Determining heart attack risk

Seven's On Call with Dr. Jay Adlersberg
July 9, 2008 4:46:14 PM PDT
There is a new technology that is helping doctors determine if patients are at risk for a fatal heart attack, even if they show no symptoms. Some patients at high risk for heart attacks are found to have major cholesterol blockages in their heart's arteries. Some blockages are stable, but some can burst and cause disaster. Until now, it has been hard to tell one from the other. Now, a new test gives doctors new information that can save lives.

Salvatore Taormina is in the hospital because a heart stress test recently showed heart strain from a blocked artery.

"I was surprised, but I'm overweight and there are things I wanted to control," he said. "But I didn't have any heart symptoms."

He had no symptoms, but was overweight and thus at high risk. His arteriogram showed his main heart artery was more than 50 percent blocked with cholesterol. That in itself isn't a danger. But Dr. Joseph Puma, an osteopathic heart researcher, helped develop VH introvascular ultrasound from inside the artery to show how likely a blockage is to burst and completely block the vessel.

"This is a ground-breaking technology," he said. "With this technology, we will be able to more aggressively treat patients we find at risk for heart attack."

The tiny ultrasound probe at the wire tip paints a sound wave picture of the artery, and software helps distinguish stable scar tissue from dangerous cholesterol and calcium.

The technology to do ultrasound inside a blood vessel is about 10 years old. The new technology has only been around for about a year.

The new test can help point out which high-risk patients may die from a sudden heart attack, even when they have no symptoms. Taormina will now get more aggressive drugs to lower his cholesterol.

"We are going to be much more aggressive to see if we want to fix that blockage with a stent or a bypass operation," Dr. Puma said.

The bottom line is that for the first time, doctors may be able to predict which blockages are dangerous and which are not. There is a study going forward right now to prove whether using this ultrasound technique truly saves lives.


STORY BY: Dr. Jay Adlersberg