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| Cardiologists Wendy Post and Roger Blumenthal, on the cutting edge of prevention |
Cardiologist Wendy Post, M.D., is on the phone, consulting with another physician about a 50ish patient who had previously been symptom-free. He came to see Post after feeling some chest pain a week earlier, and left with a diagnosis of major blockages in his coronary arteries.
“If we had gotten to this man 5 or 10 years ago, we could have helped prevent the progression of disease and the need for angioplasty or bypass surgery,” Post says.
Coronary plaque, Post explains, is a silent stalker for many patients. Unaware of the accumulating blockages in their arteries, they make no lifestyle changes, like diet and exercise, to reduce their risk. Drugs to lower their cholesterol would help them avoid invasive procedures, or even death, but why ask about them when you’re feeling ok?
The scenario is all too frequent for Post and cardiologist Roger Blumenthal, M.D., which is why they’re constantly developing novel ways to reduce the risk of coronary artery disease, capitalizing on innovative diagnostic tests and imaging technologies, new diets and preventive exercise programs – all aimed at getting to the plaque before the plaque gets to the patient.
Rather than routinely put patients on a treadmill to detect signs of coronary artery disease, for example, Post and Blumenthal rely on a new type of CT scan, called Electron Beam Tomography, or EBT. While stress testing only picks up blockages that are at least 60 percent obstructive, EBT takes stop-action images of the beating heart that reveal white specks of calcium on artery walls before they develop into significant blockages. The amount of coronary calcification determines a patient’s risk. “We can clearly see abnormalities that predict future blockages,” Blumenthal says.
In an innovative screening test called IMT, or intima media thickness, Post and Blumenthal use ultrasound to measure the thickness of the carotid artery in the neck. The greater the thickness, the greater the likelihood of a heart attack. Another new test, CRP, which measures the amount of inflammation in the body, also has been shown to predict future risks.
Post and Blumenthal also prescribe diets low in saturated fats, rich in fruits, vegetables and whole grains, and cardiovascular exercise at Hopkins Heart Health in Timonium. While the facility offers supervised exercise for patients who have had a heart attack, angioplasty or surgery, it also helps at-risk patients avoid those outcomes.