New Technology Providing Early Detection of Heart Disease

 

In providing the most up-to-date care medical advancements provide, Dr. Zepick wants you to know that cardiac CT has come to the forefront in the investigation of chest pain and early detection of coronary artery disease.

New technology continues to be developed improve medical care and more effectively treat patients. Read on to understand how this advancement in cardiac medicine is giving cardiologists an enhanced view into seeing what is happening with a patient’s heart.

 

What is Cardiac CT?

Cardiac Computed Topography (CT) Scan is a procedure using x-rays to view the heart. With multiple x-ray beams, the scan records high-quality images from multiple angles to produce a 3D image of an individual’s heart. This image includes visuals of vessels and surrounding structures. Some of the areas shown in these CT scans include the coronary arteries, heart chambers, pulmonary veins, thoracic aorta and the pericardium, the sac around your heart.

Simply put, this is advanced technology providing cardiologists like those at Zepick Cardiology the clearest picture of your heart and surrounding areas. We’ve never had a better view of a person’s cardiovascular system.

 

When Does Someone Need a Cardiac CT?

A cardiac CT is used to look for a variety of cardiovascular issues, including:

• What could be causing chest pain or shortness of breath
• Source for blockages: potential calcium or plaque buildup
• Heart-related birth defects
• Tumors or masses around the heart
• Signs of aneurysms or problems with the aorta

Since these images provide such clear images of the heart and surrounding area, medical professionals are also utilizing these scans to help them prepare for procedures on their patients. The cardiovascular team may order a cardiac CT scan to prepare for a heart surgery or other procedures such as a transcatheter or an arrhythmia ablation.

Generally, a cardiologist orders a cardiac CT scan. However, the scan itself will most likely be performed by a team of trained technicians. Nurses will be involved to place an IV line or administer any necessary medications and doctors will oversee and interpret the images.

How Safe is the Cardiac CT Scan?

A cardiac CT scan is a relatively quick and low-risk procedure. In fact, the entire procedure usually takes between 30-60 minutes, and that includes preparation time. The actual scan takes less than 1 minute.

Because CT scanners use a small amount of radiation, they are not recommended for anyone who is pregnant, unless additional measures are taken to protect the baby.

You may receive medicine to slow down your heart rate for the scan. If you have asthma or COPD, that may impede normal breathing. Talk with your doctor if you have either of those conditions.

 

Preparing for a Cardiac CT Scan

While a cardiac CT scan is not invasive, it does require some preparation by the patient.

In advance of the appointment, consult with your healthcare provider on:

• All medicines you take, including over-the-counter.
• If you have diabetes, discuss how you may need to adjust your medications for the day of your test as you will be avoiding food for many hours.
• Inform them if you have any of these conditions:
  • currently pregnant
  • allergic to iodine, shellfish or any medications
  • undergoing radiation therapy
  • older than 60 or have a history of kidney problems

 

After a Cardiac CT Scan

After the scan is over, you will be released to go home. Then, you can go back to life as normal, enjoying your regular activities including eating, drinking, and taking your regular medicines (unless otherwise directed by your healthcare provider).

If you have diabetes or kidney disease, you may be instructed to increase your fluid intake to help get the iodine out of your body.

 

Getting your Scan Results

Your healthcare provider will inspect the images and interpret them. It will likely only take a couple of days before you come back in to go over the results.

 

More Information about Cardiac CT Scans

“Computed tomography coronary anatomy with functionality assessment could potentially become a first line in diagnosis.” Learn more about the state-of-the-art review of this advanced cardiological procedure in this article from the Journal of the American College of Cardiology.

For questions on cardiac CT scans or other heart issues, contact the experts at Zepick Cardiology in Wichita, Kansas. Call our office at (316) 616-2020.

How Diet, Vitamins & Hormone Therapy Effects Your Heart

Before 1991, very little research was done on health issues relating specifically to women’s health. This was especially true regarding heart health as cardiovascular problems were often considered more of an issue for older men. However, serious conditions like coronary heart disease, cancer, and osteoporosis are some of the most leading medical problems affecting death rates and quality of life in postmenopausal women in the United States.

Fortunately, in the 1990s, a massive study was launched to research specific treatments for postmenopausal women and their risks for cardiovascular disease and other serious medical problems. But while this study made massive gains in understanding postmenopausal women’s health, it is not widely known outside of the medical community.

Women’s Health Initiative Landmark Study

Three decades ago, the Women’s Health Initiative (WHI) was launched. The WHI is a long-term national health study aimed at finding strategies for preventing heart disease, breast and colorectal cancer, and hip fractures in postmenopausal women. In this article from Zepick Cardiology, you will learn how such common treatments as taking hormone supplements and vitamins changed from what this study found.

This study yielded important information that changed how postmenopausal women have been cared for over recent decades.

The study resulted in such landmark trial findings, that it even continues to this day! The main study ran from 1993 – 2005. But extensions of the study are in process to last through 2027, and possibly beyond.

161,000+ Postmenopausal Women Studied

The depths of this study go beyond how long it has run. The number of postmenopausal women studied is quite staggering. Since the launch of WHI, more than 161,000 post-menopausal women have been included in the study.

To put that in perspective. There are approximately 30,000 women of postmenopausal age here in Wichita. If every single postmenopausal woman in the city of Wichita participated, that would not even amount to one-fifth of the number of total participants in the WHI study!

This massive WHI research can be broken down into three separate studies looking into three specific types of treatments that were common for postmenopausal women: hormone therapy, dietary modification, and supplements.

Hormone Therapy & Heart Disease

The most significant findings from the research were on hormone therapies. The part of this WHI study focused on whether hormone therapy can decrease the risk for heart disease among postmenopausal women. Participants were either given estrogen alone or were taking both estrogen plus progesterone.

The WHI found that hormone replacement therapy did not prevent heart disease in postmenopausal women as once thought.

In fact, using hormone therapies can increase a woman’s risk for a variety of problems including:

• Increased risk of stroke & blood clots
• Increase risk of breast cancer
• Increased risk of heart attack and stroke

This chart shows effects the difference between women in their 70s who took both estrogen and progestin versus those who took the placebo. You can see there is a clear increase in instances of heart disease, breast cancer, and strokes for women taking hormone therapy. Similar, yet less dramatic increases, were seen among the participants who were in their 50s and 60s.

These findings caused researchers to prematurely stop this part of the study in 2002. While taking hormones were found to decrease a postmenopausal woman’s risk for hip fractures, the increased health risks for such serious issues as cardiovascular issues and cancer outweighed whatever benefits that were possible.

The WHI trial changed the scientific community’s understanding of hormone therapy benefits for postmenopausal women. These results were a major reason why there was a sudden and sustained decline in prescribing hormone therapy treatment in the United States starting in 2003.

Dietary Modification Benefits

Many postmenopausal women in the group were studied to determine if dietary modifications could improve their heart health and decrease their risk for breast cancer and colorectal cancer. Participants undertook a low-fat diet that was high in fruit, vegetables, and grains.

While eating better has many great benefits, this study did not find a significant reduction in the risk of coronary heart disease, cardiovascular disease, or stroke in these participants.

Calcium & Vitamin D Supplements

One other part of the WHI study examined the effects of calcium and Vitamin D supplements. In particular, they were trying to see if postmenopausal women who took these supplements would have a decreased risk for heart disease, colorectal cancer, and hip fractures.

The study found no sufficient change in risk for heart disease and cancer from taking vitamins.

Better Care for Postmenopausal Women

Thanks to this WHI landmark study, we have improved cardiovascular care for women who are postmenopausal. This study is one factor that has helped to greatly reduce instances of heart disease in women over the decades.

As this graph shows, the number of women 45-64 dying from heart disease or stroke has decreased since 1980.

Prior to this study, estrogen therapy had been recognized for decades as an effective treatment for many of the menopausal symptoms women experience. It was also believed to reduce the risk of cardiovascular disease. In fact, estrogen became one of the most widely prescribed medications in the world by the 1980s and early 1990s.

According to the study published in the Journal of the American College of Cardiology, “The findings shocked the medical and lay communities, leading to a seismic shift in clinical practice and a 70%-80% reduction in HT (hormone therapy) prescriptions.”

Another long-running study focusing on cardiovascular care is the Framingham Heart Study which began back in 1948. You can learn more about that groundbreaking research and how it changed heart health care in dramatic ways in this article on the Framingham Heart Study. You can also learn more about the cardiovascular risks unique to women in this article on The #1 Cause of Death for Women.

For questions about your heart health and to understand your risk for cardiovascular disease, contact the friendly team of Cardiologists and medical staff at Zepick Cardiology in Wichita, Kansas.

The Research Unlocking the Answers of Cardiovascular Risks & Treatment

The care you receive for heart disease and other cardiovascular issues is incredibly different than a century ago. Advances in heart research gives cardiologists like those at Zepick Cardiology the most current and well-researched information to provide patients the best care available today. It was only a few generations ago that heart disease issues often went undetected or not treated successfully.

The reason behind so much of what doctors and scientists know today about the heart can be traced back to one amazing long-running study.

The Framingham Heart Study began in 1948 when we didn’t have a good understanding on what people at risk for developing cardiovascular disease. Also back then, the medical community did not have many answers for how to successfully treat it.

The Framingham Heart Study was so extraordinary at unlocking such life-saving information that it never stopped. In fact, the study continues to this very day with the children and grandchildren of the original participants. The study itself is an incredible story of scientific discovery. You can learn about how the Framingham Heart Study and the origins of modern heart care in this article.

What We Know About Heart Health Today Thanks to the Framingham Study

There are many things that we know about heart health we simply didn’t know 70 years ago. Some of the conditions that put people at risk for heart problems that may seem obvious to us now were not known before this study.

Thanks to the Framingham Study, in the 1950s we learned the following health issues increase a person’s risk for cardiovascular disease:

• High blood pressure
• High cholesterol levels
• Being overweight

In the 1960s, the Framingham Study added these risk factors to the list:

• Smoking
• Lack of physical activity

More risk factors were identified in the 1970s, including:

• High blood pressure levels
• Postmenopausal women

In the 1980s they discovered:

• High levels of HDL cholesterol reduce risk of heart disease

In the 1990s, another big advancement occurred:

• The Framingham Risk Score is published which correctly predicts 10-year risk of coronary heart disease

More findings came out in the 2000s including identifying increased risks from having prehypertension (blood pressure levels of 120-139) and the effect of a person’s social contacts. Researchers looked how the people you spend your time with affect such things as obesity, smoking cigarettes, and efforts to quit smoking.

Nearly 4000 medical journals have been published based on data from the Framingham Heart Study.

The 10 Most Important Framingham Heart Study Findings

1. Hypertension (high blood pressure) is a serious risk factor for heart disease. Before the study, it was believed that hypertension was a normal part of the aging process. Understanding this connection allowed for changes in treatment and further research into high blood pressure, including the contemporary SPRINT Trail that revised the standards of acceptable blood pressure rates.
   
   
2. The study created the first and most impactful information on the risk factors for coronary heart disease (CHD). These primarily related to physical activity, cigarette smoking, diabetes, cholesterol levels and obesity. The study led to creation of a 10-year coronary heart disease risk calculator. Here is a link to the American College of Cardiology’s risk calculator.
   
   
3. The major risk factors for heart failure were clearly identified as diabetes, obesity, hypertension, and parental heart failure.
   
   
4. The Framingham Heart Study was one of the first to report on atrial fibrillation risk factors. In addition, it linked atrial fibrillation to higher instances of stroke, heart failure, and cognitive decline.
   
   
5. The study looked at the connection between the heart and the brain. Framingham was the first study to show a higher level of a type of amino acid in your blood (serum homocysteine) increases your risk for dementia as well as heart disease.
   
   
6. It identified a connection between smoking and intermittent claudication, a condition where a person has leg pains or aches while exercising. That symptom is an indication that there is likely too little blood flow to the muscles.
   
   
7. The use of cardiac imaging was found to be a helpful tool in locating cardiovascular issues by looking at such things as heart wall thickness and atrial dimension. The study established normal levels of ventricular mass, cavity volumes and systolic function measures.
   
   
8. The Framingham Heart Study established verifiable biomarkers in the prediction of cardiovascular risk for individuals.
   
   
9. Thanks to having participants that span 3 generations, much was learned regarding the genetic and hereditary factors for heart disease.
   
   
10. The study continues providing insight that delves into the molecular level of biology. For example, Framingham research is looking at how our gut microbiomes affect our risk for various diseases. This type of research has already solved the mystery of why some people absorb cholesterol from the intestines, yet others do not (it has to do with having certain bacteria inside the gut that metabolizes cholesterol).

The Future of Solving Heart Mysteries & Saving Lives

There is still so much to learn about the heart. Fortunately, the Framingham Heart Study continues into its 7^th decade with an even greater ability to discover more cardiovascular disease risk factors and, even better, solutions to improving heart health and saving lives.

The data collected over the years continue helping scientists unlock new information about the heart. Using modern medical research technology, they can look at decades-old blood samples and discover even more information about what puts a person at greater risk for developing cardiovascular disease.

Today, the Framingham Study includes new research into the effects of exercise. Smartphones and devices participants can wear to track such things as activity and heart rate have been added to the information researchers are gathering.

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“It is an exciting time for cardiologists and medical researchers. The scientific community continues gathering even more information into what makes the heart healthy and strong, allowing our doctors here at Zepick Cardiology to provide the most up-to-date information and best treatment for all our patients.”

-Dr. Lyle Zepick, Cardiologist, Board Certified in Cardiovascular Disease

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The Story Behind the Amazing 7-Decade Study into the Heart

When you receive treatment for your heart health at Zepick Cardiology or other cardiology clinic across the country, you are receiving expert care based on decades of medical research. Knowing what puts you at risk for heart disease and how to treat it came from intensive scientific study done over the past century.

Most of the cardiovascular knowledge we have today is thanks to a long-lasting and highly involved research done in one small town. In fact, the life-saving information we have today regarding heart disease can be traced back to a remarkable study that began 70 years ago.

For as long as many of you have been alive, scientific research has been (and continues to be) underway in one incredibly long and intense study on the heart. The longest-running cardiovascular study of its kind is the Framingham Heart Study.

A Brief History Lesson

The Framingham Heart Study began in 1948. Up until that time, cardiovascular disease was not as significant of a health concern as it is today. Not much was known about cardiovascular disease – neither where it came from nor how to prevent it.

Take for example President Franklin Roosevelt who died in office in 1945. FDR had a history of high blood pressure.

It was high before he entered office and became worse over time, reaching 210/100 the year before his death. On the day of his death, President Roosevelt’s blood pressure was an astounding 300/190.

While today we recognize this as a very serious case of hypertension, medical experts simply didn’t have that information back then.

“Today, presidential blood pressure numbers like FDR’s would send the country’s leading doctors racing down hallways,” remarked Daniel Levy, Framingham Heart Study Director.

For the first half of the 20^th century, the primary cause of death was from communicable diseases. We simply did not have the antibiotics and vaccines then as we do today.

But as medicines and vaccines were developed and started reducing deaths from illnesses like rheumatic fever and pneumonia, heart-related diseases started to come to the forefront.  In a rather short period of time, non-communicable diseases like cancer and heart disease became the leading causes of death. By 1950, 68% of all deaths were from cardiovascular disease, cancer, and renal disease.

The Participants of Framingham

This instrumental, decades-long heart study is named after a modest-sized town in Massachusetts. Framingham, located just about 20 miles away from Boston, was home to about 25,000 people in 1948 when the study began.

Nearly one in five Framingham residents were involved in the study. More than 5000 men and women of the town participated in this study at its start. All these participants were considered normally healthy and free from apparent cardiovascular disease.

The original plan of Framingham Heart Study was to follow the participants for 20 years.

There was an atypical number of women participating. Just over half of the participants were women, which was not usual for medical studies on chronic disease at that time.

The study initially failed at including a variety of ethnicities among the participants. But as you continue reading, you will see how the study’s great successes led them to include participants among more demographics.

Continuing the Heart Study: More Generations & Ethnicities

The Framingham Heart Study was proving to provide such great results, researchers didn’t want to it to end after two decades as was originally planned. Not only did they pursue continuing the study, but they also expanded it to include more participants.

Starting in the 1970s, many children of the existing participants were included in the expanding Framingham Study.

But the study would further expand beyond this 2^nd generation. Beginning in 2002, many of the grandchildren of the original participants were included in the study. Having three generations of participants allowed for great opportunity to research genetic patterns related to cardiovascular disease.

The study also expanded to include more demographics to better match Framingham’s racial and ethnic population. Starting in the 90s, the study began including a diversity of ethnicities in the study. They expanded to include people of African American, Asian, Native American, Indian, and Pacific Islander descent.

To date, more than 15,000 people have been participants in this ongoing study of the heart.

Thanks to the dedication of researchers diligently looking into cardiovascular care and risk factors, cardiologists like those at Zepick Cardiology are able to provide exacting care to treat patients with heart disease. Decades of science and research have allowed doctors today to treat patients for cardiovascular issues better than ever before.

Imagine how much more will be learned from this ongoing Framingham Study and how more we can even improve cardiovascular care in the future!

Understanding Cardiovascular Disease Risks for Women

It’s a sobering statistic. One in three women die from some form of cardiovascular disease.

It is the leading cause of death for women. In addition, it is also a rather common disease for women to be living with. Nearly half of all women over the age of 20 have some form of cardiovascular disease.

But how cardiovascular disease impacts women is different in many ways.  This has become a focus for a lot of new research. The factors that cause a person to be at risk for cardiovascular diseases aren’t always the same for men and women. And sometimes when the factors are the same for both sexes, the risk factors are worse for women.

Science is uncovering new information that is helpful in both the prevention and treatment of heart disease for women.

A New Focus on Women’s Heart Health

Over the past few years, new studies have begun focusing specifically on cardiovascular problems for women. A large summary of recommendations for prevention of cardiovascular disease in women was put out just this year by the Journal of the American College of Cardiology.  

All this research is great news to women, especially those facing a higher risk for developing heart issues. Instead of a one-size-fits-all treatment, these new efforts to understand how cardiovascular disease is different for women have led to improved guidelines customized for the most optimum and successful treatment specific to the needs of women.

Cardiovascular Risk Factors Unique to Women

Why do women get heart disease? Obesity, poor access to health care, and underlying health conditions are all risk factors that affect both men and women. But studies have found there are specific risk factors that put women particularly at a higher risk for cardiovascular problems.

PREMATURE MENOPAUSE

A woman is considered to have premature menopause when she experiences menopause before the age of 40. The body’s response to a drop in estrogen (including such things as changes to the distribution of body fat, glucose tolerance and higher blood pressure) causes in increased risk for cardiovascular disease. The recent research on this has been extensive, involving more than 300,000 women in testing. Early menopause (ages 40 – 44) and relatively early menopause (ages 45 – 49) were also studied and found to increase cardiovascular disease risk, although not as high.

However, there is still much we do not know about the link between early menopause and cardiovascular issues. It may be that there are other factors at play here. It could be that women who have certain factors that increase their chances for having both cardiovascular disease and early menopause.

POLYCYSTIC OVARY SYNDROME

Women of reproductive age can develop the hormonal disorder called polycystic ovary syndrome (PCOS). Women who suffer with PCOS may have infrequent menstrual periods or prolonged ones. The problems are often more severe if the woman is obese. Having polycystic ovary syndrome puts you at a higher risk of developing both heart disease as well as type 2 diabetes.

HYPERTENSION

While hypertension is a problem that can occur in both men and women, there are differences among the genders. Hypertension is less common in pre-menopausal women than of men of similar age. However, after menopause, women are more likely to suffer from hypertension then men of their age group.

Studies show there are various factors unique to women who have it. It is common for women with hypertension to:

• Be obese
• Decrease physical activity
• Increase salt intake
• Develop diabetes
• Increase alcohol consumption (more than moderate use)

These activities or factors are also some of the biggest risks that cause women to develop heart disease. Women in this situation are recommended to reduce their salt intake (ideally less than 1500 mg daily) and to increase their daily amount of potassium from foods (ideally to at least 3500 mg daily).

DIABETES

Having diabetes increases a person’s risk for heart disease, making them twice as likely to have a stroke or heart attack. Like hypertension, diabetes affects both men and women. But there are differences between the sexes in this disease and how it affects each gender’s risk for cardiovascular disease.

Girls are more likely to develop Type 2 diabetes than boys. Because of this, women tend to live longer with this disease than men. Studies show that people diagnosed with Type 2 diabetes before the age of 40 are at higher risk of dying from a cardiovascular disease.

While recent studies bring to life information that some may find troubling, it also creates the opportunity to find treatment that is most affective. Studies on gender differences regarding diabetes has resulted in revelations about certain medications working better for men with other medications working better for women.

HIGH CHOLESTEROL

The first noticeable difference between men and women who have high cholesterol is in regard to medications. Women are less likely to be given statin therapy than men for their high cholesterol. Statin therapy has been shown to reduce occurrence of cardiovascular disease. However, a lack of proper studies in the past involving women cast doubt on whether statins were a safe and effective treatment for women.

RAPID OR IRREGULAR HEARTBEAT

Atrial fibrillation is a condition where you have a rapid or irregular heartbeat. Women with atrial fibrillation are 20% to 30% greater at risk of having a stroke than men with this disease.

DEPRESSION

Having depression, emotional stress, or other form of psychological issue has been shown to increase your risk for developing cardiovascular problems. These issues been proven to be risk factors for heart attack and cardiac death. It’s been shown that women diagnosed with clinical depression face twice the risk for developing cardiovascular disease.

Depression affects about 7% of the popular each year, and it’s twice as more common for women than

men. Psychological issues are often tied to childhood instances of adversity such as child abuse or neglect. Women have a higher exposure to these adversities. Such early life adversities are known risk factors for cardiovascular disease, but even more of a predictor for women.

PTSD

Post-Traumatic Stress Disorder has been found to increase a person’s risk for heart disease. This is true of either gender but is worth noting as an increased risk factor for women since they experience this problem more than men. PTSD affects 9.7% of women and 3.6% of men.

The problem relating PTSD to cardiovascular disease is increase when you consider lifestyle factors. Those who have suffered childhood trauma are more likely to take part in unhealthy activities and choices. Whether it’s smoking, over-eating or excessively drinking, people with PTSD are often exacerbating their heart risk with such poor health behaviors.

PREGNANCY & CARDIOVASCULAR DISEASE RISK

There are many issues related to pregnancy and childbirth that put women at a much greater risk for developing cardiovascular disease. From gestational diabetes to low birth weight to pre-eclampsia, the many different types of health problems a woman can face during pregnancy leads to a high risk.

In fact, the various factors related to pregnancy are so many that we put that information out in its own article to go in depth into this article on Pregnancy & Cardiovascular Risks.

What can women do to protect your heart?

For women, this may feel like only a lot of bad news. But in reality, the new information that focuses on women’s health will help lead the way to improved treatment and care and preventative help.

1. Understand that heart disease is indeed a serious risk for all women.
2. Be proactive in getting medical care and seeking necessary treatment.
3. Stop poor health behaviors such as smoking, too much drinking and salt intake.
4. Start/increase good health activities such as incorporating physical activity in your daily lifestyle.
5. Take your mental health needs seriously.

Knowledge is power. Knowing how you are uniquely affected by heart disease or the factors that put you at greater risk creates great opportunity for you to take proper steps to help your heart health.

Heart Disease Problem in Kansas

Do we have a bigger problem with cardiovascular disease here in Kansas than they do in other states? Not really. Kansas ranks right about in the middle among most statistics on heart disease.

As you see in this graph from America’s Health Rankings, 3.6% of all Kansas females and 5.3% of all Kansas males have diagnosed heart disease. This is just a little more than the national average.

If you have any questions or concerns about your heart health or proper treatment and care, feel free to call us at Zepick Cardiology here in Wichita, KS at (316) 616-2020.