(upbeat music)
- Welcome back to "We Are Austin."
February is American Heart Month
and Dr. John Williams from ARA Diagnostic Imaging
is here this morning with really important information
for men and women about coronary artery disease,
CT calcium scoring in a really simple screening exam
that can let you know if you're in danger of a heart attack.
So important. Good morning, Doctor.
Thanks for joining us today.
- Good morning, thanks for having me.
- Well, it's a really important topic.
So many people are at risk, but let's start with you.
Tell us a little bit about yourself
and what you do there at ARA.
- I'm John Williams.
I'm one of our radiologists
at Austin Radiological Association.
My particular specialty is body imaging.
So I primarily interpret x-rays, ultrasound,
CTs, and MRIs of the chest, abdomen, and pelvis.
- Fascinating work, and so important too.
And today, we've brought you in to talk
a little bit about heart attacks.
And this really, frankly, amazing CT scan
that can help you know if you're at risk, but first,
and I've learned a little bit about this
in my personal life recently, what is a heart attack?
It can vary, and how do people know?
- So a heart attack effectively is when you have a blockage
of the blood vessels that feed the heart itself
with the oxygen and nutrients
that the heart needs in order to do its job,
which is to pump blood to the rest of the body.
And so
those blood vessels along the heart
are called the coronary arteries.
And what can happen is you can get plaque
that builds up in those arteries,
or ruptures, and then, causes an occlusion
or a blockage of those arteries.
So then, that area of the heart
that's typically supplied by that coronary artery
to get the nutrients and oxygen
that it needs to function to pump is compromised.
And so it's no longer able to,
it either has diminished function,
or just lack of ability to function at all,
which causes the heart attack.
And that's whenever people get the symptoms
of chest pain, et cetera.
- When you have conversations about heart health,
you hear the word plaque a lot. What exactly is plaque?
- So you can kind of think of plaque
as just little sticky pieces of fat and cholesterol,
and oftentimes calcium that are either along the lining
of the wall of an artery or in the artery,
the wall of the artery.
And when it's in the coronary arteries
that supply the heart,
it's called coronary artery disease.
And so the most common cause of a heart attack
is when one of those plaques basically ruptures,
and the contents go downstream
and cause the blockage in that artery.
- So how common then is coronary artery disease?
- It's, unfortunately, very common. It's very prevalent.
It remains the number one,
coronary artery disease and heart attack remain
the number one cause of death
in both men and women in the United States
every year. - Wow.
- And one of the problems with this disease is
that you can have a significant,
or you can have this disease, you're asymptomatic.
You don't know you have this disease
until you have one of these plaques that ruptures
and then causes an event.
And so the challenge is then,
finding tools that we can use to identify people,
to screen for this disease and try to catch it
with the intent of preventing
any sort of those bad outcomes,
like a heart attack. - Right.
- And so what we have in radiology is this tool,
it's called a CT calcium scoring
or a CT cardiac screening exam
that helps us identify patients prior to having an event.
- Yeah, that enters kind of our hero of today's story,
which is the CT calcium scoring
because it's known as the heart saver.
Tell us a little bit more about that.
- Yeah, so it's a nice tool.
It's a CT. It's just a quick examination.
It's noninvasive, but we don't even use contrast.
So you don't have to have an IV placed
or anything. - Wow.
- The patient experience is,
basically they lie down on the table.
Images are acquired within a matter of seconds.
And then, effectively, their portion is done.
They go on about their day.
And then, what we do is we take those images
that were acquired, and then, review them visually,
and also, utilize some software to basically identify
those calcified plaques and kind of stratify
a patient's risk-based upon if they have any plaque.
And if so, how much of that plaque that they have.
- Wow, that's amazing to think that just a few minutes
that it takes for this procedure can be lifesaving.
So I'm curious,
can we see what plaque looks like on a CT image?
And then, learn a little bit
about how you make your diagnosis?
- Absolutely, so we have some examples here today,
representative images from a CT calcium scoring study.
Our first image is kind of what we want to see.
This is a patient that does not have any evidence of plaque.
So in the center, this is all the heart,
and this kind of little V-shaped area over here is,
that's actually the coronary artery.
And that's what it's supposed to look like.
It's gray and doesn't have any evidence of plaque within it.
The next image that we have is someone who's developed
what we've categorized probably
as moderate volume of plaque.
And so you see that red circle,
and that's circling the coronary artery there,
in the middle of that,
there's a white, kind of a bright white spot.
And so that is the calcified plaque.
And so that's what's really nice about this examination
is it makes it pretty easy to be able to identify
the presence of that plaque.
And then, the next slide that we have
is someone that has a more extensive amount of disease.
So all through that same area in those coronary arteries,
all those little white dots all throughout those vessels
are basically buildup of those calcifications,
calcified plaques. - Wow.
- And so this person,
this patient is going to have extensive disease,
going to have a high risk of having
a significant coronary artery disease
that would result in a heart attack,
possibly in the near future.
The utility of this examination is
that we're able to provide that information to the patient,
as well as their healthcare provider so that they can then,
they know that and they can decide and guide treatment
or intervention based upon that knowledge.
And it may be as simple as just lifestyle modification
as far as diet and exercise,
maybe places them on medications
that control blood pressure or cholesterol,
all the way up to interventions that include
stenting of the coronary arteries to keep them open
to allow blood flow to prevent heart attack.
- Well, it's great to know those next steps as well.
So some of us are walking around
with coronary artery disease.
You mentioned earlier that sometimes it's asymptomatic.
So who is at risk and who really should be
looking closely at having a CT calcium scoring?
- Yeah, you're right. Yes, we said it's very common.
And basically, the primary risk factors include obesity,
smoking again, diet, lack of exercise,
family history, and then, just simply age.
All of that being said,
even if you do not have any of those risk factors,
there are studies and guidelines that indicate
that patients 55 or over
would benefit from having this examination performed
just as an early detection tool and to gain the benefit.
- Absolutely, early detection we speak of a lot with ARA,
and that is kind of the point.
So if someone is interested
and they fall in these categories,
they really kind of want to know what's going on in there.
How do they take those steps to get a CT calcium scoring?
- Sure, so yeah,
someone's sort of been aware of these risk factors
and had a conversation with their healthcare provider,
and it seems that this is an appropriate examination,
based on age and risk factors,
typically they'll get a referral from their provider.
And then, they contact ARA,
and we schedule an appointment for them to come in
and have that CAT scan done.
- Well, this has been a really fascinating conversation
and so important for people out there.
If they want to learn a little bit more
and to learn more about ARA,
where can we go for more information?
- So probably the easiest way is to go to our website,
which is ausrad.com, A-U-S-R-A-D dot com.
And that has a lot of great links on there,
informational items about this examination
and other examinations,
and some online scheduling capabilities as well.
- Excellent.
Information and procedures that save lives there at ARA.
Dr. Williams, thank you so much for joining us today.
We appreciate it.
- Thank you for having me.
- Well, thank you so much.