Health Check for Cardiovascular Diseases

Dr. WONG Yiu Tung, Anthony

Specialist in Cardiology

There are many risk factors contributing to cardiovascular diseases, some of them are non-modifiable, such as old age, gender (i.e. male), a family history of premature heart disease etc. Others are modifiable, e.g.  obesity, smoking, hypertension, hypercholesterolemia, high-fat diet, diabetes, lack of exercise, anxiety, etc. Recent researches have shown that patients having kidney failure, chronic inflammatory conditions (e.g. rheumatoid arthritis and systemic lupus erythematosus) or premature menopause also have a higher risk of developing cardiovascular diseases.

Symptoms

The most common symptom of cardiovascular disease is chest pain. Patients may experience a squeezing sensation or heaviness in the chest, often triggered by physical exertion or emotional unset or excitement. The pain typically lasts from a few minutes to half an hour. One usually is symptom-free when calm or at rest. In some cases the pain may radiate to the chin, neck, jaw or shoulders.

Chest pain, shortness of breath and fatigue during exercise are symptoms of inadequate blood supply to the heart. This could also lead to arrhythmia causing palpitations, irregular heartbeats, or even fainting episodes. One should consult a cardiologist if any of the aforementioned symptoms occurs.

Diagnosis

A basic cardiac check-up typically includes a resting electrocardiogram (ECG) and an exercise ECG which is effective in detecting myocardial ischaemia. However, results of these basic examinations may not exclude heart disease if one is experiencing typical chest pain symptoms. In such cases, doctors will order further heart tests such as echocardiogram to assess heart function and structure as well as to detect heart valve diseases. Furthermore, CT coronary angiogram may be performed to evaluate blockages in the coronary arteries, while Holter study could detect arrhythmias.

When severe coronary artery blockages or myocardial ischaemia are suspected, doctors may arrange conventional invasive coronary angiogram to further assess the severity of the condition. This allows for both diagnosis and potential treatment (coronary stenting) to be performed in one go. Furthermore, depending on individual’s condition, nuclear medicine or cardiac MRI scans may be arranged to provide further diagnostic information.

Blood tests can help accessing risk factors of cardiovascular diseases, including hypercholesterolemia, diabetes, and kidney function. Nowadays some health check-ups also include more advanced tests like lipoprotein (a), ApoB, hs-CRP, etc., whose higher values may indicate an increased risk cardiovascular diseases. You may consult your doctor for more detailed information about these tests.

For patients with severe coronary artery disease who need to be put on an anti-platelet, a complete blood picture test is usually ordered to rule out platelets disorders or anaemia before prescription.

Health Checks

The American Heart Association (AHA) recommends that cardiovascular risk assessment should begin as early as the age of 20, mainly to look for inherited genetic condition e.g. familial hypercholesterolemia. Those with normal results are recommended to have another basic body check-up 4 to 6 years later. And for individuals aged above 40, cardiac assessments are recommended every 2 to 3 years. For patients who are diagnosed to have coronary heart disease, especially those who need long-term medication control, should have regular follow-ups every 3 to 4 months to monitor the progress.

A healthy lifestyle is crucial in maintaining a healthy body weight so as to prevent cardiovascular diseases. This includes a diet that is low in sodium, saturated fats/trans fat and carbohydrates; and at least 30 minutes of moderate aerobic exercise every day. No smoking, limited alcohol consumption and a happy mood can also keep your heart healthy.