Is there any method to determine the extent
of blockage of heart arteries? I know
angiogram is the best method. But I was
wondering if there is any other (non invasive)
method that can do this.

What do others think about the Coronary Artery Scan
procedure? Is this reliable and accurate?

Thanks in advance!

you can have an echocardiogram it will also show sclerosis same as ultasound good luck to you. Katherine

gosri,

As you said, the angiogram is the final arbiter of these tests.
An MRI scan can show the calcium deposits in the arteries and thus correlate to some extent the laid down arterial plaque. Insurance companies don't typically pick up the $300 fee for this probably because there are lots of false positives which then must be angiogrammed needlessly$$$$.
The PET scan is supposed to be nearly as good as the angiogram but cost several thousand dollars...Maybe your insurance comapany will pay, maybe not.
(I have no personal experience with either test...only angiography.

A usual middle ground is the noninvasive (except for a shot of chemicals)stress/echocardiogram with radioactive nuclear marker .

I can only give you my husband's experiences and what we've been told. But I'll add in that I am an RN and know not all doctors in every speciality are created equal. I have a chronic syndrome (epilepsy) and have seen some real clunkers for neuro's myself, so I have researched extensively cardiologist's and the cardiothoracic surgeon who operated upon him to make darn sure he is getting optimum medical care available in our area. I'm satisfied. One thing I really like about his present cardiologist is that he tells us all the tests and treatments he can do. He discusses the pro's and con's, gives his opinions too on what he prefers and doesn't and why, but always leaves any treatment decisions up to my husband. Right now he is feeling so frightened and helpless I know this gives him back a feeling he still has some control over his life.

All 4 of the men in my husband's nuclear family have severe atherosclerosis. My husband has had far better treatment than the other 3 and I can't tell you the difference in the preservation so far it's been on saving any damage to his heart muscle. And that's very important. He had quintuple (5) coronary artery bypass in l999. About 3 years ago he started having symptoms of angina again that progressively got worse. He had no health ins. until this last December so the health care he had for those 3 years wasn't hot, very scanty. In our state? They do not bill you. In fact all doctor's offices have signs that state "If you do not have your copay, please tell the receptionist and we will be happy to reschedule you". IOW, you pay up front or go home.

About a month ago he had cardinal symptoms of a myocardial infarction except he had no pain or chest pressure. Later the cardiologist we like and he now sees said that 30-40% of all people who have an MI don't have any pain or feelings of pressure. Shortness of Breath (SOB), which my husband has periodically off and on every day, is a far more frequent occurring symptom. That statistic surprised me.

When he was admitted thru the ER to begin with he was assigned the clunker. Plus I know this isn't a medical factor but that man was rude as H*ll and I feel if you can't have good communication with your doctor? Switch. He ran a lot of tests: stress treadmill, stress echocardiogram, I don't know how many EKG's, xrays, blood tests and maybe more and THEN he discharged him the next day stating he didn't know if he'd had a heart attack but he has ischemia or a lack of oxygen to his heart muscle as evidenced by his abnormal EKG, his EKG remained as abnormal as when he was admitted and he got no restrictions about returning to work so he went right back, feeling like puke and scared. All the symptoms he was admitted for remained. We did our research and got a much better cardiologist. Plus we traveled quite a ways and got a second concurring opinion with his present cardiologist from a large heart center I know to be nationally recognized.

His present cardiologist in fairness did have all the results the clunker did, plus his operative notes from l999 which I'm sure helped direct him. With my husband's "classic" symtoms he said, operative notes from l999, and current test results he said the only definitive way to find out what was wrong with his heart was with an angiogram. My husband had had one before and couldn't even remember it but he was really scared, I don't blame him either. It does carry some risk but after reading the literature I was very surprised what an extremely low percentage the worst risks are. I'd ask your doctor to give you a booklet about angioplasty and read for yourself, the risks, and the percentile chances of it happening. But he had it done and doesn't remember the second one either. They sedate you BTW. He was ordered no lifting for 8 days so he could protect the IV site of his femoral artery from the angiogram. He wasn't the first time, but he was wheeled into surgery fairly rapidly too, I can't remember the interval.

The point is though he hadn't been diagnosed, couldn't be diagnosed without the angiogram. He could have had less invasive testing but we opted out of that because to us false positive or negatives would still leave us in the dark. To get appropriate treatment you simply have to know what your diagnosis is. What we found out to our relief was that he did not have a heart attack. He does have chronic angina due to atherosclerosis and it is severe, a lot more severe than we had even thought about before, which was like ice water in the face but still we'd both rather know, so we can start dealing with it. Everyone was nearly certain his coronary arteries clogged again but they were completely open. Also he's had no heart muscle damage. Almost ALL of that is the opposite of what his EKG and symptoms appeared or consider, he was being treated up to his angiogram inappropriately, because they didn't know what was wrong with him and even the best of doctors, were guessing wrong. What he does have is severe clogging of the many tiny vessels that are imbeddded in the heart muscle that feeds the muscle oxygen, nutrients and carries off cellular wastes. All of his heart is involved as well as in some intensity now some other vital organs. That's only been explored a little bit right now.

His cardiologist has been very frank with him and I'm glad. It's been hard on him, is today, but we both agree we'd rather just know, then proceed onto appropriate treatment. I asked him yesterday if he is glad he had the angiogram because he was really dreading it. He said for one, he can't remember it, but he also said he has a lot less fear knowing what's wrong altho it's very serious then all this guessing and stabbing in the dark testing. Plus he knows he's being targeted with treatments now directly at his problem.

His disease process is so severe though, and because of what it is his cardiologist has told us that he has only two tools to help him. Medication and a noninvasive treatment called EECP, which takes 35 days and will hopefully open a passage through his clogged small arteries. EECP is compared to an angioplasty except it is noninvasive, of the small vessels that an angioplasty can't reach. It's not known how much benefit he'll get. It's very individual, but the statistics I've read of studies of others is encouraging his health will improve and his life span can be extended. I'm praying also because for him right now, at least so far all these medicines except for his BP and nitro aren't doing anything for him yet, but they're still playing around with them aggressively. On the medications? That's been almost like Russion Roulette but I know his doctor is working very hard to maximize his health through all these dsrugs. They're constantly changing in kinds, strengths,when they're taken and he has gotten significant relief with nitroglycerin, which isn't a cure, I'd say it masks the symptoms in a way, but to feel better is at least something.

I'm very glad he had the angiogram. If he wouldn't have? Theories of he had a heart attack, or maybe his chest would have been opened again and there is a 20% mortality rate with the second surgery which is grim, all might have been considered his diagnosis. What I'm saying is you have to be diagnosed correctly to be treated correctly. Right now we're now waiting for his ins. co. to approve this 35 day treamtent because it is expensive, $19,000. I've thought all day - what a cheap price for a man I adore.

Good luck. Get diagnosed and stick around longer .

Ingrid