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Symptomless crisis: Many heart attacks take place without warning

February 22, 2011
By KELLY FOSNESS Houghton Daily Mining Gazette

LAURIUM - Gordon Rintala, director of diagnostic services for Aspirus Keweenaw Hospital, said one in three people who end up in the emergency room with a heart attack never had one symptom.

An even more shocking statistic, Dr. Jerry Luoma said, is the first sign 15 percent of patients with heart disease experience is sudden death.

"Coronary disease is the No. 1 cause of death in men and women in this country," said Luoma, medical director for Aspirus Keweenaw Hospital. "Not having symptoms is not a guarantee that you don't have significant heart disease."

Article Photos

Aspirus Keweenaw Hospital CT technicians Christy Baccus, left, and Sonja Kivari, demonstrate the procedure of a coronary artery calcium scoring test in the X-ray department Tuesday. The screening test measures the amount of calcium build-up in the coronary arteries, which calculates a person’s risk of a heart attack. (Houghton Daily Mining Gazette photo by Kelly Fosness)

To help inform patients about their risk for heart disease, Luoma said they offer a screening test called Coronary Artery Calcium Scoring, which measures calcium build-up in the coronary arteries. The coronary arteries, he said, are the vessels which supply blood to the heart.

"If you are developing atherosclerosis, or hardening of the arteries, one of the manifestations is calcium buildup," he said. "If you look at someone who has a calcium score of zero to nine, the correlation is nearly perfect. There's no significant heart disease."

On the other hand, he said, if a patient is over 400, especially in a localized area, there is a higher probability of there being significant hardening of the arteries.

"The purpose of the screening is early detection," he said. "It's not a definitive test but it's something that raises a red flag."

Most men start developing calcium at age 40, Rintala said, while most women start around age 50 because their estrogen protects against it up until that point.

Major risk factors for coronary artery disease and heart attack include high blood pressure, obesity, family history, smoking, high cholesterol, sedentary lifestyle and a high stress lifestyle.

"You may have all the things that put you in this category but you don't know," Rintala said. "You can't always judge the book by its cover."

For patients with a strong family history of heart disease, the screening test can ease their concerns.

"They think they're going down the same path as dad or grandpa," Luoma said. "Then they come and get a good score and it's a relief. They might say, 'I'm good at this point, now let's try to keep it that way and move on.'"

Rintala said Aspirus Keweenaw started to offer self referral for calcium scoring five years ago. The procedure is performed with a CT scanner which takes an image of the heart and measures the amount of calcium in the blood vessels. Computer software gives the results in the form of a number.

"We've had people as high as 4,000, just off the charts," he said. "Almost all of them have gone and had triple bypasses."

Patients with higher scores, Luoma said, are encouraged to see their doctor or cardiologist for further evaluation and testing.

"It's a very individualized thing at that point," he said.

Coronary disease claims more lives than lung, colon, prostate, and breast cancers combined, Rintala said. And, women are 10 times more likely to die from heart disease than breast cancer.

"People think smoking is bad on the lungs," he said. "It kills the arteries."

The bottom line, Rintala said, is the calcium scoring test saves lives.

"It's going to prolong life for people who become aware and make lifestyle changes," he said. "It's definitely going to catch some people who didn't know, who would have been one of those 15 percent."

Since February is American Heart Month, Aspirus Keweenaw Hospital is offering the calcium scoring tests at a reduced rate.



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