A CT SCAN CAN SAVE YOUR LIFE

I am a physician. I am not a cardiologist and I am a young physician.

The best thing you can do for your health is see a physician regularly so that he/she gets to know you, have your cholesterol and blood pressure checked annually. Your age, cholesterol, blood pressure, and smoking habits are the best predictors of having a heart attack at this time. There is some evidence that people who have NORMAL cholesterol may have increased natural inflammation in their arteries, and possible new markers to assess whether or not checking additional blood markers will be valuable for assessing risk of a heart attack. (specifically, high-sensitivity CRP blood test) However, there is very little guidelines on how to use this information, and much of it is still experimental.

A baseline EKG for your physician to have is usually helpful in case you have symptoms.

Zed, I am very glad that you went to the hospital. Sounds like you had a life-changing experience and I am happy you got the treatment you needed.

I would say to most people on this thread, though, that the title of this thread should be changed to "Going to the ER when you have chest pain can save your life." The fact that you sought medical care is what saved your life. A CT scan would never have been performed for you during a routine physical exam- because if we irradiated everyone, regularly, "just to see," to check their hearts on a cardiac CT, we would cause a lot more harm than good. In the absence of symptoms, a cardiac CT just isn't that useful. Contrary to public belief they do not predict risk of heart attacks in the absence of symptoms. They do not show "plaque buildup" in any manner that will predict heart attacks in symptomless patients. There is some research now about how valuable a calcium score is for predicting heart attacks. Right now, that answer is unclear. So if any of you go and want to spend some $$ on getting a calcium score, you're welcome to, but most physicians will not change their medical management on a calcium score. If you really want to have your heart looked at, you need an angiogram and a pretty good reason, unless you've got $$ just lying around to pay for it yourself.

The bottom line is, we all are dealt the genes we've got. Eat healthy, don't smoke, minimize your stress, and know what diseases your parents have. See your doctor for annual checkups. Beyond that, demanding CT scans are pretty much a waste of medical $$ and limited resources.

Be well,
JW

PS-- John Langston: don't hesitate to ask questions to your docs. If they laugh at you, fuck 'em, find one you like. It's a good idea to start seeing a doc at least every other year after the age of 25. You want someone who actually KNOWS you, and whose advice you trust. Regular skin checks for cancer are not inappropriate at all, especially spots that you think may have changed. That is standard for a physical exam. In terms of your heart, as I tried to say before, a lot of "heart tests" aren't all that useful in predicting heart attacks. Tim Russert had a normal cardiac stress test the week before he died. It wasn't incorrect, it's just not a perfect test. There isn't one. So the best thing you can do, is have your blood pressure checked, and your cholesterol checked, and if you have a history of family heart disease, find a cardiologist to see at a younger age.

John L-

You should make an appointment with a dermatologist to get a skin cancer check. It can take a long time to get an appointment with a dermatologist, depending on your insurance, etc.

A good dermatologist will look EVERYWHERE. Not just at your face and forearms. If they don't give you a thorough check, find a new dermatologist.
Do this yearly, or at least every other year. Skin cancer can kill you, so thats not paranoid at all.

JW
Good advice. I've been lucky enough to have been seeing my family
practioner since 1984. Now I'm just worried when he's going
to retire. I don't always like his advice, but he's pretty much on the money.
Just like your comments were.
Thanks

And Zed, it's good you're doing well.

My CAT scan only proved an obvious fact. I have no brain.

yup Lee no brain there, but damn you have a lot of dental work.

The problem is that they were looking too far north for it.