What are the screening options for heart disease?
Dr Paul Chiam discusses the tests physicians use to screen for heart disease
The simplest screening method involves a clinical examination and the analysis of the patient's history, Dr Chiam says. “From there we can assess how many risk factors the patient has and then create a general risk profile for that patient.”
Once that is done, we have to decide what needs to be done next, Dr Chiam says. The next simplest test in the office is a bedside ECG, or what we call an electrocardiogram. What the ECG does is it takes an electrical picture of the heart and from this ECG we can see many things - we can assess the heart rhythm, we assess the electrical stability of the heart, and in some patients we may even be able to see underlying heart artery blockages from previous heart attacks.
For patients who have chest discomfort but are not really sure whether the pain is due to heart blockages in the arteries or not, we can do a treadmill stress test. A treadmill stress test is the same as an ECG test, except the patient runs on the treadmill to stress the heart, to make it beat harder and pump faster. Then we see if there is any indication of any underlying blockage that may not be detectable on the resting ECG.
Another test that is very useful in the clinic is to do a heart ultrasound, what we call an echocardiogram. This is an ultrasound that looks at how the heart functions. “We can look at how strong the heart pump is, whether it’s normal, how thick or is there anything abnormal with the heart muscle, and also assess the valves, there are four valves in the heart, and only with the ultrasound can we really assess these valves in more detail," Dr Chiam says.
We also do a general assessment for the patient, whether he has any pre-existing diabetes, high blood pressure or cholesterol. We try our best to manage those conditions and bring the patient’s risk profile into assessment and control some of those risk factors.
Dr Paul T.L. Chiam is a consultant cardiologist with a subspecialty interest in interventional cardiology. He is in private practice at The Heart and Vascular Centre at Mount Elizabeth Medical Centre in Singapore and can be reached at +65 6735 3022.
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