Little-used scan can find hidden heart disease
But other physicians say some of these tests
have not proved their value, and they cite the expense of widespread screening
programs in a time of rising medical costs.
About 1.5 million Americans
this year will not be as lucky as Clinton was. They won't get a warning sign —
allowing time to get to a hospital — before they suffer a heart attack. About
half of those will die.
Clinton appears to have never had the simple
$250-to-$400 diagnostic scan that the eradication association and others
advocate, although Walter Reed Army Medical Center, near the White House, has
been using such tests in middle-aged Army personnel for years, after finding
that traditional treadmill stress tests failed to identify many future heart
attack victims.
The scan, known as an electron beam computed tomograph,
or EBCT, probably would have detected the extensive plaque that lined Clinton's
coronary arteries, some cardiologists said. Aggressive interventions, such as
stents that open the blockages, could have been taken long before emergency
bypass surgery was necessary. Even if the measures couldn't have averted open
heart surgery, doctors would have been prepared, rather than surprised, to find
such threatening problems.
Some physicians are skeptical of the
scans, however. "There's cost and there's radiation, and we don't know how much
information it adds beyond traditional indications," says Dr. Lori Mosca,
director of preventive cardiology at New York-Presbyterian Hospital.
She
notes that the National Institutes of Health are sponsoring national trials
ending in 2008 that may show whether the test actually changed the fates of
those who were determined to be at high risk.
Many cardiologists have
complained that the scan isn't recommended to more Americans now. That is
changing slowly as the evidence supporting the benefits of the test becomes more
convincing and more medical organizations endorse its use. Earlier this year,
three studies published in leading medical journals, including the Journal of
the American Medical Assn., found the scans to be of benefit in detecting heart
attack risk.
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