Dr. Friedman recommends for many patients to undergo a relatively new test to evaluate their heart status, called the “electron beam CT scan” (EBCT).
This is often part of what is called a “body scan,” which also looks for lung cancer and other types of cancer. The electron beam CT scan of the heart detects early calcification in the heart vessels. Early calcification is a sign of atherosclerosis (coronary heart disease, cholesterol plaques in heart vessels), which is the main cause of death for most Americans.
Therefore, screening for atherosclerosis is of primary importance, and as an endocrinologist, Dr. Friedman is very concerned with reducing your risks for developing diseases, such as atherosclerosis. Many endocrine conditions, including growth hormone deficiency, Cushing’s disease
and hypothyroidism predispose patients for atherosclerosis.
The electron beam CT scan of the heart is done at most major medical centers and costs between $350 and $500. Sometimes it is covered by insurance but often is not. It is a relatively quick procedure that takes about five minutes and one usually gets a preliminary reading at the time it is done. Patients get a calcium score, which indicates how much calcium plaque the patient has in his or her heart’s vessels. It tells you the number of plaques and how big they are, to come up with a calcium score, and also usually tells which coronary artery contains the plaque.
In some circumstances, if the calcium plaques are in a dangerous region, such as in the main coronary artery called the left anterior descending, it may be more dangerous than having them in a more minor heart vessel. A person can get a zero score, which is ideal; and the lower the score, the better. Generally, a score above 300 is considered dangerous. However, recent studies show that the higher the score, the more likely you are to get heart disease, no matter what the score is.
Dr. Friedman recommends this test in patients that are being considered for treatment of elevated cholesterol and points out that the cholesterol is only a marker for heart disease, and it is much better to look for actual heart disease.