CT Calcium Scoring - Screening for Arterial Plaque Heart Disease at ARA
CT Calcium Scoring - Screening for Arterial Plaque Heart Disease at ARA
See ARA’s Dr. John Williams describe how CT calcium scoring detects calcified plaque in the arteries that supply the heart with blood. Finding and treating arterial plaque can help prevent stroke and heart attack or stenosis.
Content
0 -> Welcome back to We Are Austin. Today is
3.75 -> the last day of national heart month but
6.12 -> that doesn't mean we should ignore heart
7.799 -> health for the rest of the year.
9.42 -> Dr. John Williams from ARA is here to
11.519 -> tell us how we can stay proactive. Thanks
13.889 -> so much for being here. Sorry about our
15.9 -> mixed messages after we just ate some,
18.24 -> you know, real healthy grilled cheese.
19.92 -> It looks good - moderation!
21.66 -> We gotta have balance, right? Moderation.
23.609 -> So let's talk about heart disease. It is the
24.9 -> leading cause of death in the US, which is pretty startling.
27.18 -> Can tell us a bit about the disease?
28.769 -> Sure. So it's definitely, um, heart disease is
30.96 -> very common and often serious. It
32.969 -> accounts for 600,000 deaths annually in
35.34 -> the United States, which that means
37.649 -> that it actually is responsible for the
39.21 -> death of one out of every four Americans
41.07 -> every year. My goodness. To put that in
42.96 -> context that's as many as all cancers
45.36 -> combined annually. The most common form of
48.36 -> heart disease is coronary artery disease
49.8 -> which is responsible for 300,000 of those
52.739 -> 600,000 deaths. The coronary arteries
55.02 -> are the blood vessels that
56.28 -> basically supply oxygenated blood to the
58.41 -> heart that the heart needs to pump.
61.44 -> We can kind of think of arteries throughout the
62.489 -> body as pipes so that when they're open
65.189 -> and clean things flow through easily but,
67.229 -> you know, just like pipes can accumulate
68.189 -> debris over time that narrows and
70.02 -> dimensions the flow, arteries can
72.18 -> as well and that's in the form of a
73.799 -> plaque that builds up in the wall of the
75.18 -> vessel and narrow the vessel down,
77.369 -> decrease flow. Those pipes can sometimes
79.68 -> rupture and they cause a blockage in the
81.75 -> vessel and so that's what results in
83.909 -> a heart attack or even death.
85.17 -> Yeah, so when you're assessing someone
87.45 -> for the risk of heart disease or trying
89.04 -> to look at these things what are the
90.45 -> factors that you're taking into account?
91.619 -> Yes, so, your doctor or healthcare
93.36 -> provider they basically when they look at
95.49 -> your risk for coronary disease they'll
97.17 -> take into account your personal medical
98.82 -> history, your family history of heart
100.259 -> disease. Yeah. Physical examination, results
103.86 -> of certain blood tests like a lipid
105.6 -> profile and then your risk factors and
107.52 -> in those known risk factors are basically
109.079 -> hypercholesterolemia which is high
110.67 -> cholesterol, hypertension, which is high
112.619 -> blood pressure, obesity, smoking, diabetes
116.04 -> lack of exercise, an unhealthy diet.
118.979 -> How much do you think the awareness is
121.77 -> of heart diseases? Those numbers that
123.659 -> you gave are so staggering. Do you feel
125.31 -> like the general public knows that this
127.079 -> is such a risk? I think fortunately,
129.33 -> thanks to, you know,
130.2 -> events like this that
132.36 -> there's a growing awareness.
134.28 -> Luckily we see fewer and fewer people
135.84 -> smoking - Austin's a pretty fit city - see people
138.15 -> taking their health seriously. But you know
140.7 -> it's always good to be aware of it and spread
142.53 -> the word. Yeah, absolutely, that's why we're glad you're
144.18 -> here educating us. So how can you detect
145.86 -> some of the things you were just talking
147.09 -> about - the presence of heart disease.
149.22 -> So there are a few examinations
150.269 -> that attempt to - the one we're going to focus on is
151.98 -> called a CT cardiac scoring
153.48 -> examination or calcium scoring
155.16 -> examination. So what that does,
156.69 -> it's a CT that's looking basically for the
158.549 -> presence of those plaques on the wall,
159.93 -> those plaques that have become calcified.
163.62 -> So this is actually an image here from
166.89 -> one of those scans. Gotcha. This is what's called
169.049 -> an axial or cross-sectional image
170.73 -> through the patient from front to back.
173.43 -> This gray area in the center here, that's
176.91 -> that's all your heart and so then
178.38 -> within that white circle, that's where
180.54 -> one of the coronary arteries that we
182.22 -> look at you know is located. And so what
184.769 -> we're assessing is these little kind of white
187.26 -> flecks - those are calcified
189.12 -> plaques on the wall of the vessel. Gotcha.
191.13 -> So the next image shows kinda what we
194.459 -> hope to see which is, here's the coronary
197.13 -> artery on this slice.
198.569 -> It's all nice and grey and you see he doesn't
199.98 -> have any of those white calcifications,
201.299 -> so that's basically a negative
203.25 -> test. So there's no consultation no
205.26 -> calcification, no coronary disease. And this is
207 -> what you want to see. In this next image is what
209.609 -> we can and often see. You see the same thing:
211.859 -> there's the vessel and again the
213.299 -> coronary artery but you start to see
214.41 -> some of these white califications within
217.019 -> the wall of the vessel. So this indicates that
219.329 -> there is, you know, coronary calcification
221.04 -> present. This is a relatively, you know, mild
223.29 -> burden. What we don't want to see is
225.09 -> like, on this next image, now you see the
227.91 -> whole vessel basically is just white and
230.19 -> it's occupied and involved with this
231.69 -> calcified plaque. So this would indicate
233.489 -> that, not only is there presence of coronary
235.44 -> calcification, in this patient it is
238.23 -> extensive and they probably have a pretty
239.819 -> significant risk of having a stenosis [heart attack],
242.19 -> a narrowing in the vessel that that could cause some
243.989 -> cardiac events. So that's pretty alarming
245.609 -> when you see this. Who's the type of
247.019 -> candidate that would be good for this
248.79 -> kind of testing? Sure. That's a good question.
251.19 -> So your doctor kind of knows
253.12 -> based on those risk factors that we
255.4 -> talked about, and then your age and your
256.93 -> gender,
257.59 -> sort of knows your pretest likelihood of
259.449 -> having a coronary disease and then this
261.31 -> examination helps sort of better
263.889 -> elucidate that and so patients that are
266.979 -> that sort of pretest moderate risk
268.449 -> category or indeterminate risk category
270.01 -> are kind of best suited for this
271.75 -> examination. Yeah. The results of the
274.12 -> examination, if it's negative, there's no
275.949 -> calcification like on the one we saw,
277.15 -> that's great, you have you have no
278.56 -> coronary disease. That means your risk for
280.6 -> having a heart attack in the next 2 to 5
282.13 -> years is basically almost zero. But
285.01 -> if you do have some calcification then
286.66 -> what we do is we sort of quantify that
288.22 -> and then use that to stratify patients.
289.72 -> We determine what's called the
292.03 -> plaque burden which means how much of
293.59 -> that calcification is there. Put you in a
295.479 -> category, you know, minimal, moderate,
298.03 -> extensive and then that again indicates
300.07 -> you know how high your risk of having a
302.02 -> stenosis [heart attack]. That helps your doctor
303.729 -> determine what kind of treatment
305.919 -> you may need. Dr. Williams, thank you so much
307.81 -> for being here. So if people want more
309.07 -> information or they want to get this
310.449 -> type of testing done they can reach out
311.86 -> to you guys. Sure. Tell us a bit about ARA,
313.93 -> where's the best way to find ya. So we
315.55 -> have a 17 imaging centers
317.38 -> throughout Austin and the surrounding area.
319.09 -> Yeah. You know, ARA - ausrad.com.
322.33 -> And a lot of doctors very educated like you
324.25 -> and excited to help people feel their
325.75 -> best.
326.32 -> Thank you so much for being here.
328 -> Thank you.
329.5 ->
Source: https://www.youtube.com/watch?v=ytHCzqRYul8