Taking it to Heart

Tests to keep your ticker ticking.

Theresa Garnero By Theresa Garnero, APRN, BC-ADM, MSN, CDE

Q: How do I know if a little ache in my chest is something to worry about?
A. You won’t know unless you get it evaluated. If the ache comes and goes it could be a problem, according to cardiovascular surgeon Dr. Ash Jain. The first step is to acknowledge the issue because denial of chest discomfort leads to many heart attacks. The second step is to have it evaluated. Your doctor will decide if you need a referral to a cardiologist.

  • Electrocardiogram (EKG): a printout of the electrical activity of the heart. This is useful to detect past problems, but does not predict the future.
  • Exercise stress test: an EKG is recorded at rest and while a person exercises by walking on a treadmill or pedals on a stationary bike for a specific time and pace (about 70 percent accurate).
  • Stress echocardiogram: an ultrasound of the heart activity before and after exercise (about 85 percent accurate).
  • Thallium stress test: a type of nuclear scanning test that shows how well blood flows to your heart muscle. A radioactive substance called thallium is injected into the bloodstream immediately after exercise (or for those who are too sick or have physical problems and can’t exercise, a medication is given to “mimic” an exercise test prior to the thallium). A series of pictures are taken afterwards to check blood flow (up to 90 percent accurate)
  • Coronary angiogram: a small plastic tube (cardiac catheter) is inserted through the artery in the upper thigh and maneuvered into the coronary arteries. A small amount of iodine is injected and X-rays are taken to view the inside of the arteries. This is still the gold standard of detecting narrowing of the coronary arteries (100 percent accurate).
  • Coronary Computerized Tomography Angiogram (CAT) scan: a non-invasive way to determine the level of plaque build up in the coronary arteries. Not as effective in identifying problems in the smaller coronary arteries and needs quite a bit more dye than a coronary angiogram. This technology is undergoing rapid development. Not appropriate for people with kidney dysfunction.
  • C-reactive protein (CRP): a blood test that identifies blood vessel inflammation or damage, and shows your cardiovascular risk. CRP is made in the liver and is released to fight infection or deal with injury. CRP results and their relation to cardiovascular risk are as follows: Less than 1 mg/dL = low risk; 1 to 3 mg/dL = average risk; more than 3 mg/dL = high risk. (Other blood tests are important for cardiac risk reduction including HbA1C and cholesterol.)

Laughing reduces repeat heart attacks

OK, so you may find it a stretch to fit humor into this topic, but it does relate. One study reported that laughing helps to significantly reduce repeat heart attack rates. Two groups were given conventional treatment of a beta blocker medication and nitroglycerin. One group watched 30 minutes of comedy a day (re-runs of “Friends”) and the other group did not. One year later, only 8 percent of participants in the comedy-watching/laughing group had a second heart attack compared to 42 percent rate in the group that didn’t watch comedy. This study also found that the average adult laughs 40 times a day, whereas the average child laughs 500 times a day. Instead of measuring how many times you laugh, just get a regular dose of comedy!

If you are having vague or not-so-vague cardiac symptoms, such as (and not all of these need be present) shortness of breath (with or without chest pain), pain or discomfort in one or both arms/the back/neck/jaw/stomach, chest pressure/squeezing or fullness, nausea, dizziness, lightheadedness, or breaking out into a cold sweat without cause, do something. Get worked up about it!

Read Theresa’s bio here.

Read more of Theresa Garnero's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: November 28, 2012

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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