Heart scan that can spot disease

London: A new scan that can spot heart disease up to ten years before symptoms appear is proving startlingly successful. A quarter of people scanned so far at one UK centre were found to have significant heart disease — despite having no symptoms.

The scan, which detects furring up of the arteries at its earliest stages and which has picked up disease in people as young as 35, allows preventive treatment to be taken before any damage has been done to the heart.

‘The fantastic advantage of this technology,’ says Dr Paul Jenkins, medical director of the European Scanning Centre, ‘is that it picks up disease when you can do something about it, whether it’s lifestyle changes, drugs or surgery.’ The electron beam computed tomography scan, or EBCT, is a sophisticated X-ray that detects coronary calcification — how hardened the arteries are — which is the first sign of heart disease.

Most other tests, such as exercise stress ECG (which measures the rhythm and electrical activity of the heart) or stress thallium (in which a radioactive marker is put into the bloodstream to reveal blood supply to the heart muscles) are reliable indicators only when heart disease is already so advanced that it has stopped the heart from working properly.

The scan, available at only a handful of UK centres, takes a series of images of the heart over a few minutes, while the patient is fully clothed, lying flat on their back. Then a ‘calcium score’ is calculated, which is compared with the scores of other men or women of the same age to determine individual risk of heart disease.

Treatment depends upon the level of calcium found and the age of the patient. For many, it will simply be lifestyle changes involving diet and exercise. For others, it will be statins, the cholesterol-lowering drug, while for a few it will mean angioplasty to open up the arteries, or bypass surgery.

‘The scan is non-invasive with very low-dose radiation,’ says Dr Jenkins, who is also a consultant physician at St Bart’s Hospital in London, ‘and it is an open scanner, so there is no problem for people with claustrophobia.

‘Calcium should be in your bones, not in your arteries. The total cost of heart disease in the UK is £7 billion and a lot of that goes on patching up people.’

Data from the European Scanning Centre shows how effective the scan can be: ‘We picked up many people who had very significant heart disease, before it had caused symptoms,’ says Dr Jenkins.

Although the scan does not calculate the risk of a stroke — which can be caused by furring up of arteries to the brain — the results can be an indicator, as people who have furring of the heart arteries are more likely to have furring up of the head and neck arteries. Ultrasound scans can assess stroke risk more directly.

Advice about just who should have the scan varies. In America, where it has been available for longer, some centres advise that men over 40 and women over 45 should consider an EBCT scan.

The more risk factors you have — high cholesterol, high blood pressure, smoking, diabetes, obesity, sedentary lifestyle, stress, and family history of heart disease — the more important the scan is.

The scan is available privately at the European Screening Centre in Harley Street, London, for £525.