I often hear stories of a guy who has a heart attack and come to find out that 95% of a major blood vessel to the heart was clogged.
How is this not picked up earlier during normal exams? Why isn’t it?
Can’t they do radiation shots to see where the blood flows or whatever?
In: Biology
They DO check. It boils down to: it depends.
You have to divide people into 2 groups. People with chest pain, and people who don’t have chest pain.
If you are having chest pain when you’re walking, going up stairs, etc, then you might be at risk of a heart attack. You might get imaging tests like a coronary CTA or nuclear stress test or exercise stress test.
If you are not having chest pain, which is basically the entire population, then there are step-wise ways to risk stratify people, because it’s not feasible or useful to run every single test on every single person. It costs a lot of $$$ and it’s not utilitarian to do 1 million tests to find only 1 patient.
Your risk factors for having a heart attack are many: age, high cholesterol, high blood pressure, diabetes, family history of heart attacks (“my dad had a heart attack when he was 48”). If you check off multiple of those boxes you might get a coronary calcium score CT which is an imaging test. If that’s normal then great. If it’s abnormal you might get pushed up into the same category as people with chest pain, and get more imaging tests like a coronary CTA or nuclear stress test or exercise stress test.
So when you go to your doctor for an annual physical and they ask you:
Are you having any chest pain lately?
Are you exercising?
Has anyone in your family had heart disease?
And they check your blood pressure.
And they have you get blood draws for hemoglobin A1C, fasting glucose, cholesterol.
These ARE the stepwise ways in which they’re picking out who is at risk of heart attacks and who to do MORE tests on.
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