Sugar Matters
October 4, 2011
How is heart disease diagnosed?

For the most part, many doctors will approach people with type 2 diabetes as though they already have heart disease, meaning that the recommendations are often the same-strict blood sugar control, cholesterol control, blood pressure kept low, take an aspirin everyday, eat properly, get some exercise. But it is very important to know with certainty, because it affects your overall health approach.{{more}}

Although having chest pain does not 100 per cent mean you have heart disease, IT IS ALWAYS IMPORTANT TO HAVE THIS CHECKED OUT BY YOUR DOCTOR. There are other VERY dangerous reasons for chest pain. Do not ignore it without letting a medical professional check you out.

Back to heart disease:

Your doctor can diagnose this several ways in fact.

An EKG: this is one of the most common ways that we discover heart disease. The EKG uses 12 wires snapped to various areas on your body (most over the heart) to make recordings that are then interpreted to give lots of useful information about the heart. Specific patterns on your EKG reports can tell your doctors if you are actively having a heart attack, if your heart is straining and having ischemia (too little oxygen), and/or if you have had a heart attack in the past.

Blood tests: whenever you complain about chest pain that is worrisome, your doctor will likely have blood tests done. When your heart is damaged it leaks some muscle enzymes as the muscle dies. We can measure this in your blood to be able to know if you have had some damage, and at times the timeline – did you have a heart attack a few days ago, last week, or is it happening right now?

Physical exam: this one is tougher, but there are often some clues that some damage has occurred in the heart. A new heart murmur, sudden drop in blood pressure, fluid in the lungs and big veins in the neck can be signs that your heart has been damaged.

A stress test: The least expensive version is the walking treadmill, where you are hooked up with wires to an EKG and you walk at faster and faster pace. Your doctor will look at the changes on your EKG to see if your heart strains when you exercise. If it does, this is a strong sign that you have heart disease. Please do know that a negative treadmill is not 100%, especially in women. So you can still have undiagnosed heart disease with a negative test, and your doctor may recommend further testing.

The advanced tests:

Nuclear and chemical stress tests are versions of the walking treadmill that use chemicals to speed up the heart rate (so you don’t have to walk), and measure the changes in your heart through radioactive dyes instead of using the EKG.

Cardiac catheterization is the Mercedes of heart disease testing. It is only performed in major medical centers by specially trained cardiologists. It involves the doctor threading a very small catheter into your heart and looking at the vessels with some dye. The doctors can also do some repairs during a cardiac catheterization—blood vessels can be cleaned out or have stents (like little pipes/funnels) placed to help improve blood flow.

Every Type 2 diabetic over the age of 50 should have an EKG at least once, even without chest pain. The other tests come as needed.

Until next week, stay safe and healthy Vincies…

Anita Ramsetty, MD [email protected]

Medical Director Endocrine Care Group

Tel: 843-798-4227