Cone goes 3D

Diagnosing heart problems just got personal. At Moses H. Cone Memorial Hospital in Greensboro, patients who undergo a computed tomography (CT) scan to identify potential coronary artery blockages and blood-flow issues no longer automatically follow up with an invasive catheterization to determine treatment.

A new technology called HeartFlow Analysis, which Cone physicians acquired this spring, uses CT scan data to upload a 3D model of the patient’s heart labeled with a color-coded vessel-by-vessel assessment.

“It will tell us functional information about an anatomical lesion, so if we see a blockage that is borderline that doesn’t need any intervention or stent, the physician can look at the numbers and come to the conclusion of whether the lesion needs to be treated,” says Katarina Nelson, Cone’s director of non-invasive cardiovascular imaging. “We have had really good results, and we’ve had good correlations with other studies, so we are very pleased with that. Previously, borderline lesions would send patients for catheterization. Now, we get the data the same day.

“Not every patient needs HeartFlow Analysis. Some are clearly normal, and some are clearly abnormal, but the ones in between where we don’t know, they can get the results right away,” Nelson says. “The patient doesn’t have to do any more testing.”

That saves money, she says. Data shows a 26% accumulated savings after accounting for the $1,500 cost of HeartFlow Analysis.

Katarina Nelson, Moses H. Cone Memorial Hospital’s director of non-invasive cardiovascular imaging, administers a CT scan for the hospital’s HeartFlow Analysis

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Cardiac CT Site Colorado

Another successful initiation of cardiac CT program happened last week. In Colorado mountain region where patients frequently must be air transferred to the nearest cath lab, a CCTA can significantly improve care of local patients and visitors by rapid triaging of acute patients and avoiding many unnecessary transfers to Denver.

This program will serve residents by facilitating earlier diagnostic workups for chest pain and keeping patients local, decreasing the amount of travel required to care. This cardiac CT program is also equipped with some of the newest AI programs that supplement anatomical CT images with plaque analysis and CT FFR information, providing more information to support physicians with treatment planning.

How can cardiac CT support your program with early diagnosis and keeping patient care local?
Coronary Calcium Scans Heart Health

Medical technology advancements have paved the way for early detection and the prevention of heart-related issues. One such groundbreaking diagnostic tool is the coronary calcium scan. This non-invasive imaging procedure plays a crucial role in assessing the risk of heart disease by detecting the presence of calcified plaque in the coronary arteries.

We spoke to Katarina Nelson, MD, FACC, a non-invasive cardiologist specializing in general cardiology, preventive care, women and heart disease, and a wide range of cardiovascular imaging. She joined CommonSpirit Health at the St. Anthony Hospital in Summit in August 2022.

February is American Hearth Month

We asked Dr. Nelson to share a few heart health statistics with us to recognize American Heart Month. She told us, “Cardiovascular disease is the leading cause of death in the U.S. for both men and women. There are 400,000 deaths a year among women and 386,000 deaths among men a year in the U.S. Coronary Artery Disease (CAD) alone is the cause of 175,000 deaths a year. This makes CAD the most common cause of mortality among adults in the United States.

“While common, it is preventable,” Dr. Nelson emphasized, reminding us that “CAD and its risk factors can be screened, identified, and treated early.”

Understanding Coronary Calcium Scans

A coronary calcium scan is a specialized imaging test using computed tomography (CT) technology to create detailed images of the coronary arteries. The primary purpose of this scan is to identify and quantify the amount of calcium deposits in the coronary arteries, which are indicative of atherosclerosis or plaque buildup.

Calcium deposits in the coronary arteries are a key marker of atherosclerosis, a condition characterized by the hardening and narrowing of the arteries. As plaque accumulates over time, it can restrict blood flow to the heart, leading to cardiovascular issues, including heart attacks. “The calcium score, also known as the Agatson score or coronary calcium CT scan, is a special computerized tomography (CT) scan of the heart,” Dr. Nelson said. “It looks for calcium deposits in the heart arteries.

“Coronary calcium scan results can help determine the risk of heart attacks or strokes, and the results from the scan can guide therapies for coronary artery disease.”

How Can It Save Your Life?

The information obtained from a coronary calcium scan is invaluable in assessing an individual’s risk of developing heart disease. By identifying the presence and extent of calcified plaque, healthcare professionals can gauge the severity of atherosclerosis and tailor a preventive strategy accordingly.

Early detection through a coronary calcium scan allows for timely intervention, enabling individuals to make lifestyle changes, initiate medications, or undergo medical procedures to prevent the progression of heart disease. This proactive approach significantly reduces the risk of heart attacks and other cardiovascular events.

How Can You Get a Coronary Calcium Scan?

Getting a coronary calcium scan involves consulting with a health care provider, who will assess your risk factors for heart disease. Common risk factors include age, family history, smoking, high blood pressure, and high cholesterol levels. Your provider may recommend a coronary calcium scan to evaluate your cardiovascular health based on the evaluation.

The procedure itself is quick, usually taking 15 minutes or less, and painless. During the scan, you lie on a table that slides into the CT scanner. The scanner captures detailed images of your heart, and the results are analyzed to determine the presence and extent of calcium deposits.

Popularity of Coronary Calcium Scans

Coronary Calcium Scan

The popularity of coronary calcium scans has steadily increased as awareness of preventive cardiology grows. Many recognize the importance of early detection and intervention to safeguard their heart health. Health care providers also incorporate these scans into routine screenings for individuals at risk of heart disease.

The availability and recommendation of coronary calcium scans may vary based on geographical location, health care infrastructure, and individual risk profiles. However, the rising prominence of preventive health care is contributing to the widespread adoption of these scans in many regions.

Who Benefits Most?

“The calcium score is best for asymptomatic patients with no known coronary artery disease, who are over 45 years old with a strong family history of early coronary artery disease, borderline or elevated lipids to guide treatment decisions for cholesterol management and potential further testing.”

It is not, she warned, the best course for those at high risk of heart attacks or who have previous heart conditions.

“It is a screening tool for coronary artery disease equivalent to a mammogram for breast cancer or colonoscopy for colon cancer,” Dr. Nelson said. She described a recent 46-year-old active patient with a significant family history of premature coronary artery disease. Telling us his risk factors, she said, “His father died of myocardial infarction at age 42, and his first cousin underwent bypass surgery at age 40.” The scan showed a high calcium score, which led to further workup that showed critical stenosis or blockage in one of the main coronary arteries. “He was treated with coronary artery stenting to open the pathway and to prevent heart attacks and sudden cardiac death.”

Next Steps

The decision to undergo a coronary calcium scan should be in consultation with a health care provider. Before recommending the scan, they will assess your overall health, medical history, and risk factors. Additionally, guidelines may vary, and health care professionals will consider individual circumstances when making recommendations.

In the quest for optimal heart health, coronary calcium scans emerge as a powerful tool for early detection and prevention of heart disease. By providing crucial insights into the presence of calcified plaque in the coronary arteries, these scans empower individuals and health care professionals to take proactive measures to mitigate cardiovascular risks. As awareness grows, the coronary calcium scan will play a pivotal role in preventive cardiology, ultimately saving lives through early intervention and personalized care.