Why screen for cardiovascular disease (CVD)?

Despite tremendous improvements in our understanding of the underlying process of cardiovascular diseaseDisease of the heart and blood vessels, usually due to atherosclerosis. (CVD) if you have a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. there is still a 30% chance you won't survive. Professor Avijit Lahiri says early detection is critically important -  especially when you consider that almost 80% of heart attack victims have had “silent” heart disease for many years.

Diagnose your pain.

It’s vital to obtain an accurate and rapid diagnosisThe process of determining which condition a patient may have. of coronary artery diseaseNarrowing of the blood vessels supplying the heart muscle, leading to symptoms such as angina and sometimes to a heart attack or myocardial infarction at the outset. Chest pains are often the first telltale signs of CVD, however, in many instances the differential diagnosis of chest pain is elusive, leading to a large number of ‘false’ diagnosis, which creates a very significant impact on the NHS.

Stress Electrocardiography (ECGThe abbreviation for electrocardiogram, a tracing of the electrical activity of the heart to help in the diagnosis of heart disease.).

In the 1980’s Rapid Access Chest Pain Clinics (RACPCs) were set up in order to systematically evaluate patients and have now become a de facto standard of care within the NHS. The first test which is usually performed on patients presenting with chest pain is a stressRelating to injury or concern. electrocardiographyA technique for tracing the electrical activity of the heart. Abbreviated to ECG. (ECGThe abbreviation for electrocardiogram, a method of recording the electrical activity of the heart muscle. It is useful for diagnosing heart disorders.).

Leads are attached to your chest whilst you perform light exercise, usually on a bike or treadmill, to ascertain how your heart functions under stress.  The problem is that the results of Large Clinical trials suggest that incorrect diagnoses from ECG may run as high as 25%. Some patients are unable to perform enough exercise to allow an accurate diagnosis, others give false positive or false negative results.

Doctors are well aware of the shortcomings of stress ECGs. They frequently order subsequent tests such as coronary angiographyA technique for X-ray imaging of the coronary arteries, which involves introducing a catheter through a blood vessel and threading it towards the heart, then injecting a contrast medium to improve visibility. (CA) even when the stress ECG is normal. This has led to an increase in the number of coronaryRelating to the arteries supplying the heart itself. angiography procedures. Unfortunately, coronary angiography is an invasive and expensive procedure with a small but significant risk of major complications such as; death, heart attack (myocardial infarctionDeath of an area of heart muscle due to poor blood supply. This is commonly known as a heart attack. - MIMyocardial infarction. Death of a segment of heart muscle, which follows interruption of its blood supply.) and strokeAny sudden neurological problem caused by a bleed or a clot in a blood vessel.. This is clearly an unsatisfactory state of affairs, from both a clinical and economic perspective.

Click the link to read more about screening for cardiovascular disease.