Prevention

Early Intervention Leads to Prevention

Learn about how we diagnose the signs and help prevent Coronary Heart Disease. The imaging shows the discovery of coronary calcium that needs to be addressed. Below you can read and see how we use advanced PET Scans with immediate test results to classify your risk level.

What is a Coronary Calcium Scan?

A Coronary Calcium Scan is an examination of the heart using a low X-ray dose to visualize calcium which is often present in coronary artery plaques before they restrict blood flow.

How does a PET MPI Contribute to Risk Assessment?

Risk of cardiac death is estimated more accurately when myocardial flow capacity is added to both, risk factors and results of standard nuclear stress testing.

Low Risk

NORMAL FLOW CAPACITY

Intermediate Risk

REDUCED FLOW CAPACITY

Potentially Requires Prevention/Regression Therapy

High Risk

SEVERELY REDUCED FLOW CAPACITY

Potentially Requires a Stent or Bypass

What is Primary Prevention of Coronary Heart Disease?

Primary prevention of Coronary Heart Disease (CHD) comprises lifestyle changes and medical treatments aimed at keeping a person free from the clinical complications of coronary plaque buildup throughout their lifetime.

How is Primary Prevention Different from Secondary Prevention?

Primary prevention of coronary heart disease is meant for asymptomatic people with risk factors who have not yet developed clinically manifest cardiovascular disease. Secondary prevention is for people with an established cardiovascular disease, which would include a history of a heart attack or a stroke, coronary revascularization or peripheral arterial disease.

Who Requires Primary Prevention?

Lifestyle modifications which reduce the likelihood of CHD are not sufficient for some people.

How is Risk Assessed?

The Framingham Risk Score (FRS) and similar tools estimate the risk for CHD in 10 years. Although widely used, it is of limited accuracy.

How can Risk Assessment be Improved?

Two cardiovascular imaging techniques improve risk assessment markedly by determining the extent of a person’s CAD more directly.

These techniques are:

Coronary Calcium Scan, also known as a Heart Scan.
PET MPI with measurement of absolute blood flow to the heart muscle (in cc/min/gm) at rest and during stress.

Can Improvement of Risk Factors be Detected by Cardiovascular Imaging?

Myocardial flow capacity improves with successful risk management, including weight loss, exercise, blood pressure control and reduction of cholesterol with statins. Calcium Score, however, increases with age regardless of treatment.

Who Benefits from Risk Assessment with Cardiovascular Imaging?

The usefulness of cardiovascular imaging in asymptomatic people depends on the risk factor profile. If the risk is intermediate or high a Coronary Calcium Scan and assessment of myocardial blood flow with PET may be useful. Approximately one third of people whose risk was classified as “intermediate” based on their risk factors and nuclear stress tests were correctly reclassified as either being at low or at high risk, when flow capacity was added.

Cardiovascular imaging is not recommended for asymptomatic people who have no risk factors and thus are at low risk.

Do Insurances Cover Cardiovascular Imaging for Risk Assessment?

Coronary Calcium Scan and PET MPI for risk assessment of coronary artery disease are not covered by Medicare. Our staff is available to work out a cash plan (including Flexible Spending Account) and set up an appointment with one of our cardiologists who will order the PET MPI (which includes a Coronary Calcium Scan) if appropriate and follow up with a detailed review as well as a prevention and reversal treatment plan.

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