Very commonly a patient will remark to a physician…”I want my heart checked out” or ask them…”How do I prevent a heart attack or stroke?” The first step in answering these questions is to first clarify for the reader that there are no tests, procedures or treatments that actually prevent a heart attack or more broadly prevent the occurrence of a Major Adverse Cardiovascular Event or MACE (stroke, heart attack, heart failure, sudden death etc.). What a physician can do is determine the patient’s “risk” of MACE. Based on that assessment, the physician can then direct the appropriate tests that might further define the presence or absence of atherosclerosis (ASCVD = cholesterol plaque within an artery) and ultimately guide treatment that will in fact lower the risk of MACE for that person. The idea is to identify those patients that are at the highest risk and initiate treatment that reduces that risk, whether it is weight loss, treating high blood pressure, lowering cholesterol, managing diabetes or smoking cessation. No matter what, the risk of MACE will never reach zero but it can be substantially reduced by up to 30% with the appropriately directed treatment. The process of defining the risk of MACE always starts with a complete history and physical examination of the patient. Although limited in its utility, an electrocardiogram is often performed. The essential laboratory tests are the basic blood chemistries and cholesterol levels (Fasting Lipid Profile or FLP). Further testing such as stress test, echocardiogram, nuclear or echo stress testing is only reserved for patients with documented ASCVD or with symptoms that strongly suggest obstructive ASCVD. If you have any of the following symptoms or conditions you may benefit from Cardiovascular Risk Assessment:
CHRONIC CONDITIONS ASSOCIATED WITH INCREASED RISK OF MACE:
Diabetes Mellitus High blood pressure Family history of ASCVD Elevated cholesterol levels Smoking Documented ASCVD by carotid ultrasound (Carotid intimal thickening test) or Coronary Calcium screening
SYMPTOMS OF ASCVD:
Chest pressure or tightness with exertion Jaw pain or arm pain with exertion Shortness of breath with exertion Shortness of breathing while lying flat Excessive swelling of the feet Rapid or racing heart beat Unexpected fainting or loss of consciousness
If you have concerns about your risk of MACE and wish to learn how you can lower that risk, then our Marque Medical physicians are prepared to provide a thorough risk assessment with appropriate follow-up testing, education and treatment if warranted.