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"We’re siblings: Same family history, different scan results"

Roberto and Beverly are siblings who found out they were both at risk for premature cardiovascular disease. They had some health factors in common, but their HeartLungTM scans showed they had very different results.



Roberto was 60 and his sister, Beverly, was 57 when they decided to get a heart scan. Both had just returned from their family reunion where they became aware of the family’s history of cardiovascular disease.



They were both in college when their father died of a heart attack at age 50. “I always thought it was because he worked too much,” said Roberto. “What else could it be?” After their father’s death, their mother remarried. Roberto and Beverly graduated, got good jobs, and eventually married and started their own families.



It wasn’t until the family reunion, when relatives talked about how many parents and siblings had died too soon, usually of a heart condition, that they thought about their father’s heart attack. Beverly, who worked in health care, took notice: “Holy cow, I thought. There’s a pattern here. We need to get checked out!”



Back home, Beverly did a quick internet search and found HeartLung™; the scan would show if there was calcium in the blood vessels that bring oxygen and nutrients to the heart. It would even show which vessels were affected and how much they were blocked. Artificial Intelligence would analyze the scan and compare their results to thousands of others. They would then each receive a Coronary Artery Calcium (CAC) score.


She called Roberto and told him they needed to go for a heart scan. “I told him we might find out if we’re at risk for a heart attack. And that the scan would also look at our lungs, bones, and other parts of the body.” Robert wasn’t as concerned as his sister but agreed to go.



As they rode together to the HeartLung™ testing site, they talked about their own health. Both had “borderline high” cholesterol levels but didn’t take any medications to treat it. Roberto had never smoked; he worked out regularly, and except for one trip to the Emergency Department for chest pain a few years ago, he felt well.


Beverly was also a non-smoker. Family obligations kept her too busy to exercise, but she was on her feet all day at work. She was overweight and her physician was concerned that she might be developing type 2 diabetes and high blood pressure. Beverly insisted she was eating as healthy as she could.



Getting the scan was easy; it’s a non-invasive low-dose chest CT scan that takes a few minutes. They didn’t have to do anything—not even change into a hospital gown—except hold their breath once or twice for about 20 seconds. By the time they got back home, the results had already been sent to them and their health care providers.



Roberto was pleased: He did have some mild calcium in the main coronary artery, but the other three arteries were clear. He’d been worried about the results because of his chest pain event, but the scan didn’t show blockage. Roberto’s health care provider explained that most people who go to the Emergency Department with chest pain don’t have a heart-related source of their pain.



Roberto also learned when a parent has premature cardiovascular disease (CVD), their children’s risk of also having premature CVD increases by 60% to 75%. He and his physician discussed how to minimize the genetic risk of a family history. Roberto would maintain his healthy lifestyle and begin to take a statin to lower his cholesterol. Roberto’s physician commended him for getting a heart scan; now they could prevent a heart attack.



Beverly was shocked at her results. She thought she’d do as well as Roberto, but her CAC score was over 400! She had severe deposits of calcium in the arteries of her heart and was at risk to have a cardiac event within the next ten years. She made an appointment to see her physician right away. The physician told her that along with her family history, being overweight, with stage 1 hypertension, climbing blood sugar levels, and poor lifestyle habits added risks for having a heart attack. She was also surprised to learn that women could get heart disease. “I thought only men had heart problems.” Her physician explained that heart disease is the leading cause of death for women in the United States, about 1 in every 5 deaths. Beverly was referred to a preventive cardiologist for follow-up and aggressive treatment, including a statin to lower her cholesterol and a blood pressure medication. She was eager to change her lifestyle; she committed to daily exercise and a heart-healthy diet. Although Roberto and Beverly had the same family history, just a few risk factors led to different outcomes for them. They both need to adhere to their prescribed medications and to follow recommended lifestyles. Getting a HeartLung™ scan was the first step in learning their CAC scores and how to avoid a heart attack.





REFERENCES

  1. Landon D et al. Computed Tomographic Coronary Artery Calcium Assessment for Evaluating Chest Pain in the Emergency Department; Long-term Outcome of a Prospective Blind Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848419/#

  2. Kolber M, Scrimshaw C. Family history of cardiovascular disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229162/#

  3. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/ APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000625

  4. Greenland P, Blaha MJ, Erbel R, Watson KE. Coronary Calcium Score and Cardiovascular Risk. http://www.onlinejacc.org/content/72/4/434?_ga=2.258992398.500469687.1636212949-977973796.1636212949

  5. Know Your Risk for Heart Disease. Centers for Disease Control and Prevention, Atlanta, GA. https://www.cdc.gov/heartdisease/risk_factors.htm

  6. Women and Heart Disease. Centers for Disease Control and Prevention, Atlanta, GA. https://www.cdc.gov/heartdisease/women.htm


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