A silent and not-so-silent killer

Published 1:12 pm Tuesday, March 21, 2023

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In June of 2022, I introduced Dr. Evans Kemp to the community as the Director of Cardiovascular Medicine at St. Luke’s—a new practice at our local hospital. I outlined the details of his world-class talent and experience, and your response has been overwhelming. Many of you have shared how impactful it has been for you to have access to exceptional cardiology right here at home. I also recently shared about the new GE Revolution Apex Elite Computed Tomography platform—our best-in-class CT scanner now available and the advancements it has brought to our community. 


We are now screening for coronary artery disease. This painless life-saving test would not be possible without Dr. Kemp and the Revolution Apex.

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Coronary artery disease affects the arteries that supply blood to the heart. This disease is the narrowing of arteries most often caused by plaque buildup, restricting your heart of oxygen-rich blood. The most common symptom of coronary artery disease is chest discomfort or pain called angina. Left untreated, CAD can lead to arrhythmia, heart failure, and heart attack.


Have you heard of the term silent killer? It’s not unusual to have symptom-free CAD for years and then, out of the blue, experience a heart attack. Our family experienced this phenomenon and perhaps someone in your family has as well. 


To hear Dr. Kemp’s analogy, “Heart arteries are like pipes in your house, which deliver oxygen-rich blood to your heart muscle. As clogs develop in your pipes that slow the flow of water, so does plaque buildup in your heart arteries, slowing blood flow. The slowing blood flow causes chest pain due to a lack of oxygen to the heart. However, if the drain becomes completely clogged, like when a plaque ruptures and forms a blood clot, the blood flow is blocked to the heart muscle, and a heart attack occurs.”


Unfortunately, coronary artery disease is common, with more than eighteen million adults in the U.S. afflicted and nearly 400,000 dying annually. Furthermore, coronary artery disease is the leading cause of death in the U.S. and worldwide for men and women alike. In the U.S., coronary artery disease affects 1 in 10 people between the ages of 40 and 80. In addition, one in five CAD deaths occurs in people under age 65.


In Stable Ischemic Heart Disease, coronary arteries narrow over many years. Your heart gradually receives less and less oxygen-rich blood. But because your symptoms are mild, you can live with the condition.


Dr. Kemp says, “the symptoms include predictable chest discomfort brought on by stress or physical activity. Remove the stress and physical activity, and the symptoms alleviate.” You may also experience shortness of breath, lightheadedness, heart palpitations, fatigue, nausea, and weakness.


Acute Coronary Syndrome is a life-threatening and sudden medical emergency. A plaque-narrowed coronary artery is suddenly blocked, obstructing blood flow and resulting in heart cell death—a heart attack.


The onset of symptoms associated with acute coronary syndrome often occurs without warning. It can vary based on the severity and location of the blockage, your age, sex, and underlying medical conditions. 


In men, chest pain can be aching, burning, heavy, numb, pressure, and tightness. You may also experience dizziness, excessive sweating, fatigue, palpitations, and upper abdominal pain that can be mistaken for heartburn.


Symptoms of acute coronary syndrome in women are often quite different. For example, women do not always experience chest pain but have pain that spreads through the neck, jaw, shoulder, and abdomen. In addition, women are more likely than men to experience nausea, vomiting, and shortness of breath.


If you are experiencing symptoms consistent with stable ischemic heart disease, please don’t ignore them. Addressing the symptoms sooner increases his ability to help you avoid an adverse cardiac event. For example, Dr. Kemp said, “With chest pain suggestive of ischemic heart disease, we can perform special testing such as stress test, CT coronary angiogram, and calcium-score screening.” With our new menu of cardiac testing, we can achieve up to 95% sensitivity and 99% predictive value for CAD detection. Dr. Kemp will evaluate the best testing for your situation, and with this kind of accuracy, we may avoid you needing an invasive heart catheterization. We know about 50% of all catheterizations nationwide are negative and ultimately unnecessary.


With Dr. Kemp coming on board, the establishment of our Echo-stress test lab, and our new GE Revolution Apex Elite CT coming online, your local options for world-class cardiac health have greatly expanded. Combining our talent and technology now gives you the best opportunity for successful diagnosis and treatment found anywhere in the region. And that makes my heart (and I hope yours) very happy!


Dr. Evans Kemp is located at St. Luke’s Cardiology at Foothills Medical Associates (828) 894-5627. To learn more about Dr. Kemp and our cardiology unit, visit, StLukesNC.org/heart