For the past five years, 59-year-old Marsha Van Nuys had been taking medications to lower her blood pressure and cholesterol. But when a routine visit to her internist revealed that her blood pressure had risen and her heartbeat was irregular, Marsha's doctor ordered an EKG and sent her to Cedars-Sinai Medical Center to undergo an EBCT scan. The test showed that there were extensive calcium deposits indicating that plaque had built up within her coronary arteries. Marsha then underwent a thallium stress test to determine whether there was any blockage of blood flow to the heart. Surprisingly, her thallium tests came back normal.
But given the level of plaque in her arteries, Dr. Daniel Berman, a cardiologist and the Director of Cardiac Imaging at Cedars-Sinai, thought a second look with a new imaging test called a non-invasive coronary angiogram using the GE e-Speed(tm), might be needed. The scanner, just acquired by the Cedars-Sinai S. Mark Taper Imaging Center, works by creating images like a CT scan, but is ten times faster in taking images than a conventional CT scanner. The non-invasive coronary angiogram is a procedure that can image the coronary arteries similar to a conventional coronary angiogram, but without requiring catheterization and therefore with greatly reduced risk and discomfort to the patient.
"The rapid imaging of the e-Speed CT scanner is vitally important because the constant motion of the heart often prevents us from getting blur-free images," said Dr. Daniel Berman, a cardiologist and the Director of Cardiac Imaging at Cedars-Sinai Medical Center. "Now we get clear pictures regardless of the patient's heart rate so that we can see exactly what's happening in the heart and coronary arteries to determine the best course of treatment for our patients."
Two weeks later, Marsha underwent the 15-minute e-Speed non-invasive coronary angiogram, which showed a 50 percent blockage in two of the three major coronary arteries.
"This more accurate information led to our becoming more aggressive with Marsha's medical management putting her on additional medications that would help to prevent further plaque build-up," commented Dr. Berman.
Instead of feeling frightened, Marsha says she now feels safe. "I feel comfortable knowing that this was found because I never would have known the extent of blockage without this scan," she said. "It has saved my life."
With more than 61 million Americans with heart disease today, the number of invasive procedures to assist in evaluating the extent of disease is high. For example, there are an estimated 3.4 million cardiac catheterizations performed each year alone. This procedure, which measures blood pressures in the heart, involves placing a long, thin catheter in an artery in the arm or leg where it is advanced to the heart and surrounding vascular system. The catheters are also used to inject dye into the coronary arteries, which is called coronary angiography, so that radiologists can see the heart and its surrounding arteries and vessels.
But the GE e-Speed provides physicians with a non-invasive imaging tool to help determine the extent of a patient's heart disease, despite the constant motion of the coronary arteries. The technology can acquire 33 millisecond images at 30 frames per second, which is faster than CT imaging and provides pictures that are free of motion, similar to that in cardiac catheterization or coronary angiography. Patients simply undergo a 15-minute scan and have their results within minutes of the test.
"The unprecedented speed of this scanner enables us to not only measure the amount of calcium in the coronary arteries, the first sign of coronary artery disease, but also to see the extent to which there are actual blockages of the arteries," said Dr. Berman. "These non-invasive angiograms are not for everyone. The patients who benefit the most from this procedure appear to be those with an intermediate amount of calcium in the coronary arteries or those in whom the diagnosis is uncertain after stress testing."
Since the beginning of the 20th century, heart disease has been the number one killer of Americans. In fact, heart disease claims more lives each year than the next five leading causes of death combined - namely cancer, chronic lower respiratory diseases, accidents, diabetes, influenza and pneumonia. In the year 2000, heart disease claimed 39.4 percent of all deaths in the United States.
Cedars-Sinai Medical Center is one of the largest non-profit academic medical centers in the Western United States. For the fifth straight two-year period, Cedars-Sinai has been named Southern California's gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthroughs in biomedical research and superlative medical education. Named one of the 100 "Most Wired" hospitals in health care in 2001, the Medical Center ranks among the top 10 non-university hospitals in the nation for its research activities.
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