Bryant Stamford | Special to Courier Journal
Recently I provided an overview of my experience with the coronary calcium scan, a comfortable, non-invasive, and inexpensive test that allows docs to see inside heart arteries. The test determines the amount of calcium present in arteries, indicating the degree of clogging, known as atherosclerosis. I also emphasized that my having a CCS was very important, because it showed me that my smugness about my state of heart health was misplaced.
In a nutshell, at age 35 I had a large, calcified plaque in one of my major coronary arteries first detected as a “white splotch” on a chest X-ray. This was later confirmed with a CCS in 2003 (age 56).
Thankfully, by then I had changed my lifestyle dramatically and became a vegetarian. I had another CCS in 2016 at age 70, which revealed that the white splotch (calcified plaque) grew even larger. I was disappointed and doubled down on my healthy lifestyle.
Now, five years later at age 75, I was curious if my considerable efforts had at last put a halt to the progressive clogging in my heart arteries. I contacted Dr. Henry Sadlo with University of Louisville Health, and he arranged for my CCS at the University of Louisville Hospital. Let me add that it’s not necessary to go through your doctor. You can walk in, but I strongly recommend having a doc involved to interpret and discuss your results in detail.
After the test, I went for a consultation on my results. Sadlo asked Dr. Dinesh Kalra, chief of the Division of Cardiovascular Medicine at UofL, and a world-renowned expert on cardiac imaging, plus his pioneering work on preventing atherosclerosis, to sit in with us.
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Wow! I was honored and a bit nervous and proceeded to sit up especially straight in my chair.
Here’s what they told me:
How a coronary calcium scan can detect problem areas in the heart
Whatever smugness I had left was shredded when we discussed my results.
My CCS score over the past five years had more than doubled, increasing to above 500. Worse, the dreaded white splotch greatly increased in size as well. In addition, a new highly calcified location in a different heart artery was detected. These findings put me in the danger zone, and in my consultation, we had a lively conversation about how to proceed in the future.
No doubt I was very disappointed at the CCS results, but I was comforted by the fact that I could put my heart health in the hands of Sadlo and Kalra, two incredibly accomplished doctors.
The decision was made, and an appointment was set for an echocardiogram stress test in Sadlo’s office. This is a major step beyond a typical treadmill stress test in which the EKG is monitored during exercise. In this case, an echocardiogram is conducted at rest and then compared with results following exhausting treadmill exercise.
What is an echocardiogram stress test?
The purpose of the echocardiogram stress test is to determine if the clogging in my arteries is negatively impacting heart function. I was very impressed with the sophistication of the process as I lay there watching the computer screen with amazing interior images of my heart displayed clearly.
Nadiya Meriwether, a highly skilled registered cardiac sonographer, patiently talked me through the process while expertly taking a variety of measurements, like the size of each of my cardiac chambers, the diameter of major blood vessels, the degree of movement of heart walls to determine elasticity or stiffness, etc.
It was fascinating, and I felt like a kid in Disneyland, watching my heart valves open and close with each beat. It also made me appreciate the enormous complexity of the human body, and all the things that must be coordinated perfectly from moment to moment just to keep us alive.
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Thankfully, at rest to this point in the test, it was all good news. Next, however, would be the real test of how well my heart functions under the extreme stress of intensive exercise. I mounted the treadmill under the watchful eye of Sadlo and began walking. The speed of walking and elevation was increased rapidly, and I was exhausted in 13 minutes, a pretty good score for my age indicating that I’m highly fit. I dismounted and immediately the echocardiogram was repeated.
So, how did my heart do in meeting the exercise challenge? Sadlo studied my results, then reported that despite my lousy CCS score, my heart is functioning well in all aspects. I was relieved and happy to hear it, and I silently offered a prayer of thanks.
I need to add that although Sadlo is my friend, all his patients get the same royal treatment I received. I’ve seen Sadlo in action at his office and know that he’s never in a rush, and always goes the extra mile with every patient, which explains why he rarely gets home after work at a decent hour.
How a healthy diet, exercise can help stave off heart attacks
Given my CCS results, I realize it could be argued that my dedication to living the healthiest lifestyle possible was a waste of time and effort. What good did it do me if it did not prevent clogging in my heart arteries, the primary cause of almost all heart attacks?
Sadlo provided a reasonable explanation that there may be a glitch in my genetic makeup that a healthy lifestyle, while helpful in slowing the clogging of my arteries, cannot overcome it completely. There is also the possibility that my healthy living habits and daily vigorous exercise brought about alternative coping mechanisms in my cardiovascular system, allowing me to reach age 75, and hopefully beyond.
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Regardless, I shudder to think how bad things might be if I had not dedicated the second half of my life to healthy living. At the least, I am convinced I would have had a major heart attack years ago, and given the location of my large, calcified plaque, the white splotch, odds are good it would have been fatal.
Let me conclude by saying the reason I reported these personal findings is that I believe many others are in a similar boat without realizing it. Due to my smugness, I could not imagine I might be at risk for heart disease. Sound familiar? If so, and you are middle age or beyond, I urge you to toss your smugness out the window and get a CCS.
And whatever you do, please don’t wait for symptoms to appear before taking action, because by then, it’s often too late.
Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.