With this test, a CT scanner checks the heart’s arteries for signs of atherosclerotic plaque, made up of calcium, cholesterol and scar tissue. Electrodes are attached to the chest and to an EKG machine that monitors heartbeat. The patient lies on an exam table that slides into a short, doughnut-shaped tunnel, and is asked to hold their breath for 10 to 20 seconds. Cost can range from $99 to $399; duration of test is only 10 minutes.
Calcium scoring is the best predictor of a future heart attack, according to Dr. Agatston, leading preventive cardiologist and creator and author of “The South Beach Diet.” Calcified plaque, a major warning sign of coronary artery disease and the leading cause of heart attacks, shows up at least 10 years before a heart attack or stroke hits. If caught early, it can be treated before a buildup narrows arteries so severely that it triggers a heart attack.
Advised for those 50 or older with risk factors, or at a younger age if there is a family history and several risk factors. Since the test involves X-rays, women shouldn’t have it if there is any chance they might be pregnant.
Carotid intimal medial thickness test
This “ultrasound of the neck” takes a picture of the left and right carotid arteries, which supply blood to your head and brain. A gel is applied to the neck, and an ultrasound transducer slides over the carotids to measure thickness of the arteries’ lining. Cost ranges from $150 to $500, duration: 15 minutes.
Studies have shown a link between abnormal thickness of the carotid lining and coronary artery disease. This test can detect the earliest stages, before blood flow is blocked.
Advised for those 40 or older, or younger if a close relative (parents or siblings) had a heart attack or stroke before age 55.
High-sensitivity c-reactive protein test
A blood test that measures CRP, a protein in the blood that is a strong indicator of inflammation throughout the body. Cost $8, duration: 5 minutes
Blood vessels are injured by cholesterol plaque. This in turn triggers inflammation and raises CRP levels in the blood. Women with high levels of CRP may be up to four times more likely to suffer a heart attack or stroke. A high CRP is most dangerous if you also have a waist circumference of more than 35 inches for women or more than 40 for men, indicating the presence of belly fat. Advised for those 40 or older.
Advanced lipid profile and lipoprotein(a) test
Traditional cholesterol blood tests measure total cholesterol, HDL, LDL, and triglycerides, while this test goes a step further, looking at particle size. This is important because some particles are larger and fluffy, tending to bounce off artery walls as they travel through the body. Others are small and dense, and can penetrate the artery lining and form clumps of plaque. Having many large particles lessens risk of heart disease, while small ones increase it. The Lp(a) blood test analyzes a specific type of cholesterol that can triple heart risk.
Cost: $19 each. Duration: 5 minutes. Advised for those with a family history of heart disease.
A1C blood glucose test
A simple way to detect future risk of diabetes, this blood test indicates average level of blood sugar over the prior 3 months. Unlike other glucose tests that require fasting or drinking a sugary beverage, this test requires neither. An estimated 5.7 million Americans have undiagnosed diabetes, in addition to 17.9 million who have been diagnosed. Diabetes puts you at five times higher risk of developing heart disease.
Cost: $50. Duration: 5 minutes.
Advised for those 45 or older, or younger if overweight and have one or more diabetes risk factors, such as family history, high triglycerides, or low HDL.
Genetic tests
A blood sample is tested at a lab for mutations of the KIF6 and APOE genes.
Cost: $130 each. Duration: 5 minutes.
A common variation in the KIF6 gene and two mutations in the APOE gene raise heart disease risk. These tests can help your doctor better tailor treatment to help prevent a heart attack.
Advised for those 40 or older.
Stress echocardiography
A step above a standard stress test because it adds an ultrasound both before and after exercise to evaluate blood flow to the heart’s pumping chambers and check for blockages in arteries.
Cost: $850 to $1,600. Duration: 45 minutes.
Advised for those who have signs of heart disease, regardless of age. Symptoms can include shortness of breath, chest pain, nausea and neck pain, to name a few. If reduced blood flow is detected, one or more of the coronary arteries may be blocked.
Marjie Gilliam is an International Sports Sciences Master certified personal trainer and fitness consultant. She owns Custom Fitness Personal Training Services. Write to her in care of the Dayton Daily News, call her at (937) 878-9018 or send e-mail to marjie@ohtrainer.com. Her website is www.ohtrainer.com.
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