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Heart Disease: Hidden Killer

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Many of the roughly 850,000 Americans who have heart attacks each year don't even know they're at risk until it's too late.

How is it that so many people are ticking cardiac time bombs and aren't aware of it?

In the conclusion of The Saturday Early Show's "Heartscore" series, medical correspondent Dr. Mallkia Marshall explains that physicians have tried over the past few years to drill the most common risk factors for heart disease into all of us. But, she continues, many people are still walking around with untreated conditions that put them at high risk for heart disease – conditions such as obesity, diabetes, high blood pressure, high cholesterol and smoking.

Part of the answer, Marshall observes, is that we're still not reaching a large percentage of the population with this important message. Another problem is that some people simply think they're invincible and that it may happen to someone else, but it won't happen to them. Another issue is that some of the conditions that raise your risk for heart disease are frequently symptom-free, such as high cholesterol and high blood pressure. And then there are people who do have symptoms consistent with heart disease, but are either in denial or unaware that these symptoms could herald a heart attack.

According to Marshall, warning signs include:

  • PRESSURE IN CHEST: When people think of someone having a heart attack, they often picture what is seen on TV -- a middle-aged man who suddenly clutches his chest in excruciating pain. Well, most heart attacks don't present that way. The most common chest complaint is pressure that feels like someone or something is sitting on the chest. It's often not painful; people will describe it as a nagging ache and will often blow it off as indigestion or gas.

  • SHORTNESS OF BREATH: Sometimes people who are at risk of heart disease experience bouts of shortness of breath, often at night. They wrongly attribute their breathing problems to something else, when they should be thinking about heart disease.

  • NAUSEA, VOMITING, AND ABDOMINAL PAIN: These are fairly common heart attack symptoms, but again are often confused with indigestion or stomach upset. So, if you're at risk for heart disease and develop these symptoms out of the blue, call your doctor.

    Also, symptoms of a heart attack in women may be very different from those in men, and as a result are often dismissed as being caused by something else. A woman who is having a heart attack may complain of symptoms very different from that of a man. She's more likely to report shortness of breath, nausea, palpitations, or feelings of anxiety, and not necessarily the chest pressure or chest pain that a man may experience. This makes it more challenging to diagnose heart disease in women, but fortunately doctors are being better educated on how to recognize heart attack symptoms in women, or at least not to blow them off as indigestion or stress.

    But if you do realize you may be at risk, there are some newer tests that can confirm or disprove it, Marshall points out. Among them:

  • CORONARY CT SCANS: This is a non-invasive way to check if you have plaque buildup in the arteries in your heart. It only takes about ten minutes and costs between $500 and $700. One drawback is that its results are negative in up to 10 percent of people who have heart disease.

  • ULTRASOUND: High resolution ultrasound is also non-invasive, fast, and relatively inexpensive. Ultrasound enables physicians to see the thickening of the arterial walls as plaque grows. But many experts feel further studies are needed to determine how effective high resolution ultrasound really is at predicting heart disease.

  • MRI: An MRI, or magnetic resonance imaging, gives doctors a very clear view of the blood vessel walls, as well as the plaque. It's not widely available yet, but that is changing.