You know the statistics.

Heart disease is the number one killer in the United States - more than 500,000 Americans die of heart attacks each year. That is 2,600 a day, one every 33 seconds.*

For 150,000 Americans, their first sign of heart disease is sudden death.*

One in five Americans has some form of heart disease. One in three men can expect to develop heart disease before the age of 60. The odds for women are one in 10.*

You don't have to be part of those statistics.

You can't change your heredity, but the combination of early detection, watching your diet, getting regular exercise and taking prescribed medication will go a long way to keep you as healthy as possible.

Early detection has always been a key factor in helping reduce the impact of heart disease. Advancements in medical technology have redefined how soon doctors can detect indications of coronary artery disease. Today, a 30-second coronary calcification scan can detect calcification in your arteries, a portent of atherosclerosis.

This test gives people peace of mind, says William Stanford, MD, chief of Chest and Cardiovascular Radiology, University of Iowa Health Care, and a pioneer in the field. "Although the coronary angiogram and stress radionuclide test are widely used, the results depend on the artery being more than 50 percent blocked before there is an indication of heart disease.

"Without this scan, people who have plaque buildup in their coronary artery wall, but who don't have any narrowing of the artery would not be identified. You could pass an EKG or a treadmill test, and yet you would be at significant risk for heart disease," Stanford says. "The scan is another information tool we use to assess a person's health." Early screening and identification allows people to make the necessary lifestyle changes or receive the appropriate medication.

"There is good evidence," he says, "that calcium can be used as an indication of the potential for atherosclerosis. The identification of calcium within the arteries is a gigantic step forward. We now have the tools to detect, very early on, an individual's risk for developing heart disease."

University of Iowa Hospitals and Clinics is one of 60 locations worldwide, and the only one in this area, to use electronic beam computed tomography (EBCT) to scan for calcium deposits in coronary arteries. Its image speed is 200 to 400 times faster than the traditional CT scan and 10 times faster than a helical CT scan. University of Iowa Hospitals and Clinics has had an EBCT since 1984, one of the first in the nation. Stanford said the Radiology and Cardiology departments worked in tandem on the early testing. "We were pioneers in the field," he said. The EBCT coronary calcification scans have been available from UI Health Care since the mid-1990s.

"The test gained public attention in 1994 when Russian figure skater Sergei Grinkov, 28, died of a heart attack while practicing for the Olympics. This test might have been able to identify him as being at risk for heart disease," Stanford said. Results from various studies indicate the coronary calcification scan is 90 to 95 percent reliable in predicting heart disease.

The test is non-invasive. The procedure takes about 10 minutes, but the actual scan is completed in only 30 seconds. "Unlike other imaging technology, you aren't enclosed in machinery. You lie on a moving table. First, a scout film is taken to be sure we're in the ballpark. Then, you're asked to hold your breath and in 30 seconds the scanner views the entire heart. You can get up and go home then," Stanford says. Test results are generally available in 24 hours.

Coronary calcium scans can be scheduled by calling University of Iowa Health Access, 800-777-8442. No physician referral is needed.

*American Heart Association

Who will benefit most from a coronary calcification scan? The ideal candidate is anyone over the age of 40 with any of the following risk factors:

• A family history of heart disease
• Elevated cholesterol levels
• Diabetes
• Smoking
• Overweight
• High blood pressure.

If you have already had a heart attack or have had bypass you are not a candidate for this test.

Traditional coronary artery disease detection methods include:

• Coronary angiogram - a catheter is placed through an artery into the heart and x-ray dye is used to define the anatomy of your coronary arteries.
• Stress radionuclide - a radioisotope is injected intravenously and the distribution of the radionuclide in the heart muscle is assessed using nuclear imaging technology.

Stanford said there is no evidence at this time to link taking calcium supplements for such things as osteoporosis to an increased risk of heart disease.

According to Stanford, calcium is not the culprit. It does not clog arteries. The problem, he said, is plaque buildup in coronary arteries. So why scan for the presence calcium? The scan cannot detect soft plaque, but it can detect the trace amounts of calcium in plaque. The detection of the calcium is a good indicator that soft plaque is beginning to form.

More information:

• www.americasdoctor.com
• www.strokeassociation.org (American Stroke Association)
• www.americanheart.org search: calcification scans (American Heart Association)

Listed above are several Web sites that offer additional information on this topic. University of Iowa Health Care does not sponsor or endorse these sites, or guarantee the accuracy of the information contained on these sites. These links are here for general information only, and should not be used for personal diagnosis or treatment. If you have any questions, please contact UI Health Access.

With electronic beam computed tomography (EBCT) scans, doctors can detect the earliest evidence of coronary calcification. The top scan shows the early presence of plaque (bulge in upper right) in the artery wall, however there is not enough blockage to register on a coronary angiogram or stress radionuclide test. The lower scan shows how plaque has already significantly closed the artery. Before the advent of an EBCT scan, doctors were able to detect the presence of plaque only after it had damaged the artery.