Heart Disease UK

A blockage in the heart's arteries may reduce or completely cut off the blood supply to a portion of the heart. This can cause a blood clot to form and totally stop blood flow in a coronary artery, resulting in a heart attack (also called an acute myocardial infarction).
Irreversible injury to the heart muscle usually occurs if medical help is not received promptly. Unfortunately, it is common for people to dismiss heart attack symptoms.
Many medical experts say the body likely will send one or more of these warning signals of a heart attack.
The actual diagnosis of a heart attack must be made by a doctor who has studied the results of several tests. The doctor may:
Review the patient's complete medical history.
Give a physical examination.
Use an electrocardiogram (or EKG) to discover any abnormalities caused by damage to the heart.
Use a blood test to detect abnormal levels of certain enzymes in the bloodstream.

Heart disease is the leading cause of death. There are many factors which may put you in a high-risk group for heart disease. If you have a family history of heart disease, have been diagnosed with high cholesterol, or have high blood pressure, you may be at risk to develop heart disease. A heart scan can reveal even minor problems, which could not be detected by physical examination, EKG, or stress test, giving you the foresight to take the necessary steps to maintain your health.
The heart scan, captures detailed, cross-sectional images of your heart, revealing the presence of coronary artery calcification, a key factor in determining your risk of heart disease. The overall condition of your heart health is based on this "calcium scoring."
Since most people have no warning of an impending heart attack, a heart scan can give you the foresight to take the necessary steps to maintain your good health.

Most people who die from a heart attack had no previous symptoms. Knowing the physical condition of your heart could save your life. A quick and easy procedure, the Preventive Heart Scan tests men and women who may be at risk, even though they may be symptom-free. All you're required to do is hold your breath for about 30 seconds while the GE Light Speed CT scanner slides over your chest area as you're lying on your back, resting comfortably. You could be just a breath away from breathing easier about your heart health with this heart scan, which provides you and your physician with valuable information about the physical condition of your heart.
A PHS exam is an excellent tool for helping your doctor get the specific information needed to make a well-informed, accurate diagnosis, so he or she can provide you with the very best care. Your PHS exam will be a big comfort to your family, too. Since the scan is quick and easy, both you and your family -- as well as your doctor -- will get the answers you're looking for.

What's a cardiac score?
The CT images provide precise, high-resolution pictures of your heart's vessels. These images are evaluated to measure the calcium and plaque build-up that leads to heart disease. A board-certified radiologist reviews your test results and a cardiac score report is provided to you and your physician. Early warning signs of heart disease can assist your physician in recommending treatment or lifestyle changes that can slow, stabilize, or even reverse heart disease

The facts about computerized tomography (CT) and heart scans
• A computerized tomography (CT) scan is a valuable diagnostic medical tool combining X-rays and computer images.
• CT scans have been used successfully in diagnostic medicine for almost 30 years.
• CT scans are non-invasive, meaning that there is no penetration of the body, either by injection or incision.
• CT scans can be put together in a computer imaging program that shows a three-dimensional image of the heart for in-depth clinical evaluations.

Constantinos Anagnostopoulos and Richard Underwood

Despite major advances in prevention and treatment of coronary atherosclerosis, coronary heart disease (CHD) remains a major cause of mortality and morbidity in the western world. Its management consumes a large proportion of national health care budgets, a significant part of which is spent in imaging technologies. Amongst them, myocardial perfusion imaging (MPI) is an established technique with important applications in the overall management of CHD, including, diagnosis, prognostication, selection for revascularisation and assessment of acute coronary syndromes.
This supplement covers the current applications of MPI and also its cost effectiveness and use in clinical practice in the UK. In the first article, Loong and Anagnostopoulos perform a systematic review of the existing literature on the diagnosis of heart disease by radionuclide MPI. The message is that MPI possesses a high overall diagnostic accuracy and remains the standard technique for assessing myocardial perfusion in the everyday clinical practice.
The assessment of myocardial viability and hibernation in patients with cardiac failure is another area where MPI also plays an important role because it can assist in the differentiation of ischaemic and non-ischaemic aetiology and it is an optimal technique for management and assessment of prognosis.
Evidence from modelling and observational studies supports the enhanced cost effectiveness associated with MPI use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPI are more cost effective than those not using the technique. Despite this and the fact that MPI is an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction, the technique is under-utilised in the UK as judged by the inappropriately long waiting times and by comparison with the numbers of revascularisations and coronary angiogram performed. In view of the publication of the UK National Institute of Clinical Excellence, guidance on the role of MPI in the diagnosis and management of patients with angina and myocardial infarction, we believe that the current supplement will be a valuable source of information for both providers and users of the technique.

From Richard N. Fogoros, M.D.
By DrRich

In standard textbooks of cardiology, much space is devoted to a description of the symptoms that typically occur with heart disease. In most cases, these "typical" symptoms turn out to be a recitation of the symptoms men get. In women, the symptoms can be quite different, and are usually regarded by cardiologists as being "atypical." However, since more women are dying from heart disease than men these days, it may be statistically more correct to consider men's symptoms as the ones that are "atypical."

Angina in women
When women have angina, they are more likely than men to experience "atypical" symptoms. Many women report a hot or burning sensation, or even tenderness to touch, in the back, shoulders, arms or jaw; often they have no chest discomfort at all.
Any good doctor will think of angina whenever a patient describes any sort of transient, exertion-related discomfort located anywhere above the waist, and they really shouldn't be thrown off by "atypical" descriptions. However, because many doctors persist in believing that CAD is uncommon in women, they are all too likely to write such symptoms off to mere musculoskeletal pain or gastrointestinal disturbances.
Myocardial infarctions (MI, heart attacks) also tend to behave differently in women. Frequently they experience nausea, vomiting, indigestion, shortness of breath or extreme fatigue - but no chest pain. Unfortunately, these symptoms are easy to attribute to something other than the heart. Women also are more likely than men to have "silent" MIs - that is, MIs without any acute symptoms, and that are diagnosed only at a later time when subsequent cardiac symptoms occur.

Chest pain with normal coronary arteries
Furthermore, women are more likely than men to experience true angina (chest pain due to a coronary artery disease) but with "normal" coronary arteries seen on cardiac catheterization.

Women minimize their symptoms
Women tend to complain less about their cardiac symptoms than men, thus leading doctors to think they are doing better than they actually are. Now, scientific evidence exists to show that, indeed, women tend to minimize their symptoms of cardiac disease.