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Heart Health: Testing for Heart Disease

If you get nothing else from this post, take this: Determining your heart health takes more than a cholesterol test. That one well known test is just not enough, and since for some reason the general medical profession seems to be behind the curve, it’s probably going to be up to you to keep your heart and vascular system pumping at full flow.

We’ve been discussing clogged arteries for the past few weeks, since Dave’s quadruple by-pass surgery February 23rd, and to wrap things up for this round, let’s look at the routine tests we should all get, and for those with heart failure symptoms, let’s take a glance at the path Dave’s heart treatment took.

There are too many variables between all of us to make an easy checklist. We each — individually — need to walk through the process and stick with it until we’re satisfied with the answer. Your doctor, assuming you even have one, does not have time to monitor your compliance, and, in fact, may not even know some of what follows.
Here’s how to get started.

The basic fasting (fasting… this is important) lipid panel includes cholesterol, LDL/HDL and triglycerides. Interesting, but not nearly enough.

Add to that:
VDL cholesterol
Cholesterol subparticle size
Homocysteine
LP(a)
IDL
C-Reactive Protein
Fibrinogen

The specifics of the above are developed more in this post on inflammation and oxidation. I know this looks like a bunch of gibberish, but it’s likely only one or two will be elevated, and you’ll only need to research those. You don’t need to become a lab tech to understand the basics that effect you.

Also check:

Blood pressure

Glucose (fasting)

Insulin (fasting)

Iron (serum iron, TIBC & serum ferritin)

You’ll want to specifically request that a copy of the the lab report be sent to you; this isn’t automatic, for some reason that I can’t imagine. The point of the entire effort is for you to have the results to comb over (don’t fret, the report will show both your results, plus ratings for low, desirable or high ranges to gauge them against), and to have for later comparisons. Don’t simply get the blood test and count on your doctor to call you to tell you to take a B vitamin. That probably isn’t going to happen; you have to follow through.

While Dave’s clogged arteries were fixed by the surgeon, the underlying problem remains. Bottom line: the replacement arteries will clog if his blood oxidation and inflammation are not lowered.

There were only two dings on Dave’s blood test results over the years: ultra-dense LDL subparticles and an elevated CRP of 4. He took high-dose niacin for several years to address the LDL subparticles, but unfortunately, we didn’t understand the C-Reactive Protein elevation and didn’t research or tackle that. In hindsight, there’s no way to discover if changes over the past few years would have kept him off the surgeon’s table.

He’s now backed off the milkfats and lowered his beef intake to see if that will bring the CRP back in line. Because he’s coming off artery by-pass surgery, we both feel it’s warranted to protect the replacement arteries by taking a statin, Vytorin, which he hasn’t taken in the past since his earlier cholesterol readings have always been quite low. With his doctor’s knowledge, I suspect he’ll test his cholesterol without the statin sometime later this summer to see if his new fish-over-beef diet changes things.

If you do take a statin, please please please take a high dose CoQ10 supplement. Throughout this recent process I haven’t heard a doctor or nurse mention that, so I suspect yours hasn’t either. Statins blunt CoQ10 in the same way they work on cholesterol, and if nothing else, lack of CoQ10 will sap your energy and make your muscles ache. Bad juju.

Dave takes 450mg of Now Foods CoQ10 daily, without fail, and he takes an NSP B-Complex to lower oxidation and clotting.

Tip: Donate a pint of blood quarterly to lower your fibrinogen and remove excess iron.

Your doctor can order these blood tests, but in some cases you’ll have to be persistent. In fact, many of these tests aren’t on the lab sheets, and your doc will have to look up the codes to get the orders right. Here’s a further discussion of these lab tests at Genova Diagnostics.

You youngsters may feel immortal, but I’ll betcha in 20 years you’ll be real happy to have a baseline report for comparison, assuming there’s nothing drastically wrong that needs life-extending attention.

Now then, let’s get serious. Are you having trouble right now?

If you have shortness of breath regularly, which is what got Dave moving toward his recent surgery, or find you need to elevate your upper body more in order to sleep, get yourself to a cardiologist and walk through the test procedures. (If you have chest pain, use the emergency room instead!) The full gamut took Dave about two months — go here, go there, come back next week — just put your head around it and get ‘er done. It may save your life. Well, I mean, you’ll still die eventually, but hopefully when you’re closing in on a hundred instead of next year.

Exercise Stress Test (basic or advanced if possible)

Radionucleide Stress Test

Echocardiogram (ultrasound view of the heart chambers, valves and lining)

Electrocardiogram (EKG) (looks at heart rhythm)

Holter Monitor (24-hour EKG used to watch heart during normal activities)

Chest X-ray (checks for heart size, fluid in the lungs, pneumonia and other causes of shortness of breath)

Cardio Catheterization — angiogram (the most invasive of the tests, uses a thin catheter tube into blood vessel to inject dye seen on an x-ray — stents may be inserted at the same time if needed)

Brain natriuretic peptide (BNP) (used to determine if you have heart failure)

Signing off for this session. That should be enough to get you started on your path to good heart health and cardiovascular immortality.

14 Responses to 'Heart Health: Testing for Heart Disease'

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  1. Anonymous said,

    on March 28th, 2007 at 7:35 pm

    Dave and Laree, You are right on and I hope this saves a few lives! I have heard more and more that low cholestrol does not mean you are out of the woods and the test you mentioned are all important. Thank you both and Gods speed! Bill Cullen

  2. Anonymous said,

    on March 28th, 2007 at 11:45 pm

    Excellent summary Laree!

  3. Carrie Franklin said,

    on March 29th, 2007 at 6:51 am

    Thank you for the information, Laree, and for giving us a list to take to the doctor. Since I have heart disease in my family, I’m going to print this out.
    Carrie

  4. Mike Montague said,

    on March 29th, 2007 at 9:53 am

    Dave and Laree,

    As I sit at my work station, dining on a salad, hard-boiled egg whites, pineapple chunks, yogurt and green tea, having read the volumes that have been spoken in such few words, I ponder if these few words will reach the masses that could benfit the most from them, those within and without the medical profession, whether they are doctors or nurses or patients, all can learn and benefit from them. I know, that now armed with the information above, I can take further charge of my own health destiny, and be better informed about the choices that I make and the advice that my doctor gives.

    Thank you,

    Mike Montague

  5. Jim Wilson said,

    on March 29th, 2007 at 10:57 am

    Testing is very important. I go twice a year for regular followup visits with my heart doctor and I am tested via excercise and nuclear stress test. I also get copies of my blood tests so that I am also in control of my body. One of the biggest things to do is to communicate with your doctor. Do not be afraid to ask questions.. You know yourself better than anyone else.

    Keep Moving and God Bless

    Jim Wilson

  6. Jim Ganley said,

    on March 29th, 2007 at 5:36 pm

    Not to cast aspersions on all of this comprehensive information, my older brother had been a “hospital hobo” for the past several decades. Under the care of a cardiologist he went regularly for tests, was given a veritable pharmacopea of meds, but never a diagnosis. At Christmas he began to cough up blood, and was airlifted to Dartmouth-Hitchcock Medical Center where they determined he was suffering from small cell carcinoma of the left lung. The cancer was untreatable because they also determined that he had aoritic stenosis and a defective valve……something all of the testing done by his cardiologists failed to find. He died two weeks ago at age 77. No one in here gets out alive. Be careful out there.
    Jim

  7. markie-mark said,

    on March 29th, 2007 at 5:38 pm

    I’m 44 Bomber and thinking, all my milk intake could
    do me in artery wise, and have to get the quaddie.
    Like you I’m on the fence about milk. I love the stuff
    with my protein powder, or my natural peanut butter and banana sandwiches. Yeah,Yeah, I should
    cut it out all together.

    But I guess the most important thing is you’re back in the pink Dave. By the way I liked the picture of you
    and Bill Pearl talking away. Keep up the workouts and your online success in the fitness game.

    Markie–Toronto Canada

  8. Tim Engel said,

    on April 3rd, 2007 at 3:00 pm

    Hi, Dave and Laree – just curious. Is it still considered OK to take desiccated liver as a lean muscle building supplement? Or would it lead to excess iron problems?

    Thanks.


  9. on April 9th, 2007 at 8:21 am

    […] –A long and detailed post by Laree Draper about testing for heart health. This is a compelling subject for her because Dave Draper (her husband, and a great guy to read on anything to do with weightlifting) just had quadruple-bypass surgery. Testing for Heart Disease […]

  10. Dawn said,

    on May 3rd, 2007 at 10:03 am

    I have a question for anyone who might know — Recent lab work shows I have high LDL and borderline high total cholesterol, and given that a family member died at 56 of sudden heart failure, the doctor is recommending a Radionucleide Stress Test. Are there any downsides/possible complications from taking this test (ie. putting radionucleides into your body)?
    Thanks – Dawn

  11. ldraper said,

    on May 3rd, 2007 at 12:11 pm

    Dawn, Dave had that done; no downsides that I know of other than it not telling the full story. Did you get the full list of blood tests done? That’s much more important than LDL cholesterol, and will tell you more than an RST.


  12. on September 10th, 2008 at 9:41 pm

    Iam 49 yrs. I have been told by my Dr. that Iam in stage 3 kidney failure. My GFR est. is (41) my creatian can range from 1.3 to 1.7 My ALT(SGPT) is 71H my ASTT (SCOT) is 54 my BUN is (18) H My A/G ratio is 1.1 my MCH is 34 low my Glucose is 139 high myCRE-s is 1.36 high my BILIT is 0.2 low my AST is 43 high my ALT is 54 high I realize that the standard of ranges vary. I recently went to the E.R. with chest pain that had been going on for the past 3 yrs.nothing major although a little scary, Dr. said it`s stress. Ok very possible! It was also 3 years ago I was told I was in stage 3 kidney failure. Anyway back to the E.R. pretty much all the above was unchanged, but my Troponin I was High o.140 and my Ckmb was 12.40 high total CK was 929 high norms were (21-215) I was told only to see a cardio. whenever I could. No rush! so I guess I am fine. During the past 3f months my left arm has been numb and pain to my elbow. shortness of breath and a little heavy on my chest. Stress? I don`t know, although I have enough to go around. for sure! My chest pain ahs been getting a little worse sometimes a little scary now. In the E.R. the Dr. put me on blood pressure med. blood pressure was high and had been high at home and at Dr. office. This is 2 months later I have an appt. to see cardio. first of Oct. The Dr. in the E.R. acted like no big deal. The EKG by the way was fine. but when your walking out of the hospital doors to go home within 4 hr. still having same symptoms. Something just didn`t feel right? Just me! Stress Ha Ha! I must be crazy to be concerned. I seem to be the only one. My M.D. does not seem to be to concerned either. Really Iam scared to death inside.

  13. John Greathouse (aka RxBlaster) said,

    on August 9th, 2009 at 6:11 am

    Excellent overview of what to do, what to avoid and making folks “aware.” As a pharmacist, I often counsel patients on the same types of things, trying to get people into the doc when they should, working on their diet and watching for problems and when to do something about it. But alas, we cannot reach everyone! It’s good to see another voice out there reaching a few (or rather many) more.

  14. Ray Rod said,

    on May 27th, 2011 at 5:39 pm

    Laree:Phenomanal advice.Thank you…………..

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