With recent advances in medicine, especially in the field of Cardiology, myocardial infarction or Heart Attack could be mostly prevented. Although current treatment options for heart attack are vastly different from 10-20 years ago, still prevention is the key. Unfortunately many young individuals suffer from this event, and their life would never be the same. Heart attack still causes significant morbidity and mortality, even in first world countries, with most advanced treatment options.
Current risk calculators for coronary artery events, although very robust, can miss about 50% of the heart attack cases. There are additional tools which if used appropriately, can reduce this percentage significantly.
At Heartcare Sydney, our primary goal is Prevention. Appropriate use of the current imaging modalities like Stress echocardiogram, CT coronary angiogram (CTCA), Coronary Artery Calcium scoring (CAC score) and blood test, could reduce the risk, significantly.
Having said that, there are also many other factors involved in increasing someone’s risk of Heart Attack and lifestyle, is at the top of the list. If you choose to smoke, eat unhealthy and be sedentary, reducing the risk of heart attack, will be a big challenge.
If you have Hypertension, Diabetes, positive family history of heart attack, or smoke, then your risk is higher. If you smoke or have high cholesterol, your risk is high. If you are male, over 45, you should consider having at least one check-up. If you are a female, going through menopause, a check up is recommended.
Here I present few real scenarios:
John, is a 47 year old man who suffered a massive heart attack in early 2020. He considered himself quite healthy. He never smoked, no had Diabetes or high blood pressure. He didn’t have a significant family history of heart attack either. BUT, he was a male, over 45. He had 3 children and a desk job at an office, with not much exercise.
December last year, upon his wife request, visited his GP for a “check up”. As our traditional teachings, GP examined him, ordered few blood tests and said, “everything is ok and you have no significant risk factor for heart disease”. Unfortunately, what was done, wasn’t enough to reassure John about the risk of future heart attack, as he did suffer a massive one, 3 months later. Unfortunately, by the time he got to the Hospital, the damage was done and he had lost half of his heart function. He is now 47, and has to live with heart failure for the rest of his life. Many treatments, a shock device in his body, with its own complications and so on. John’s heart attack could be prevented if he was assessed more thoroughly.
David is a 62 year old man, who considered himself extremely healthy. He goes hiking every weekend and eats very healthy. Didn’t smoke and didn’t have diabetes or excessive blood pressure. he visited his GP for a check-up. He was plugged into a risk calculator for heart attack and reassured that he is doing great. Few months later, he suffered chest pain at work which lasted all day and night. The next morning he presented to Hospital and was told that he had a heart attack. He had severe narrowing of 3 arteries. Here we can see how traditional “risk calculators” can miss significant cases of Coronary Artery Disease.
Frequently asked questions
I visited my Cardiologist and said my risk is low, but every year I do test after test after test. Is it really required?
If your risk is low, and all the proper investigations are done, then there is certainly no need to do yearly tests like stress test. In these cases, what is recommended is healthy diet, exercise and depending on age, a review in 2-3 years, not necessarily to do “test”.
I visited my Cardiologist and said my risk is high and every 6 month I do stress test. Is it really required?
If your risk is high, and your initial stress test was done properly, all you need is medical therapy, healthy diet and exercise. It is not required to do repeated tests, if you don’t have chest pain and are on excellent medical treatment.
I had a heart attack 12 years ago and had a stent in my artery. 5 years ago my cardiologist said, you are good, don’t come to see me unless there was a problem. Is that reasonable?
Well, I would consider changing my Cardiologist, if he is waiting to see you with another heart attack. If you are feeling well, and doing reasonable amount of exercise with no limitations, you don’t need any stress test or echocardiogram done, but certainly require yearly check up to see you are up-to-date to risk factor management and in case there is any new treatments, to start for you.