Heart Disease Hot Spots

Sixty-four year old Victor Hade has done everything right.
He quit smoking, controls his cholesterol, and eats sensibly.

But after five angioplasties and bypass surgery he is still plagued by heart disease.

Victor's condition is a mystery to cardiologists who are now taking a fresh look at the underlying causes of heart disease.

They believe that the real culprit in heart attacks, may be inflammation in the arteries, reports CBS News Correspondent Elizabeth Kaledin.

The body uses inflammation to attack disease and to fight artery blockages that are caused by high cholesterol and smoking. Doctors say arteries are most likely to rupture in areas where inflammation is greatest.

"The big dilemma in cardiology today is whether inflammation is the chicken or the egg. In other words, is the inflammation a separate risk factor in addition to the other ones or is inflammation the way the other risk factors channel their damaging effects on to the artery walls," says cardiologist Dr. David Vorschheimer of Mount Sinai Hospital.

The other dilemma is how to find inflamed arteries before they cause trouble.

Cardiologists Dr. Ward Cacssells and Dr James Willerson believe they may have figured that out.

"We had this simple idea that an inflamed area would be hot," says Dr. Ward Casscells, Chief of Cardiology, at University of Texas' Medical School.

They followed a hunch and found that inflamed arteries were one to four degrees warmer than healthy arteries.

"We reason that the detection of this temperature difference will allow us to predict the arteries at risk to rupture, leading to heart attacks and strokes," says Dr. James Willerson, director of the Texas Heart Institute.

It may sound like a simple technique, but taking the temperature of arteries is not a simple process.

Researchers at the Texas Heart Institute have developed two devices which they hope can one day be used on humans.

A catheter can be wired into the artery and expanded to measure temperature. Another device uses infrared technology to potentially give doctors a look at what's hot and what's not.

"We really have not had any other way to detect vulnerable plaque with certainty to date," says Willerson.

Using catheters to pinpoint inflammed arteries is still years away, but doctors hope it will eventually open a new frontier to fight the nation's number one killer.