Heart Screening

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Heart Screening

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We have been told for decades now that detecting cardiac disease early is better than waiting for symptoms to appear, which on the surface sounds reasonable. However, years of experience belies this supposed axiom, and in fact some screenings, in the guise of “early detection,” can be downright dangerous.

For example, cardiac screening tests offered in physicians’ offices, standalone centers and mobile vans – including carotid ultrasounds, cardiac CT scans, and coronary calcium scans – are better left undone. There is no data to show any improved outcomes from these tests, but they carry demonstrated risks of serious harm.

The harms include incidental findings that are common on such tests. These are things like cysts or nodules that are not clinically important but once seen on an imaging test lead to a recommendation for more imaging tests, or biopsies or even surgical removal. In addition, there is anxiety associated with such findings.

The cardiac CT scan and coronary calcium scan both have radiation exposure which increases lifetime cancer risk. Ten years ago it was estimated 2% of all cancers in the U.S. were from CT scans. That number is even higher now.

There are even downsides to a normal or negative screening test, as many people feel (falsely) reassured and slack off of lifestyle measures, such as healthy Mediterranean-style diet, regular physical activity and not smoking. Those choices actually prevent heart disease, and should be followed by everyone, regardless of what screening tests reveal.

In addition to preventing a heart attack, these healthy lifestyle measures will significantly reduce your risk of cancer, arthritis, and even memory loss. Not surprisingly, these steps are also strongly associated with living longer, feeling better and have no harmful side effects.

No cardiac screening test can make any such claims. When a test has no known benefit, even a small risk of harm tips the balance. Contrary to popular belief, a test can hurt. They are no guarantee that you will not have a heart attack. And whatever they show, they shouldn’t change your commitment to living a healthy lifestyle. That’s the best way to feel good and stay well.

Source: Rita Redberg, Why I’m Wary of Many Cardiac Screening Tests, The Wall Street Journal, July 1, 2016.

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Last Updated : Thursday, December 10, 2020