Dr. Maciej Malinski is on the medical staff at Sherman Hospital. He has been kind enough to answer some frequently asked questions related to maintaining a healthy heart.Look for additional heart information from Dr. Malinski in the coming weeks.
Q: Dr. Malinski–What do you think of the EBT Scanner? Godsend or Scam?
Electron Beam Tomography (EBT) is a CT scan (also known as a heart scan) that shows amount of calcium in arteries of the heart. It does not accurately show arteries, so we can’t evaluate blockages in the arteries themselves, but we can assess amount of calcium deposited in the wall of the heart arteries.
The result of this test is called a coronary calcium score. The more calcium in the walls of the coronary arteries, the higher the chance of having significant plaques that cause narrowing in these arteries. There are lots of facilities advertising these scans walk-in clientele, but you should be cautious of this approach.
You should first to see your physician to discuss if this type of scan would be helpful for you. Very often in my clinic, I see patients with abnormal results who are confused about what to do with their abnormal scores. Also, very frequently primary care doctors are not sure what to do with abnormal results. The American College of Cardiology does not recommend routine use of heart scans in people who do not have symptoms of heart disease.
The theory behind using heart scans is that the more calcification you have, the worse your heart disease. But even having very small amounts of calcium might indicate that you could go on to develop heart disease. Also, having calcium in your coronary arteries may not necessarily mean that you have heart disease. It’s possible you could have false-positive results, meaning there’s an error on the scan. That means you might get unnecessary and invasive tests, such as coronary angiography, that could cause you to worry needlessly about your health.
The flip side is also true: If a heart scan shows your arteries are free of calcium, it doesn’t necessarily mean you don’t have heart disease. The plaques that build up in your arteries are initially soft and only become hard and calcified over time. So you can still have significant plaques clogging your arteries, and the scan won’t detect them. These false-negatives can give you a clean bill of health when you actually have heart disease or are at risk of developing it.
I usually start with the basics by evaluating a patient’s risk of heart disease (coronary artery disease) with the use of traditional risk factors: age, family history, cholesterol, weight, presence of high blood pressure, smoking, and exercise. You can do it yourself by looking up on the Internet (Google, of course!) Framingham risk score. This way I can evaluate risk factors that are either modifiable or treatable.
If I see a patient with a mildly-moderately elevated calcium score, I usually start with this traditional risk assessment. This is very well-studied approach with known positive outcomes.
We can’t treat calcium in the arteries, but we know that if we treat patients with high blood pressure or cholesterol by starting them on aspirin, we can significantly reduce the risk of heart disease, even in asymptomatic individuals.
Bottom line: don’t overlook the traditional risk factors that can increase your chance of developing heart disease before you spend money on the heart scan. And remember that if you do have a heart scan, it’s useful only if you actually follow up with your doctor and make lifestyle changes that can prevent worsening heart disease.
Do you have a question for Dr. Malinski? To submit your question, either post it in the comments section below or email firstname.lastname@example.org with the subject line “Question for Dr. Malinski.” For more information on heart health, click here to visit Sherman’s Heart and Vascular Center.
This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician.