What you need to know about:

Heart Screening

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Overview of

Heart Screening

in Thailand

Heart screenings provide a way for doctors to identify patients with potential heart abnormalities in order to issue necessary treatment as early as possible. These screenings are typically non-invasive and are usually carried out in an outpatient facility.

There are many different types of heart screenings available which may be performed depending on a patient’s unique situation. Some of the more common ones are as follows:

  • A coronary CT angiography (CCTA) checks for coronary arteries that have narrowed or become blocked as a result of fatty deposits (plaque) with the help of specialized X-ray images of the heart.
  • An exercise stress test (EST) enables doctors to determine how well your heart works under stress while exercising and can help pinpoint any problems that affect blood flow to your heart.
  • Echocardiography (resting echo) examines the performance of your heart in terms of its rhythm and how well it pumps blood. It involves taking ultrasound images that can be used to identify the presence of heart disease.
  • Stress echocardiography (stress echo) examines how well your heart and blood vessels perform while under stress via ultrasound imaging. It is typically performed to identify the presence of narrowed coronary arteries which affect blood flow to the heart.
  • A cardiac CT calcium score detects the presence of calcified plaque in your coronary arteries. Calcium levels signify how much plaque is built up in your blood vessels and the score acts as an indicator for coronary artery disease.
  • A preventive heart and lipid checkup involves performing an overall checkup of your heart to examine the performance of various cardiac structures such as the muscles, blood vessels, and valves, as well as a lipid profile.

A genetic heart screening is a type of test that detects the presence of heart conditions that may be inherited. Early detection allows early medical intervention to prevent conditions from potentially becoming chronic.

Goals of

Heart Screening

Regular heart screenings are performed to help prevent the onset of heart disease and early detection allows for timely medical interventions to take place, ensuring patients are kept safe and healthy from any potential long-term heart conditions.

Price of

Heart Screening

Average Cost

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Pros and cons of

Heart Screening

Pros

  • Heart screenings are reasonably affordable and enable the timely detection of heart conditions to allow for treatment as early as possible — this provides an advantage for patients with risk factors for heart disease, such as high cholesterol and blood pressure, diabetes, and obesity.
  • These screenings also enable your doctor to lay out a customized healthcare plan for you that may include essential changes in your diet and lifestyle.

Cons

  • It’s a possibility that certain heart conditions may not show up on screenings, making patients lose out on early treatment.
  • False positives are also another possibility wherein a test result may incorrectly indicate the presence of a certain condition, which may result in the provision of erroneous treatment.

How it works:

Heart Screening

Coronary CT Angiography (CCTA)

During a CCTA, the patient is intravenously injected with an iodine-containing dye to highlight the blood vessels. A CT scan is then taken to produce clear images of the highlighted vessels and identify the presence of any blockages. The entire procedure may take up to an hour to complete but may be longer if beta-blockers have been administered.

Patients are recommended to have a CCTA performed if they have at least two out of three of the following risk factors as they are considered to be in high-risk groups:

1. Family history of coronary artery disease (CAD)

2. Signs and symptoms indicative of CAD

3. Abnormal results from an exercise stress test

Exercise Stress Test (EST)

Prior to an EST, electrodes that connect to an electrocardiogram machine will be attached to your chest and arms. You will then be asked to walk on a treadmill or pedal a stationary bike at an increasing pace while your breathing, heart rate, and blood pressure are monitored. The actual test usually takes about 10 to 15 minutes on average but may be stopped earlier if you experience any difficulties.

Echocardiography (resting echo)

An echo, or “resting echo,” typically requires you to lie down on your left side with your left arm out while a transducer is held firmly against your chest. A special gel helps to aim the ultrasound waves to your heart while the transducer records the echoes which are then converted by a computer into moving images. The test takes on average 20 minutes to an hour to complete, depending on how many images need to be produced.

Stress Echocardiography (stress echo)

A stress echo differs from a resting echo in that instead of lying down, you will need to perform some form of physical activity during the test. Prior to a stress echo, a resting echo will be conducted first, after which you will then be asked to walk on a treadmill or pedal a stationary bike while your heart rhythm and blood pressure are monitored during the entirety of the procedure. You may also be asked to increase your pace while walking or pedaling, depending on your condition. Most tests should take up to an hour to complete but may be stopped earlier if you experience any difficulties.

Patients are recommended to have a stress echo performed if they have at least two or three of the following risk factors as they are considered to be in high-risk groups:

1. Family history of CAD

2. Diabetes

3. Obesity

4. High cholesterol

5. High blood pressure

6. Are tobacco smokers

Cardiac CT Calcium Score

Before conducting the CT scan, you will have electrodes attached to your chest that will record your heart activity throughout the procedure. You will then be asked to lie down on a table that moves into a CT scanner, where various images will be taken in coordination with your heartbeat. These images will then be examined to identify the presence of calcified plaque. The scan typically takes about 10 minutes on average.

Patients are recommended to have this scan performed if they have the following risk factors:

1. Family history of CAD

2. Diabetes

3. Obesity

4. High blood lipid

5. High blood pressure

6. Are smokers

7. Are physically inactive

8. Are over 55 years of age

9. In the postmenopausal stage for women

Preventive Heart and Lipid Checkup

During this checkup, you may be asked to undergo a physical examination, full blood count, kidney and liver function test, lipid and sugar profile, chest X-ray, electrocardiogram, or MRI, to name a few. These tests will enable you to obtain an overall image of your heart function. It is highly recommended that you take this checkup annually if you are over 40 years of age.

Genetic Heart Screening

A genetic heart screening usually involves taking a blood sample or mouth swab which will then be analyzed for the presence of an inherited gene that may potentially increase the risk of cardiovascular disease or other health conditions such as:

o   Coronary artery disease

o   Atrial fibrillation

o   Hypertension

o   Type 2 diabetes

o   Dyslipidemia (lipid imbalance)

Genetic screenings such as these are beneficial as they allow doctors to lay out a healthcare plan that is specially personalized just for you.

Preparation before

Heart Screening

Pre - treatment

Certain tests have specific requirements as to how you must prepare prior to it; however, it is typically recommended that you:

  • Refrain from consuming any food or drinks except water no less than 12 hours before a heart screening
  • Take your usual medication unless otherwise advised by your doctor
  • Discontinue alcohol consumption and smoking

Recovery after

Heart Screening

Post - treatment

Post-procedure instructions typically differ depending on which test was performed; your doctor will advise you on what steps need to be taken after the procedure.

Risks & side effects

There is a possibility of false negatives occurring during the test, which means that the results may indicate that a certain condition is absent when it is actually present. Risks of such false negatives include:

  • Delays in the provision of appropriate treatment
  • Lack of monitoring, which could potentially cause the condition to worsen

FAQs:

Heart Screening

Will I be under anesthesia or sedation during a heart screening?

Anesthesia or sedation is not typically administered during heart screenings so you will be conscious throughout.

 

How long will the test results be valid?

None of the test results have a set validity period as they solely depend on your current symptoms at the time the test was performed.

 

Will I have to go for a test again in the future?

Depending on your symptoms, you may have to go for repeat tests later on. Your doctor will monitor your condition and advise you on whether you need to have another examination performed.

 

At what age should I start considering heart screenings?

According to the American Heart Association, it is recommended for certain cardiovascular screenings to be performed as early as 20 years of age while others are recommended to be taken at a later stage. When you should go for a screening will depend on the symptoms you are experiencing — your doctor will advise you on when it is appropriate to get a test done.

 

What are the signs and symptoms of heart disease I should look out for?

Signs and symptoms of heart disease which require immediate medical attention may include:

  • Chest pain or tightness
  • Irregular heart rhythm
  • Breathing difficulties
  • Fatigue
  • Lightheadedness
  • Neck, jaw, upper abdomen, or back pain
  • Pain or numbness in the arms or legs
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