Transcription
There are three things I bet you'll wish you knew before you had your CT heart scan. No, CT heart scans are indeed excellent tests. I brought the first heart scan device to Milwaukee, Wisconsin, about twenty-three years ago when nobody knew what this darn thing was. But we started scanning people left and right, and you do indeed uncover a load of hidden heart disease in people who had no idea that they had it.
And there's also quantitative. It gives you an ASCR, or a coronary calcium score. Why measure calcium? Well, one, you can see it. It can be quantified precisely. And because calcium has been found to comprise 20% of total atherosclerotic plaque volume, so if you measure two cubic millimeters of calcium, you know you have ten cubic millimeters of total atherosclerosis. And that's an excellent gauge of cardiovascular risk.
So this is a test, CT heart scan, is a test of cardiovascular risk. It's not a test to find out how much blockage you have. Percent blockage is not the most important measure. The total volume of atherosclerosis, that's the most important measure. That's because people often think that heart attacks are caused by the gradual accumulation of atherosclerosis. An unruptured, a minor plaque, maybe that plaque only reduced the diameter of the artery 20 or 30%. But it ruptures because it has internal inflammation. In this plaque, it ruptures like a little volcano, and a blood clot forms on top of that minor blockage. So the most powerful predictor of future cardiovascular events like heart attack is the volume of pathologic plaque. We're not looking for blockages, okay?
But as useful as CT heart scans and coronary calcium scores can be, they're often misused and abused. So here are something you should know about CT heart scans. One, heart scans are often used as loss leaders. That's what administrators, hospital administrators and my colleagues call it. That's because they price it real low. It's not uncommon to pay for $99 and $49, something like that, for a CT heart scan. Why would they do that? That often doesn't even cover their costs. They do that in the hope that you have a high score and that can scare you into additional testing.
Now, bear in mind that people who come in for a CT heart scan are asymptomatic. This is, these aren't people who come in the ER with chest pain and can't breathe. These are everyday people like you and me, going to work, going to school, going for walks, riding our bikes, exercising with no symptoms. That's who should be having a heart scan. So it's very difficult to justify additional procedures, but it's done commonly because it pays better. A stressed nuclear test, for a nuclear stress test, called stress cardio light, stress my view, stress thallium, SPECT, a variety of names. You'll often be told you need one of these tests when it's very questionable whether that's of any benefit to you. And it makes the hospital, or the clinic, or the doctor about four thousand, five thousand dollars. Likewise, a CT coronary angiogram typically does not need to be performed in a person with no symptoms, but it generates several thousand dollars in revenues. That's an angiogram performed on the same CT device. Or worst of all, a heart catheterization, that brings in about 35, 40, 45 thousand dollars of revenue to the hospital. It's become clear over the years that putting people through these kinds of procedures is questionable. And heaven forbid, some of that tells you you need heart catheterization because you have a high score, let's say 800 or something like that, and they find a blockage, but you have no symptoms. Putting a stent in or doing bypass yields no benefit to you, okay? So it's very difficult to justify all this additional testing.
The one test, one justification for testing that might hold water is maybe a stress echocardiogram. That's, it's cheaper, involves no radiation, just to assess exercise safety. But even that's a little bit questionable. So be careful of this lost leader phenomenon that hospitals and doctors will often use the heart scan to scare you and say things like, "You're a walking time bomb," "You've got a Widowmaker," all these kind of crazy things they say to scare you into procedures because procedures, for the most part, do not need to be done based on the heart scan number.
Two, heart scans are often used as a way to twist your arm to take a statin drug. And that's, I think that's wrong. I think a much smarter way to do it is identify the actual cause. Is something coronary atherosclerosis? So if you have a calcium score, you thereby have coronary atherosclerosis. Let's find out why. That's a whole another conversation. But there are very easily identifiable causes for coronary atherosclerosis, and it's not high cholesterol. High cholesterol is a semi-fiction of the drug industry. It's a remnant of 1950s and 1960s thinking, but it makes a lot of money. This is why I have programs that show you how to identify the causes of coronary atherosclerosis and correct them. Very simple.
Three, they'll often use the heart scan also to put you on what they call optimal medical therapy. That's what that means is aspirin, a statin drug, a low-fat diet, and sometimes a beta blocker. Well, let's take a heart scan score of 500, which is a kind of a high score, moderate to high. If you do nothing, I would recommend that. But if you did nothing and another heart scan a year later, it will be 25% higher, so 625. Right? Another year, another 25% higher. And with each rise in score over the years, you get closer and closer to heart attacks, sudden cardiac death, or developing symptoms that then lead to bypass surgery, stent implantation, etc.
What if you go on optimal medical therapy, aspirin, beta-blocker, high-dose statin, etc.? How fast does your CT heart scan score go up? 25% per year. It has no impact on this measure at all. It has a slight effect on reducing events in some people because it reduces some of the softer, fibrous, or inflammatory elements in the artery. But it does not stop progression. So don't let them use your heart scan score as an excuse to scare you into optimal medical therapy.
Now, there are things you can do. You can identify the cause, but it's going to be very different from cholesterol causes. And then you can embark in a program that puts a stop to that 25% per year rise and all the dangers that brings. And you can even reduce the score in many instances. I do have a video called "How to Reduce Your Heart Scan Score." So take a look at that if you really want an in-depth dive into this. I have a three-part workshop I'll be releasing in my Undoctored Inner Circle website that goes into deep detail what the heart scan means, how precise is it, what's radiation exposure, if you have a score of zero, what does that mean, if you have a score above zero, when should you have another score, how do you gauge whether you have been successful in your prevention program, what are the, what's the diet we use to put a stop to this, what nutritional supplements and other strategies are crucial if you want to gain control over this. So that's all in my three-part workshop in my Undoctored Inner Circle.
But bottom line here, be very careful. CT heart scans and coronary calcium scores, wonderful tests, really empower you, give you a precise gauge of what your cardiovascular risk is. But don't let the system use it against you.