries of the heart,” says Dr. Ananth, adding that unless there’s a blockage, there is no medical procedure to fix the established buildup. “It’s such a powerful picture, if you look in your heart and you see all these areas of calcium. I may say to a patient, ‘The process has already begun; it’s time to stop smoking, start exercising, sleeping more, reducing stress and doing all the right things.’”

One type of evaluation that is available to all patients without a doctor’s referral and does not use radiation is an arterial health screening. A special form of ultrasound of the carotid arteries in the neck shows if there is early hardening of the arteries, which is a sign of vascular disease, a contributor to heart disease. Some hospitals also include a check of the arteries in the arms and legs.

“We’re not looking for blockages, we’re looking for early signs of vascular disease,” says Dr. Ananth.

Other common heart screening tests include EKGs to measure electrical activity of the heart and blood pressure, body mass, blood glucose and lipid profile checks. Some hospital systems offer heart health checks that cater specifically to women. Together, the tests give patients insight into where they’re at and what they should be doing regarding their heart health.

Lowering Your Risk for a Heart Attack
“Heart disease comes in all forms and it should not be stigmatized as something you must have done wrong to cause it,” says Dr. Mattina. “That being said, coronary artery disease, or the build-up of cholesterol in the heart arteries, is mostly preventable by avoiding ‘toxic substances’ in our diet – sugar, processed foods and high animal protein intake – and ‘toxic habits’ – inactivity and smoking.”

The most important steps you can take to keep your heart healthy are the American Heart Association’s “Life’s Simple 7” recommendations, says Dr. Mattina:

  1. Manage your blood pressure
  2. Control your cholesterol
  3. Reduce your blood sugar
  4. Get Active
  5. Eat better
  6. Lose weight
  7. Stop smoking

And even if you’re working out and feel you’re physically fit, pay attention to your body, says Dr. Mattina.

“It is not uncommon for heart attacks to occur with physical exertion,” she said. “Many patients may notice signs of heart disease while working out – chest discomfort or shortness of breath that improves with rest. Those symptoms may progress in severity, frequency or duration and should prompt people to discuss these symptoms with their medical provider sooner rather than later.”

Learn more now about heart screening options at Henry Ford, including our $99 HeartSmart screening and our Lifestyle Enhancement Visit through the Henry Ford Women’s Heart Center. Or call 1-800-HENRYFORD (436-7936) to make an appointment with a doctor to talk about your risk.

Dr. Deirdre Mattina is a cardiologist and the medical director of the Henry Ford Women’s Heart Center, and sees patients at Henry Ford Hospital and the William Clay Ford Athletic Center, both in Detroit. She regularly contributes to the Henry Ford LiveWell blog.

Dr. Karthikeyan Ananth is a cardiologist, specializing in cardiovascular imaging, coronary disease and adult congenital heart disease, and sees patients at Henry Ford Hospital in Detroit and at Henry Ford West Bloomfield Hospital.