By Brian Long, M.D.

Are you at risk for a heart attack? All too often, the number one killer of Americans strikes the least suspecting–those with few known risk factors. Such was the case for Scott Dannemiller, a forty-five-year old Franklin resident who was the picture of perfect health. The entrepreneur and father of two was a slim, avid runner with no history of smoking, high blood pressure or elevated cholesterol.

Following his father’s double bypass in June 2018, Dannemiller had a conversation with his dad about symptoms. “He’d had no indications, but felt like he’d pulled a muscle in his back,” Dannemiller explained. “That morning I went jogging and felt the same thing, but assumed it was all in my head.” Still, Dannemiller mentioned his concerns and change in family history during a follow-up visit to his family doctor. It was there that he learned of an affordable, non-invasive CT scan that measures calcified plaque buildup in his coronary arteries. Dannemiller paid the minimal out-of-pocket expense for his Cardiac Calcium Score at a local medical clinic. When calcium is present, the higher the score, the higher the risk of heart attacks in the long term. A score of 100 to 300 — moderate plaque deposition — is associated with a relatively high risk of heart attack or other heart disease over the next three to five years. Dannemiller’s score was 1,114.

“I went immediately and saw my dad’s cardiologist, who suggested we skip the stress test and go straight to the heart cath,” Dannemiller explained. The heart cath revealed several blockages, and Dannemiller underwent a quintuple bypass surgery in August. “It was only due to my family history that I was screened, and it was quick procedure and I was done,” said Dannemiller, who’s since become a vocal advocate for the low-cost heart scan. “That was a life saver, because at my age and in my health the first symptom is usually death.”

Brian Long, M.D., interventional cardiologist at Vanderbilt Heart at Williamson Medical Center, performed Dannemiller’s heart cath. He said the cardiac calcium score is an affordable, ideal test for someone who frequently worries about heart health, even if no symptoms are present. “For patients with a score other than zero, it’s empowering to learn they can take steps to fix their diagnosed heart disease,” Long said. “Otherwise they might not know until they’re having symptoms and it’s very serious.”

Screening for heart disease
Long said the cardiac calcium score is typically a minimal out-of-pocket cost, and is often available without a referral. It’s also low-risk, with little radiation exposure and no contrasts or IVs. He also recommends adults have a resting EKG (electrocardiogram) every few years. The resting EKG provides more information by allowing physicians to see the heart rhythm, electrical system and estimate the size of the heart.

Another common diagnostic tool is the stress test, which shows how the heart works during physical stress (exercise) and how healthy it is. A standard exercise stress test uses an EKG to monitor changes in the heart’s electrical activity. Imaging stress tests take pictures of blood flow throughout the heart. Long said stress tests are designed to evaluate symptoms and typically only reveal significant blockages, which means they’re not ideal for general cardiac screening.

If blockages are suspected, patients typically undergo cardiac catheterization. During cardiac catheterization, a long, thin tube called a catheter is inserted in an artery or vein in the groin, neck or arm and threaded through blood vessels to the heart. It’s a common, low-risk way for cardiologists to perform diagnostic tests, place stents and check for coronary blockages.

Fighting heart disease head on
Long encourages patients to adopt Dannemiller’s proactive approach to heart health: talk to someone. “If you’re concerned about anything, talk to your primary care provider,” he said. “Not everyone needs a specialist for screening or risk prevention. Just address it with someone.”

Dannemiller will undergo a stress test in March and yearly blood screenings thereafter, but maintains a positive outlook. “I’m fortunate they were able to detect and treat my heart disease so quickly,” said Dannemiller, who ran the five-mile Boulevard Bolt in Nashville alongside his wife at Thanksgiving. “I’m also glad I had something doctors know how to fix, because this was life threatening. I tell my friends to not put it off. Get scanned, because the more information you have, the better off you’ll be.”

About Dr. Long:
Brian Long, M.D., is an interventional cardiologist at Vanderbilt Heart at Williamson Medical Center. His office can be reached by calling 615.875.5337.