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Detecting coronary calcification on CT has been known as a sign of having coronary artery disease for over 30 years, but now the thinking has changed, and it might be logical to conclude that, if you have non calcified coronary artery disease, the best you can hope for is a strategy that calcifies your plaque!
Recognition that significant coronary artery disease exists without calcification led to the wider user of contrast-enhanced CT scans to detect both calcified and noncalcified plaques. Even more advanced scans identify not only the non calcified plaques, but also areas of inflammation (using data processing to measure FAI), that a non-contrast CT (such as a CAC scan) would otherwise miss. Sequential CAC to follow up disease progression quickly established that an increase in CAC with age was inevitable in most patients and not linked to clinical course, so is not widely practiced.
Is is increasingly obvious that not everyone with raised coronary inflammation and elevated risk of heart attack simply has a raised LDL Cholesterol- in fact there appears to be a mixed bag of risk factors associated with high coronary artery inflammation, including raised LDL, raised LP (a), raised Homocysteine, hypertension and dysregulated glucose. Our metabolic health assessment is therefore designed to offer a comprehensive dive into known contributory causes, the latest and most controversial of which is 'glucose dysregulation', the principle topic of this article.
Diastolic heart failure (often referred to as 'Heart failure with preserved Ejection Fraction' or 'HFpEF') arises from ventricular stiffening due to age, hypertension, and various other rarer heart conditions. The aging component of this process is unavoidable, but maintaining optimal blood pressure through midlife is achievable and, if successful, should prevent additional left ventricular stiffening attributed to hypertension. By regularly monitoring blood pressure and using effective medication, we can help patients live longer with healthier hearts.
To expedite diagnosis, SCVC arranges for cardiac imaging, such as Cardiac CT, during the initial assessment. By consolidating diagnostic tests into a single visit, patients benefit from streamlined care and reduced wait times.
In this guide, we will explore a multifaceted approach involving increased physical activity, dietary modifications, and consistent monitoring to effectively lose fat and enhance overall health.
Lp(a) testing is advised for individuals at high risk for cardiovascular disease, including those with a prior stent or bypass operation, coronary syndrome or heart attack as well as anyone with a family history of coronary heart disease, high FAI (coronary inflammation) or high risk patterns on Cardiac CT angiograms. In our practice, Lp (a) is offered as part of our comprehensive Metabolic Health assessment (MHA1).
In the absence of strong evidence, a pragmatic approach involves educating patients about the current knowledge gaps while encouraging lifestyle changes that are generally beneficial. These include reducing carbohydrate intake, choosing lower glycemic index foods, increasing physical activity, and improving sleep quality. Such measures are unlikely to be harmful and could potentially lead to improved overall health and well-being
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Numerous epidemiological studies have supported the hypothesis that high homocysteine levels are a risk factor for cardiovascular diseases. For example, the Framingham Heart Study demonstrated that individuals with homocysteine levels in the top fifth percentile had a nearly doubled risk of developing coronary artery disease compared to those with levels in the bottom 80 percent.
The medical understanding of a "heart attack" can sometimes diverge from the layperson's perception. Many people interpret a heart attack as any acute, potentially fatal cardiac event, regardless of its cause. This discrepancy necessitates a deeper exploration of heart attack causes unrelated to coronary artery disease, particularly for understanding familial risks and discussing preventative measures like statins.
With growing public awareness and knowledge, there is an understandable and increasing interest in patients employing self help techniques to look out for AF episodes. After all, it is hardly going to be possible to obtain an ECG from your GP every time you feel a slightly irregular pulse.