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February 4th, 2009
12:55 PM ET

High tech heart test makes headlines

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

There were headlines this morning about CT scans for your heart.  An article in the Journal of the American Medical Association reports that the 64-slice cardiac computed tomography (CT) angiography (CCTA) of the heart has an average of 600 times the radiation of a single chest X-ray – that was the takeaway message. Pretty scary to read that, no doubt. In full disclosure, I had one of these scans as part of a story I did a few years back and it was interesting to see 3-D pictures of my heart. Take a look.

Still, I wanted to put a couple of things in context. It’s true that if you have had a single one of these scans, you are probably not going to get cancer as a result, which seems to be the biggest concern. But, if you are being asked to get multiple scans, it’s worth asking your doctor if they are really necessary and to balance the risks. Furthermore, because these scans have been more routinely used only since 2004, the data are pretty minimal on whether they have much effect on your outcome from heart disease.

I think there is a larger issue here. What is the right screening for you and should the costs be through the roof? A CT like this one is often not covered by insurance and the cost is between $800 and $1,200 dollars. Well, according to the U.S. Preventive Services Task Force, which studies this sort of thing based on cost and effectiveness, getting a simple cholesterol check around age 35 is a good idea and approximately every five years after that, depending on what the tests show. Also, a baseline EKG (electrocardiogram –to look at the electrical conduction of your heart) around age 40 can be helpful. To be sure, they recommend a more advanced test if you have heart disease or are having symptoms, such as chest pain.

Now, despite all these screening tests, if you are pretty healthy, ironically, the advice will most likely be the same. Eat right, including less fat in your diet. Don’t smoke and try to get exercise. Yes, even will all these fancy tests, the basics still apply.

So, how good are you at getting your recommended screening tests and would you pay the extra money for a CT scan to get more information?

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soundoff (10 Responses)
  1. David Byrd

    This report on CT Scans leaves me very confused. Here's why:

    During my annual physical in 1998, a problem was discovered and I underwent treatment, including surgery. Unfortunately, the treatment resulted in a medical error that almost cost me my life. But, as a followup to this treatment, I underwent CT-Scans twice in 1999 and 2000. Then I underwent CT-Scans once a year in 2001, 02, 03 and 04.

    During my annual physical in 2004, my personal physician told me that she had just read some material reference to CT-Scans and she recomended that I stop having CT-Scans.

    Again, this recommendation was made to me in 2004. Here we are more than 4 years later and all of a sudden this is new news about CT-Scans? Something is wrong.

    February 4, 2009 at 14:24 | Report abuse | Reply
  2. Uncle Whitey

    They are probably keeping quiet in order to pay off the equipment and to allow the statute of limitations to come into effect to protect the doctors, facilities,and technicians.

    Most of these organizations are motivated by money before the desire to help and treat people.

    February 5, 2009 at 11:31 | Report abuse | Reply
  3. GF, Los Angeles

    At the risk of having inaccurate readings and having 600 times of radiation aimed at my chest then an x-ray....I don't think so.

    February 5, 2009 at 14:30 | Report abuse | Reply
  4. Mike Hanley, MD

    Most medical decisions are about balancing risks and benefits. There are risks to a baby aspirin including intestinal bleeding and allergic reactions, but the benefit of a decrease in heart attacks and stroke is well worth it.

    CT scans and x-rays are the same. A study without good reason is potentially dangerous and an indicated study should not be feared. If you want to know your risk from CT scans or x-rays you can calculate your risk at http://www.xrayrisk.com, but more importantly talk to your doctor about your concerns.

    February 5, 2009 at 16:51 | Report abuse | Reply
  5. Doctor Mike

    David, its hard to know exactly what your situation was with the sparse details you've given but keep one thing in mind. Recommendations are always changing. As a physician I wouldn't have it any other way. Changing recommendations occur because we are always learning, studying, and getting better at what we do. The advice you were given 5 years ago was based on the best information available at the time. If doctors were satisfied with that they would have done no further research and we would still be following the same practice. Patients would still be getting frequent CT scans to follow a minor abnormality. But medical science advances as we learn. Patients today who are in the situation you were in 5 years ago benefit from those advances and now have fewer CT scans. Would you have it any other way? Unfortunately there is no way to know in advance what we may learn in the future. Medicine today is light years ahead of where we were just 20 years ago, but we don't yet have a crystal ball.

    February 5, 2009 at 17:06 | Report abuse | Reply
  6. gene roberts

    I am in my late 60's and have not had a cigarette since 1978.I eat well,have low cholesterol and exercise 40 minutes 5 days a week.Always feel fine yet I had a Heart Cam test (CT) to check for plaque.Zero score is ideal.200-250 score acceptable for my age yet I scored 1776 close to 'critical'.Then they put me on Zorcor 10 mg and 81 mg aspirin.I wroked out more and watch food better.24 months later tested and scored 2000.The cardioligist now has me on Zorcor 80 mg,2 baby aspirins and 5 mg.Altace.
    There is significant plaque but I feel fine.
    I guess I will until I die.
    Gene
    Was concerned about the radiation but what is more important?

    February 5, 2009 at 17:39 | Report abuse | Reply
  7. VF

    About 3 years ago my doctor sent me for a CT scan for suspected pneumonia with a follow-up scan a few weeks later. Two lung nodules were detected and I was told to have 6 monthly scans to make sure they weren't increasing in size. I am a 59 year-old woman who smoked about 20 cigarettes per day between the age of about 18 and 21. I have been worried about the amount of radiation from the CT scans, so I have been spacing them one year apart, instead of the 6 month intervals my doctor recommends. The nodules haven't grown and I believe they might be a result of 2 previous bouts of pneumonia. My doctor insists the CT scans are necessary but I fear they are increasing my cancer risk rather than saving me from any potential risk from the nodules.

    February 6, 2009 at 22:09 | Report abuse | Reply
  8. Lori

    A cardiologist responded to my concern about possible side effects from nuclear imaging of my heart by stating - "Since you already have (thyroid) cancer, you don't have to worry about the radiation causing cancer." .....Sooooo ....it's okay to smoke because one "already has lung cancer? " Or is he just saying patients are idiots who will swallow any pill if sugar coated? I am in that alleged 1% category of patients who suffer alleged "rare" or undisclosed but known side effects from Rx drugs, MRI, even some herbal supplements, etc., as evidenced by my history ollergies and adverse reactions that I porovide to health care providers as questionnaires always ask me to list my past aggergies ....which are then ignored, leaving the patient to be his own investigator-advocate. The FDA requires side effects warnings accompany dispensing of Rx drugs. Yet the FDA resists requiring the same warnings prior to invasive diagnostic testing which is explained away with "Risk versus Benefit" lingo - How do I know whether the Benefit is greater than the Risk if no one will tell me the Risks?

    July 29, 2010 at 10:26 | Report abuse | Reply
  9. UKCAT

    I’m not employed to blogging and having material out there. Your site here is very informative and provides me with a lot more understanding as to making an effect when leaving comments. Please continue your posts and I can carry on and read all of them.

    September 11, 2010 at 00:56 | Report abuse | Reply

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.