Dr. Williams from ARA shares shares important information for men and women about coronary artery disease and CT Calcium Scoring

February is American Heart Month. Dr. John Williams, a radiologist with ARA Diagnostic Imaging, shares important information for men and women about coronary artery disease with KEYE-TV’s Trevor Scott on CBS Austin’s ‘We Are Austin.’

(Trevor Scott) 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 is 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.

(Dr. John Williams) Good morning, thanks for having me.

(Trevor) 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.

(Dr. Williams) 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.

(Trevor) 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?

(Dr. Williams) 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.

(Trevor) When you have conversations about heart health, you hear the word plaque a lot. What exactly is plaque?

(Dr. Williams) 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.

(Trevor) So how common then is coronary artery disease?

(Dr. Williams) 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.

(Trevor) Wow.

(Dr. Williams) And one of the problems with this disease is that you can have a significant, or you can have this disease, and 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.

(Trevor) Right.

(Dr. Williams) 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.

(Trevor) 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.

(Dr. Williams) 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.

(Trevor) Wow.

(Dr. Williams) 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.

(Trevor) 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?

(Dr. Williams) 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.

(Trevor) Wow.

(Dr. Williams) 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.

(Trevor) 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?

(Dr. Williams) 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.

(Trevor) 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?

(Dr. Williams) 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.

(Trevor) 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?

(Dr. Williams) 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.

(Trevor) Excellent. Information and procedures that save lives there at ARA. Dr. Williams, thank you so much for joining us today. We appreciate it.

(Dr. Williams) Thank you for having me.

(Trevor) Well, thank you so much.

Please note: When talking to your health care provider about getting a CT calcium scoring, be sure and discuss any symptoms you may be having, including chest pain or pain in the arms, back neck, jaw, or stomach; shortness of breath; palpitations; nausea; and fatigue.

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