Coronary scanner at the heart of cardiovascular prevention debates

Cardiovascular disease continues to be a major cause of accidents in our country, affecting not only an ageing population, but also an ever-increasing number of men and women under the age of 50. Prevention is undoubtedly the most convincing weapon on this subject, and the adage "prevention is better than cure" remains more relevant than ever.

How do you know if you're at risk of having a heart attack?

The coronary CT scan, which appeared over 15 years ago, has gradually established itself as an important examination in cardiovascular risk screening.




When no symptoms are complained of, i.e. when there's no chest pain, shortness of breath or malaise, the examination that may be suggested is called a "calcium score": it involves looking to see if there are any small calcified deposits on the arteries of the heart, known as the coronary arteries.
This information, known as the "calcium score", is collected by CT scan, without any needles or injections, in an examination that lasts just a few moments. All you'll be asked to do is not breathe for a few seconds.

From then on, if your calcium score is equal to zero, bravo, you have no coronary calcification, and your risk of having an accident is of the order of 1 per thousand! Incidentally, you may not be "eligible" for drug treatment, but this should be discussed with your doctor.

When the calcium score is higher, especially above 300, your doctor may prescribe other tests, and will certainly encourage you to watch your diet and your level of physical activity!
He or she will also take care to treat your "risk factors", helping you to stop smoking and normalizing your blood sugar, blood pressure and cholesterol levels where necessary.

If, on the other hand, you are experiencing certain symptoms - such as those mentioned above - it may be worth carrying out a CT scan, but this time with an intravenous injection of contrast medium..

This examination will identify the presence of calcified but also non-calcified deposits or plaque, and above all will show whether there are areas where the heart's arteries are narrowed, known as "stenoses", which would justify further examination. Generally speaking, the extent of deposits or plaques is the best predictor of risk, but we also take into account the existence of so-called "at-risk" plaques due to their particular morphology. In some cases, the presence of narrowings can lead to the placement of "stents" in the coronary arteries. Stents are small springs that restore the vessel's normal caliber.



Some very recent studies show that performing a "preventive" CT scan, combined with appropriate hygienic and dietary measures, leads to a significant reduction in the incidence of cardiac accidents.

This represents real progress in cardiovascular risk screening. Apart from stents, which are reserved for certain very specific cases, pharmacological treatments (drugs) significantly reduce the risk, but the prize goes to "hygienic-dietary measures", i.e. diet and physical activity which, if properly implemented, can halve the risk. Lifestyle is definitely in the spotlight!

Talk to your doctor if you have known risk factors (such as smoking, cholesterol, hypertension, stress, obesity, diabetes, menopause), a family history of coronary heart disease and/or cardiovascular warning symptoms.

In practice:
- The "calcium score" is recommended from the age of 35 if there is significant family heredity, and from the age of 50 in other cases. It's a bit like mammography, but for the heart!
- If there are symptoms such as chest pain, unexplained shortness of breath or loss of consciousness, a coronary CT scan with contrast injection will be very useful!