Despite all efforts, heart disease continues to be the No. 1 cause of death in the United States.

More than one and a half million Americans suffer a heart attack each year, putting the patient at a risk of death or a repeat heart attack.

While heart attacks themselves come on suddenly, they are the result of a process that takes years to develop. Over years, a person's blood vessels may become hardened and narrowed as a result of cholesterol and other fatty build ups. When blood flow is completely blocked -- usually in a vessel that brings blood to the heart -- myocardial infarction, or a heart attack, occurs.

Oftentimes, the signs a person is going to have a heart attack will manifest themselves days or even weeks before the attack occurs. Nausea, indigestion, unexplained arm pain, fatigue, shortness of breath and a general feeling of illness are some of the most overlooked signs of an impending heart attack. If a patient is feeling a painful, full or squeezing pain in the chest, they could be having a heart attack and 911 should be called immediately.

There are a variety of tests that can be performed on a patient to determine if the vague symptoms they are feeling are indicative of an impending heart attack. An electrocardiogram (EKG) is usually the first test a cardiologist will perform. This test records the electrical activity of the heart over time.

A standard coronary CT angiogram is a heart imaging device to non-invasively determine whether fatty deposits or calcium deposits have built up in the coronary arteries. An iodine-containing contrast dye is injected to help doctors read the images. During the 10 minute test, slices of X-ray images are taken of the heart to give doctors a better look at the heart.

A newer, low-dose coronary CT angiogram is now available to give doctors an even better look at a patient's heart. In five to 10 seconds, thousands of X-ray images are taken of a patient's heart from just about every angle. Doctors take the three-dimensional dataset of the detailed pictures, input them into a computer, which generates a 4-D image for the doctor to see.

According to Daniel Berman, M.D., director of Cardiac Imaging at Cedars-Sinai Medical Center in Los Angeles, it images areas of the heart fast enough that doctors can get stop-action images of the coronary arteries.

This is important because, unless the heart is stopped and the body is connected to a heart-lung machine, a patient's heart constantly moves as it beats. As it moves, images of the heart can be distorted or not capture all of the imaging for a proper diagnosis and treatment. The low-dose CTA uses 75 percent less radiation than traditional CTA scans, making it a great option for asymptomatic patients concerned about radiation exposure.

In March 2008, Medicare agreed to provide reimbursement for CTA scans, making it available to more patients. Many insurance companies will also provide coverage for the scan. If a patient is not covered and still wants the test, he or she will have to pay between $1,000 and $1,500 for the test.

Additional Resource:

Cedars-Sinai Medical Center
Patient Information Line
(800) 233-2771