Heart disease often develops silently over many years, and waiting for symptoms to appear can be dangerous. While many people focus solely on cholesterol numbers, experts say it’s important to go beyond routine blood work to gain a complete understanding of heart health.Cardiac surgeon Dr. Devi Prasad Shetty highlights the tests that can uncover hidden risks before they become serious.Why Blood Tests Alone Aren’t EnoughWhile blood tests provide information about cholesterol and other markers, heart damage can start long before these results indicate a problem. Imaging and functional tests such as an echocardiogram or CT scan reveal the heart’s structure and arterial health, helping detect plaque buildup or early signs of cardiovascular issues.Dr. Devi Prasad Shetty in an interview with CNN News18 said, “Apart from the blood tests, they should go for an echocardiogram of the heart, they should go for the Electrocardiogram (ECG), and a CT angio or a calcium score at least, a CT scan of the heart in simple terms to know whether the abnormal cholesterol has affected the heart,” Dr. Shetty explains.What Is an Echocardiogram?An echocardiogram, or echo, is an ultrasound test that uses sound waves to create real-time images of the heart. It allows doctors to evaluate the heart’s structure, function, and blood flow. This noninvasive procedure can help diagnose and monitor conditions such as valve problems, damage from a heart attack, or congenital heart defects. A probe is placed on the chest to capture echoes from the heart tissues, explains Mayo Clinic.What Is an Electrocardiogram?An ECG, or Electrocardiogram, measures the heart’s electrical activity. It records signals that indicate heart rate and rhythm and can help detect heart attacks, arrhythmias, and an enlarged heart, according to Johns Hopkins Medicine.What Is a CT Angiogram?A CT angiogram is a non-invasive scan that combines a CT scan with contrast dye to create 3D images of the heart’s blood vessels. It helps identify narrowed or blocked arteries that may cause chest pain or other symptoms. Patients lie on a table that slides into the scanner while receiving a contrast dye injection and holding their breath when instructed. This test can also determine whether a patient needs a more invasive coronary angiogram, which can be used for both diagnosis and treatment.Additional Screening With Carotid DopplerDr. Shetty also recommends carotid doppler scans to assess arterial health. “If it has affected the heart, we can do a carotid doppler to find out whether it has affected the arteries. If the arteries are all clean, if the heart is clean, of course we should do everything possible to reduce the cholesterol,” he says.This test examines the carotid arteries in the neck, which supply blood to the brain. Early detection of narrowing or blockages can prevent strokes and other complications, giving patients an opportunity to manage risks proactively.Lifestyle First, Medication LaterWhile testing is crucial, Dr. Shetty emphasizes that lifestyle changes should come first. “I would not go to the extreme form of very high dose of all these medicines and starting the medicine from day one, first get lifestyle modification, dietary changes, weight loss and if all the thing does not work, maybe they can start with a small dose of lipid lowering drugs to see whether it will make a difference,” he says.Maintaining a heart-healthy diet, staying active, and managing weight can have a significant impact on cholesterol levels and overall cardiovascular risk.Early Detection MattersDr. Shetty stresses that coronary artery disease begins much earlier than most people realize. “We are not very aggressively following up with this lipid lowering strategy because patient at the age of 50 has not developed any damage to the coronary arteries, very very unlikely that they will develop from beginning at the age of 50, very unlikely. Coronary artery disease always starts at a very very young age.”The key takeaway is clear: don’t wait for symptoms. Early screening with targeted heart tests, combined with lifestyle management, can significantly reduce long-term risks and help maintain a healthy heart well into later life.
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