Little-used scan can find hidden heart disease
Common stress tests can miss problems, cardiologists say. By Valerie Reitman
Times Staff
Writer
October 11, 2004
The former president has chest pains. A
catheter threaded through his heart finds all three major arteries and a
tributary up to 90% blocked. Surgeons buzz through his chest with an electric
saw, stop his heart for 73 minutes and use veins from his leg and elsewhere to
bypass the blockages.
Bill Clinton is saved. But some cardiologists say
the event was far from a medical triumph. As soon as word got out about the
extent of previously undetected clogs in Clinton's arteries, some of the
nation's top cardiologists began trading barbed e-mails and phone calls,
decrying the event as the ultimate failure in preventive medicine, even as
"unconscionable."
"The bottom line is, Bill Clinton's walking into the
hospital with chest pains is a shocking event in a country where we have plenty
of tools to prevent that," says Dr. Morteza Naghavi, a Houston researcher who
founded the Assn. for the Eradication of Heart Attack, an influential group of
cardiologists that advocates an overhaul of how patients are assessed for heart
disease.
As it is now, about 88% of those who have heart attacks would
have been labeled low to moderate risk by their doctors on the previous day,
according to a recent study published in the Journal of the American College of
Cardiology.
Clinton's experience demonstrates that even a former
president with access to the best medical care available can have undiagnosed
heart disease. Doctors like Naghavi advocate aggressive use of preventive
screening, such as blood marker tests and noninvasive scans. In particular, some
cardiologists are promoting wider use of a noninvasive diagnostic test known as
the coronary calcium scan.
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