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What is Cardiovascular Disease?

Cardiovascular diseases are the leading worldwide cause of death.

The commonest form is Coronary Artery Disease (CAD) affecting the arteries on the surface of the heart, which supply blood to the heart muscle.

Through an inflammatory process, called atherosclerosis, cholesterol is deposited in the wall of these arteries, which causes build-up of localised narrowings called “plaques”. This progressively reduces blood flow, especially during exertion, which can result in chest pain (called angina).

Inflammation in the arterial wall can weaken the surface of a plaque, leading to its sudden rupture and resulting in a blood clot which may block the artery and cause a heart attack or even sudden death, even when blood flow was not significantly reduced before.

Cardiovascular Disease FAQs

The major risk factors for CAD are known and include high cholesterol levels, high blood pressure, smoking, diabetes and family history. Alcohol, stress, diet, obesity and lack of fitness are also important.

Managing these risk factors with a healthy lifestyle (such as reduced alcohol intake, smoking cessation and regular physical activity), and where necessary medications, can help reduce your future risk of developing CAD and its complications.

The most common symptom of CAD is angina, which causes tightness in the chest often described as squeezing.

Symptoms of a heart attack include chest pain, which is often severe but may also feel like indigestion or heartburn, upper back or neck pain, cold sweat, dizziness or nausea, vomiting, extreme fatigue and shortness of breath.

If you have symptoms, or important risk factors, your doctor may wish to determine the extent and pattern of your coronary artery disease, to provide best advice on your care.

Inflammation cannot be detected by current tests, which aim at identifying the degree of narrowing of coronary arteries, and their impact on blood flow. Unfortunately, close to 2/3 of all heart attacks occur in arteries that were not significantly narrowed before a plaque rupture caused the event.

Caristo has developed a new technology that analyses images of a routine test called Coronary Computed Tomography Angiography (CCTA) to quantify the extent of inflammation in the coronary arteries. Large scientific studies in thousands of patients have shown that Caristo’s technology can detect inflammation before narrowings have developed in the coronary arteries.

When incorporating this information into the CaRi-Heart® Risk, close to 1/3 of patients have their future risk of having a heart attack or dying from a heart-related condition reevaluated: In 15% of the cases to a lower risk, in 16% of the cases to a HIGHER risk.

This means your doctor will be able to better define the most appropriate treatment for you to prevent future heart attacks or avoid unnecessary medication and associated side effects.

Coronary CT Angiography (CCTA), also known as cardiac CT scanning, uses an intravenous (IV) injection of iodine-containing contrast material to generate high-resolution images of the coronary arteries and the heart.

Your primary care physician or cardiac specialist will determine whether CCTA is an appropriate test for you.

CCTA FAQs

A nurse or technologist may ask you to remove your clothes above the waist and wear a hospital gown. You may be asked to remove metal objects such as jewelry, which can affect the CT images.

You will be asked to lie on your back on the scanner bed table. While you may lie on this table for approximately 10 – 30 minutes, most of this time will involve preparation. The actual images only take a few seconds to obtain.

An intravenous (IV) line will be inserted into a vein in your arm. Nitroglycerin may also be given as a tablet or a spray underneath your tongue, to widen the coronary arteries and improve the pictures. This may cause a temporary slight headache.

The technologist or nurse will apply sticky patches called electrodes on your chest. This will be used to monitor your heartbeat during the exam.

You will be asked to lie still and will receive instructions to hold your breath for short periods of time (less than 15 seconds) while pictures are taken. It is very important to be absolutely still and to not breathe, move or swallow while the pictures are being taken.

During some steps of the test, contrast dye will be injected through the IV. This may cause a warm feeling all over your body, which usually disappears within a minute or so.

Provided by the Society of Cardiovascular Computed Tomography (SCCT). For more information click here.

Based upon your condition and the doctor performing the CTA, you may be asked to do the following – always check with your doctor for your preparation before the test:

Take a beta-blocker medication to lower your heart rate. Some centers may give such medications by mouth and/or inject it through a vein prior to the test. This will help create the best images of the moving heart.
Avoid caffeinated drinks or food (e.g. coffee, tea, sodas, energy drinks, chocolate) for 12 – 24 hours prior to your test.
Do not eat for 4 hours or drink anything for 1 hour before the test (this may vary, please be sure to check with your doctor’s office prior to your test).
Do not take certain medications such as Viagra, Cialis, or Levitra for at least 48 – 78 hours prior to your test.
Temporarily stop taking Glucophage (Metformin) for 48 hours after the test.
Inform your doctor of any medications you are taking – including over-the-counter pain medications such as Advil or Motrin.
Inform your doctor and the CT technologist if you have any allergies to contrast material. If you have had prior reaction to injected contrast, the test may not be possible, or your doctor may prescribe medications to reduce the risk of such a reaction.
Women should inform their doctor and the CT technologist if there is any possibility that they are pregnant.
If needed, blood tests will be drawn to check for kidney disease prior to the test. People with mild kidney disease can still receive injected contrast but may require additional medications and IV fluids before or after the test.
If you have an irregular heartbeat it may make it difficult to get good CT images so this should be clearly mentioned when your appointment is made.

Provided by the Society of Cardiovascular Computed Tomography (SCCT). For more information click here.

Your doctor will be able to look at your coronary arteries to see whether there is any disease and if so, what the extent of it is.

The images will show everything your doctor needs to know such as the degree of narrowing, amount of calcification or level of plaque burden. They can also be sent to Caristo to measure inflammation around the coronary arteries.

With this comprehensive information, your doctor will be able to select the best treatment for you.