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"http://www.norwalkplus.com/nwk/information/nwsnwk/publish/News_1/index.shtml - News</head> : Local Published: Sep 4, 2008 - 6:06:02 AM


Norwalk Hospital offers latest advancement in detection of heart disease

By Norwalk Hospital


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Norwalk Hospital offers latest advancement in detection of heart disease
Norwalk Hospital has acquired a 64-slice Coronary CT (Computerized Tomography) Angiography in the Department of Radiology. From left are Dr. James Bauman, radiologist, and Dr. Alan Richman, chairman, Department of Radiology.
Norwalk, CT - Norwalk Hospital has introduced the latest technological advancement in the diagnosis of coronary heart disease with the addition of a 64-slice Coronary CT (Computerized Tomography) Angiography in the Department of Radiology. This has been made possible through the generosity of Mr. and Mrs. David Komansky of Westport who established the David and Phyllis Komansky Cardiac and Vascular Center at Norwalk Hospital. This non-invasive procedure provides vital information for disease management and is effective in the early diagnosis of heart disease, which is the number one cause of death in the United States, said Alan Richman, MD, Chairman of the Norwalk Hospital Department of Radiology.

"The science of imaging has exploded over the last few decades, and with the 64-slice Coronary CT Angiography, physicians can now 'see' the heart in a way that they never could before," said James Bauman, MD, Norwalk Hospital radiologist.

"With an injection of non-radioactive x-ray contrast (dye) into the vein, the CT can take images of the coronary arteries that have a remarkable similarity to conventional catheter angiography," he said. "The CT can do this in the time space of five heart beats and its sensitivity or ability to detect heart disease is 92 percent,' he added. Dr. Bauman said that most importantly, the "negative predicative value" or the ability to detect that there is no disease present is 99 percent.

The very high resolution of the 64-slice Coronary CT angiography allows accurate and detailed visualization of the heart vessels, including areas underneath the surface where atherosclerosis (hardening of the arteries) and plaques can occur.

Coronary CT Angiography is a non-invasive outpatient procedure which involves taking a beta blocker drug one hour before the exam to keep the heart rate slow and steady. EKG leads are placed on the patient's chest and x-rays, with minimal radiation exposure, are taken and displayed in 3-D. "Therefore, the angles and positions of the vessel under scrutiny are virtually infinite on the computer," said Dr. Bauman, adding that the "radiologist can determine how open or stenosed a vessel is, how much plaque has built up within the wall and estimate how much of it is calcified or non-calcified, which may be vulnerable to possible spontaneous rupture."

Risk factors for coronary artery disease include elevated cholesterol levels, high blood pressure, cigarette smoking, diabetes, family history, obesity, age and gender. The lifetime risk for coronary heart disease in men is 50% and for women is 33%, which is almost three times the risk for breast cancer. In addition, 50% of men and 67% of women who die suddenly from a heart attack have had no symptoms of heart disease.

The examination is valuable to individually evaluate a person's "risk" for a cardiac event. Most people have some of the known risk factors, such as a family history of heart disease, Dr. Bauman explained. However, a doctor may consider changing or increasing medications (such as
Lipitor) or recommend cardiac function tests if she/he determines that their patient's personal risk is 'higher' than originally thought, based upon this test, he added. "It can also be useful to determine if a person's symptom of "chest pain" is really heart-related or from some other cause, such as gastro-esophageal reflux disorder.

According to Dr. Bauman, this test is not for everyone. "Some people can't have x-ray dye because of their kidney function. Some people have irregular heart rates or have pacemaker leads that preclude us from getting a high quality study. Rarely people can't have beta-blockers because of allergy or very severe asthma. Your physician will know if you are an appropriate candidate for this examination."

"Norwalk Hospital has made this technology available and accessible because it recognizes its importance and the potentially life-altering effects on our community," he said. "The hospital has taken the lead to keep the cost at a minimum and to make it affordable even when third party insurers deny access to its members. While many institutions charge between $1,000 and $2,000 for this exam, Norwalk Hospital offers this exam at $850, and it includes reviewing the results with one of our specialists," he continued.

"Risk may be an inevitable part of life, but when we can get information and then make intelligent decisions based upon that information, we are fulfilling our obligations to ourselves and our families, Dr. Bauman said, adding that "We are pleased to be able to offer our community this advanced and potentially life-saving diagnostic technology at Norwalk Hospital."




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