Technology is advancing quickly, and one of the biggest benefactors to that rapid change is health care. In fact, new imaging technology is allowing cardiologists to get a closer, more detailed look at CT angiograms to help determine how to treat coronary artery disease.
The new imaging technology is called HeartFlow, and it allows physicians to determine more easily if a patient needs an invasive procedure to clear blocked arteries or if a non-invasive treatment, such as medication, would work. Since 2018, more than 15,000 people around the world have used it, and it is offered in select locations throughout Banner Health.
目前，横幅 - 凤凰城大学医学中心和格里利的北科罗拉多医学中心有心脏流。Cecilia Hirsch, MD, is a cardiologist at Banner Health’s North Colorado Medical Center, and she helps us better understand coronary artery disease and HeartFlow.
什么是冠状动脉疾病？
Dr. Hirsch explained that coronary artery disease is when the arteries that supply blood to the heart begin to get clogged with fatty and calcified deposits. This puts people at risk for heart attack and other forms of other heart disease.
While many people who have coronary artery disease will not have symptoms, some might. According to Dr. Hirsch, the most common symptoms usually happen when a person is exercising. These symptoms can include:
- Pain, pressure or discomfort in the center of the chest
- Pain, tingling or discomfort in other parts of the upper body, such as the arms, back, neck, jaw or stomach
- 呼吸急促
“Some patients with CAD can present with a heart attack or even sudden death as initial manifestation of the disease,” Dr. Hirsch said.
And, while coronary artery disease is often used interchangeably with coronary heart disease, or CHD, they are different. In fact, CHD is usually the result of CAD.
Who gets CHD?
正如Hirsch博士指出的那样，CHD是发达国家死亡和残疾的主要原因。实际上，它负责35岁以上的人中大约三分之一或更多的死亡人数，这表明，在美国，所有中年男性中有超过一半的中年妇女将发展一些冠心病的形式。
对于美国妇女来说，CAD是最常见的死亡原因。绝经前妇女很少患有冠状动脉疾病，例如心脏病发作和猝死，但绝经妇女的风险大大增加。
赫希博士说：“妇女经常担心随着年龄的增长，尤其是乳腺癌，尤其是乳腺癌。”“但是，与乳腺癌相比，许多女性死于心脏病。”
实际上，妇女中约有五分之一的死亡是由心脏病引起的。疾病预防与控制中心。
为了检测CAD，您的医生可能会订购心电图或心电图，该图测量心脏的电活动。可能使用的其他测试包括：
- Stress test—an exercise treadmill test
- Exercise or pharmacologic stress test combined with imaging, such as the nuclear stress test, echocardiogram or an MRI
- Cardiac catheterization或冠状动脉造影，涉及将细管插入前臂的径向动脉并将其引导到心脏附近
如果医生确定您患有CAD或表现出症状，他或她可能会选择使用心脏计算机断层扫描（CT）血管造影，这是一种旨在检测明显的冠状动脉狭窄的新测试，这意味着动脉狭窄。CT血管造影是一项测试，使用X射线来提供心脏和血管的详细图片。
使用CT血管造影，医生可能需要用心流进行分析，但这通常仅在20％的病例中发生。
什么是心脏流？
Hirsch博士说：“ HeartFlow是一项新技术，它使对患者的心脏问题进行测试的过程更容易。”“它可以提供有关患者心脏中血流的信息，并确定患者是否需要根据收集的图像继续进行更具侵入性的心脏测试。”
如果CT血管造影显示在30 - 70%之间narrowing of the artery, the images are sent to HeartFlow for a detailed analysis. HeartFlow analysis helps determine which patients would need to have an invasive coronary angiogram or cardiac catheterization done. Studies have shown that, in cases where HeartFlow is used, 45 to 50 percent of patients did not need to have an invasive procedure done, which avoids having unnecessary procedures.
And, keep in mind, HeartFlow is used only in non-emergency cases of chest pain.
Hirsch博士说：“医生建议患有与胸部不适有关的症状，胸部紧绷或其他可能的心脏问题迹象的患者进行心脏流量。”
How is CAD treated?
Dr. Hirsch noted there are a few ways CAD can be treated. First and foremost, lifestyle changes could be in order. According to Dr. Hirsch, these might include:
- If you smoke, quit
- 通过吃更多的水果和蔬菜并避免吃很多糖的食物来吃心脏健康的饮食
- 如果您超重，请减肥
- 锻炼 - 在一周的大部分日子里散步或进行某种形式的运动
“Lifestyle changes also help prevent coronary artery disease,” Dr. Hirsch said.
此外，还有一些非常重要的药物。赫希博士说，其中一些药物降低了心脏病发作的风险，可以帮助人们寿命更长。这些药物包括：
- Statins, which lower cholesterol
- 降低血压的药物
- Aspirin or other medicines that help prevent blood clots
- 治疗糖尿病的药物
- 治疗心绞痛的药物：硝酸盐，β受体阻滞剂等
In some cases, certain procedures may be needed to help improve the flow of blood to the heart, such as stents or bypass surgery of the blocked arteries.
如果您在胸部中心感到任何疼痛或不适，呼吸急促或疼痛以及身体上部刺痛，schedule an appointmentwith your doctor right away. If you believe you are having a heart attack, call 911 or get to an emergency department immediately.
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