New, Non-Invasive Imaging Test Could Help Prevent Heart Attacks

Kathy Brown says she always thought that heart disease was for those who smoked cigarettes, drank, ate a lot of red meat, and who were overweight.

The 54-year old wife of an oncologist and mother of four daughters had good cholesterol levels and was a vegetarian with a healthy and active lifestyle, although she was a former smoker with a history of heart disease on her maternal side. Little did she know that the continual nausea she was experiencing was not due to the vitamins she was taking, but was a red flag for women with coronary heart disease (CHD). It nearly cost Brown her life.

She explains that although she hadn’t felt well for several weeks, she didn’t feel that complaining was an attractive trait and didn’t want to bother with minor pains. “My life is fast-paced and I had considered myself the picture of health. I figured that everyone has aches and pain so I said to myself, ‘Stop being a baby.’”

Brown’s concerned husband was uncomfortable with his wife’s vague complaints and sent her to see their family physician who did an electrocardiogram (EKG) that showed abnormal results. The physician then sent her over to see world-renowned cardiac imager, Dr. Daniel S. Berman M.D., FACC, chief of Cardiac Imaging and Nuclear Cardiology at Cedars-Sinai Medical Center’s S. Mark Taper Foundation Imaging Center.

Berman saw her right away and ordered a stress test to evaluate the arterial blood flow to the heart muscle during physical exercise. When the heart is asked to perform increased workloads of a maximal exercise session on a treadmill, abnormalities of cardiac blood flow or function may become apparent on the EKG. Brown’s initial stress test results were what Berman termed “abnormal but inconclusive.”

Brown recalls, “When I finished the test, I looked at Dr. Berman and he wasn’t smiling; he was looking at the numbers and I was thinking, ‘Why isn’t he telling me that everything is just fine?’”

Berman then ordered a stress myocardial perfusion scan in which the results were normal. Still hunting for the cause of Brown’s abnormal EKG, he decided that she was an excellent candidate for a new procedure developed at Cedars-Sinai called the “Low-dose Coronary CT Angiogram (CTA),” an exciting new approach for certain patients.

Picking up the story, Berman says: “We decided to do a coronary CTA on Brown because she was relatively asymptomatic. We found a 90 percent blockage in the most dangerous of all locations—the left main coronary artery, which supplies about 70 percent of blood to the heart. If it gets completely blocked, the patient rarely survives. They’re at a critical risk of suffering a massive heart attack and sudden death.”

The coronary CTA uses advanced CT technology, along with intravenous (IV) contrast material (dye), to obtain high-resolution, three-dimensional pictures of the moving heart and large vessels, Berman explains. It is a non-invasive imaging test that can be used to determine if fatty deposits or calcium deposits have built up in the coronary arteries—the arteries that supply blood directly to the heart muscle.