Two tests that ‘could end heart attack deaths’ 

Words: Natasha Robinson Producer: Bianca Farmakis

Virtually no one need die of an unexpected heart attack, two top cardiologists say, as they urge doctors to more frequently order two simple tests that can determine whether someone at high risk has plaque in their arteries.

In the wake of Shane Warne and Kimberley Kitching's deaths, cardiologists Brett Forge and Richard Harper AM are calling for widespread screening of those with risk factors to diagnose coronary artery disease and treat it before it results in a fatal heart attack.

The majority of heart attacks occur following prior symptoms of heart disease, but in 30 per cent of cases, fatal heart attacks occur without warning, as in the cases of Warne and Kitching.

“The thought that because [people are] fit and they’re doing extreme exercise that insures them against sudden death is a myth. But almost nobody needs to die unexpectedly anymore.”

Dr Brett Forge Cardiologist

Dr Forge said that everyone over 40 should be having heart checks, in which cholesterol and blood pressure are monitored. For people identified with risk factors, two scans can be ordered.

Coronary calcium score: measures calcium in the coronary arteries, which is caused by inflammation due to plaque and previous scarring. CT coronary ­angiogram (CTCA): uses a dye injected into the veins to highlight any blockages in your coronary arteries.

Coronary calcium scores are not reimbursed by Medicare and cost $70-120. CTCA scans are only Medicare-funded for those with suspected symptoms of coronary artery disease and cost up to $1200 if paying privately.

Testing capacity

Dr Forge says the two tests are not ordered often enough by doctors, despite how "effective" treatment is in preventing heart attacks. Forge says "people tend to focus on stents being the treatment, but it doesn’t fix the arteries".

Reversing damage

Heart disease can be reversed through a healthy diet, regular exercise, blood pressure control and management of cholesterol levels. "Bad" cholesterol should be kept below 1.8mml/L, and for people with plaque build-up, as low as 1.4mml/L.

Many cardiologists perform exercise tests, or order stress echocardiography or nuclear studies, but those tests in general only come back positive if the blockage in an artery is greater than 70 per cent — they cannot diagnose whether lesser degrees of plaque is present.

Professor Harper said the aim of treatment is to stabilise the plaque to prevent heart attack and sudden death. That was why it was so important to diagnose when plaque was present even in the absence of symptoms.