We all know or have read about that “healthy” friend, acquaintance or relative that dropped dead of a heart attack out of the blue. The reason it was such a shock is because “he was just at the doctors office and was told his cholesterol was normal.” How does this happen and how can we prevent it from happening to you? The reality was that these patients had deadly plaque build up in their arteries that could have been easily detected using an ultrasound of the carotid artery. This is the one test that anyone aged 40 or over should have done annually. It takes 7 minutes, is painless and I do them daily in my office.
- I thought that patients who have heart attacks have bad cholesterol and were overweight?
The facts are that the majority of patients that have heart attacks have normal cholesterol levels, normal EKG’s and no prior symptoms. You can also pass a stress test (where cardiologists put you on a treadmill while hooked up to an EKG) with a 70% blockage in the arteries to your heart.
Approximate 25% of people who have heart attacks die and that was their first and only symptom that something was wrong. These statistics frighten me and should also frighten you. Unfortunately, the normal tests (cholesterol panel, complete blood count, chemistry panel) that are being done by most doctors at annual physicals are not sufficient to detect the highest risk patients. In the next paragraph I am going to explain what you need to know and what to demand your doctor orders.
- What tests should I have done?
The first thing you want have done is an ultrasound of the carotid artery on both sides of your neck. This simple test uses ultrasound to measure the thickness of the wall of the artery and can detect if there is any plaque build up in your arteries. Studies show that there is up to a 97% chance that if you have plaque in your carotid arteries that you will also have plaque in the arteries to your heart.
The reason why having ANY plaque is bad because what causes a heart attack or stroke is when these plaques rupture and a clot forms which blocks blood flow to the heart or brain. Most of the plaque we find is actually in the wall of the blood vessel and not in the lumen of the blood vessel itself. It is for this reason that patients who have heart attacks are fully capable of exercising in the days leading up to their deaths with no symptoms (they still have normal blood flow to their heart).
Then one day they step outside to head to work and within minutes are dead. What happens is that the hidden plaque ruptured and platelets in the blood formed a clot causing 100% blockage of blood to the heart. It literally happens that fast and patients have no idea it’s coming.
The flip side is that many patients that do have heart attacks don’t die obviously. The same process happens in these patients but the blockage in blood flow was not great enough to cause the heart to die.
These patients exerting chest pain, shortness of breath, sweating, pain in their arms and jaws and nausea. These patients are the lucky ones who get a second chance at life
Check out this link that shows you how simply the carotid artery scan: http://www.heartsmartimt.com
- What about blood tests?
If you have plaque in your arteries, like 60% of my patients do, that doesn’t mean it is automatically going to rupture causing a heart attack or stroke. What triggers the heart attack is an overactive immune system or what doctors call inflammation.
It is inflammation that causes a plaque to become unstable and rupture. So the second thing you need to do is measure the amount of inflammation in your body. The two tests that I check in all my patients are C-Reactive Protein (CRP) and Lipoprotein associated Phospholipase A2 (LpPLA2). Acceptable CRP levels are <1 and optimal levels are <0.5. Optimal levels of LpPLA2 are <180.
Each of these tests are measurements of inflammation in the body but LpPLA2 is very specific for inflammation in the blood vessels and if elevated is a warning sign that you have plaque that is vulnerable to rupture. In addition I always check Lipoprotein (a) levels because levels > 50 mean patients have a 64% increase in having a heart attack in the next 6 years.
In another blog I will discuss what to do if you have plaque and/or inflammation in the body.
Here is a great article about the PLAC test in life extension magazine. http://www.lifeextension.com/Magazine/2008/11/Detect-Risk-of-Sudden-Heart-Attack-Stroke/Page-01
The truth is that you very well could have hidden plaque in the arteries to your heart that is vulnerable to rupturing and you will never know it unless you have a carotid ultrasound done and the three lab tests above.
Every 33 seconds someone has a heart attack in the United States and a high percentage will die. I encourage you not to wait and immediately find out your risk.
My initial blood panels includes all three lab tests and I perform carotid ultrasound during my initial two hour consult with any patient who has risk factors for heart attack and/or stroke.
If you want to know today what your risk is feel free to pick up the phone and contact my office at 877-721-0047 and speak to my friendly staff about getting started. www.DoctorBreen.com