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Cardiovascular Health 2019

Do you know how to spot coronary heart disease?

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Dr Simon Davies

Consultant Interventional Cardiologist at Royal Brompton Hospital

Dr Simon Davies spends his days as a cardiologist performing operations on hearts. Yet, as he tells us, effective screening with sophisticated imaging techniques is helping to make the process of diagnosing the UK’s most dangerous disease a less invasive process for the patient.

We all know that our lifestyles are likely to have a direct effect on our health. Heart health is one area in particular that is likely to be negatively affected by us smoking, having an unhealthy diet or not getting enough exercise.

Lifestyle plays a huge impact on likelihood of coronary heart disease

However, the most common type of heart disease is hereditary, with family links increasing someone’s chances of developing it. Coronary heart disease is the biggest killer of both men and women, killing one third of men and 25-28% of women, making it a bigger killer of women than breast cancer.

Dr Simon Davies, Consultant Interventional Cardiologist at the internationally renowned cardiology department at Royal Brompton Hospital, still sees lifestyle as a hugely important factor.

“Yes, someone may have coronary heart disease in their family, but their lifestyle could either bring forward its development by 20 years or put it off for 20 years.”

Knowing the symptoms of the disease

Warning signs of coronary heart disease can be breathlessness during exercise, chest pain or simply the feeling of having a weight on your chest that feels uncomfortable.

Knowing your family history of the disease is vital.

Even now, in an age where education around the effects of poor lifestyle choices is as good as its ever been, coronary heart disease continues to affect both those who do the right things and those who do the wrong things to their bodies.

This is why Dr Davies argues that screening is absolutely key in spotting problems quickly and ensuring that patients aren’t incorrectly diagnosed with the disease.

Screening involves a variety of tests for your heart health

“If you notice pain or breathlessness, I would always advise going to a GP first. They’ll know more about your history and they can then refer you on to a cardiologist if your symptoms indicate that you may require some form of investigation.”

The screening process for coronary heart disease can involve several different types of test. These might include testing a patient’s cholesterol levels, non-invasive tests showing how effectively the heart is pumping blood around the body and new, sophisticated imaging techniques that will give cardiologists incredibly detailed pictures of a patient’s individual arterial health.

A modern CT scan of the coronary arteries:

LEFT :  A 3-dimensional reconstruction of the heart, looking down on the coronary arteries, is now a standard tool
RIGHT :  More recently, computers are used to analyse the images to predict the blood flow along each branch of the coronary arteries, and whether it is likely to be normal (blue), slightly restricted (green and yellow), or very reduced (red).

The use of non-invasive tests reduce complications

An angiogram, one of the imaging techniques currently used to screen coronary heart disease, involves an invasive element where a fine, flexible tube is threaded along the arteries to reach the heart in order for the pictures to be taken.

Through that same tube, a stent can be fitted to open up a damaged artery to fix the problem as soon as it is seen. However, Dr Davies believes the ‘gold standard’ in terms of screening should involve new non-invasive imaging tests taking place first.

“Putting a tube into the heart does come with complications. Through the new non-invasive imaging techniques we are now able to perform at a specialist centre, we as cardiologists can build a picture of someone’s heart health and then decide if they need an invasive angiogram. This helps achieve the best outcomes for the patient.”

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