According to World Health Organisation(WHO) estimates,

• 16.7 million people around the globe die of cardiovascular disease (heart attack and stroke) each year: this is one third of all deaths annually
• 8.6 million deaths are in women : cardiovascular disease is responsible for 2x as many deaths in women as all cancers combined
• 32 million heart attacks and strokes occur each year
• nearly 8 million deaths each year are due to heart disease
• half of all heart attack patients die before reaching hospital

By the year 2020, WHO estimates 25 million deaths each year from cardiovascular disease, making it the No. 1 cause of death worldwide.

ARE YOU AT RISK FOR HEART DISEASE? DO YOU HAVE ANY OF THE FOLLOWING RISK FACTORS WHICH INCREASES YOUR CHANCES OF DEVELOPING HEART DISEASE?

• Smoker
• Hypertension
• High cholesterol level
• Diabetes mellitus
• Family history of heart disease
• Obesity
• Stressful lifestyle
• Lack of regular exercise

With increasing life expectancy, people are exposed to cardiovascular disease risk factors for longer periods: even those with ‘low risk’ profile may develop heart disease because of age factor alone.

Atherosclerosis is the process by which the arteries of the heart develop hardening and progressive narrowing. When the narrowing becomes severe, patients develop chest pains(angina) and if occlusion occurs, it results in a heart attack which is fatal in 50% of victims. Occlusion of the artery can occur even if the narrowing is not severe, which is why heart attacks can sometimes occur without any preceding symptoms or warning.

Many people mistakenly believe that a ‘normal’ stress test result excludes underlying heart disease. A stress test only excludes advanced degree of arterial narrowing, ie more than 50%!

Now, at i heart Centre, the latest generation 64-slice multidetector CT scanner allows doctors to pick up atherosclerosis at its earliest stages in a non-invasive manner : no catheters(tubes) are required to be inserted into the heart. No anesthesia is necessary and the actual scan itself only takes 10 – 15 seconds.

Scan picture shows clearly a severe narrowing in the left anterior descending artery (yellow box).

The multidetector CT scanner can also be used to assess graft patency following coronary bypass surgery(CABG) and after stent insertion(PTCA).

Scan shows patent vein grafts to the right and circumflex arteries and LIMA graft to the left anterior descending artery.

Patency of stents in both LAD and Circumflex arteries well demonstrated in these scan pictures.

Although the vast majority of patients can be scanned by using this non-invasive technique, there are some who will not be suitable: those with irregular heart rhythm, grossly weakened heart, lung problems, kidney failure, heavily calcified arteries. These patients may require conventional coronary angiogram: our cardiologists will advise you accordingly.

Patients are advised to fast for 4 hours prior and to avoid coffee/tea on the procedure day. They will be attended to by trained staff who will go through their medical background and explain the procedure in detail. Generally, most patients will be given a tablet medication to slow down the heart rate in order to obtain the best images. Once the heart rate is stable, the patient will be placed on the scan table and an intravenous line inserted at the arm for injection of the dye. The patient will be instructed on breath holding for 10 – 15 seconds: that’s all the time needed for the actual scan! Following the scan, the patient is monitored for a short period before discharged.

Remember to tell the staff if you have a history of drug allergy, especially to any intravenous contrast material.

According to World Health Organisation(WHO) estimates,

• Men above 45 years and women above 55 years or younger if they have underlying risk factors or strong family history of heart disease
• If you have symptoms suggestive of heart disease
• If results of other tests are equivocal, eg stress test, ECG, echocardiogram
• As an alternative to conventional invasive coronary angiography

• chest discomfort: this may sometimes radiate to other areas(see diagram) especially to the epigastric and jaw region
• shortness of breath, especially on exeretion
• nausea or extreme weakness, unexplained cold profused sweating
• palpitations
• giddiness

Shaded areas show where discomfort due to heart disease may be felt.