Legacy Heart Center: The Pain You Don't Feel Could Kill You.

CT Scanner Speeds Early Detection and Treatment of Peripheral Arterial Disease

PLANO, Texas -- The ultra-fast computer tomography scanner (CT) is proving to be a new and effective tool for the early detection and treatment of a disease that has a mortality rate greater than coronary artery disease yet goes undetected in 80 percent of those who have it.

Peripheral arterial disease or PAD, which affects some 14 million Americans according to some estimates, has a five-year mortality rate of 30 percent -- greater than that for coronary artery disease and stroke -- yet fewer than 20 percent of people who have it know they do. Fully 25 percent of Americans over 65 suffer from the disease.

PAD, which is also referred to as "hardening of the arteries" is similar to coronary artery disease in that fatty deposits build up in the inner linings of the artery walls and restrict blood circulation, mainly in arteries leading to the kidneys, stomach, arms, legs and feet.

PAD develops slowly over many years and, in the early stages, most people have no symptoms. By the time the symptoms appear, the arteries are so clogged that sufficient oxygen can't reach their leg muscles, causing increasing pain.

"Traditionally, we have relied on an escalating series blood pressure, ultrasound and imaging tests to diagnose and treat PAD," explained Jose M. Rivera, M.D., F.A.C.C., a cardiologist at Legacy Heart Center here.

"But since most people who have it exhibit no symptoms and many who do -- by some estimates three to four million -- are misdiagnosed, too many people are not getting the treatment they need," he said. "The new super-fast CT scanners provide us with incredibly detailed views of the arteries giving us a nearly foolproof way to detect PAD in patients, even in those with no symptoms."

The detail provided by the CT scan also helps guide treatment, he noted, which has become more aggressive in recent years.

"Historically we treated PAD with lifestyle modifications and medications and resorted to angioplasty and stenting for only the most advanced cases," he said. "But that has changed and we now recommend aggressive interventional therapy as a first option, along with lifestyle modification and medication where needed to lower blood pressure, cholesterol and control diabetes."

During angioplasty, a thin tube with a balloon on the end is inserted into a blood vessel in the groin area and guided to the blockage, where the balloon is inflated to open the artery. Often a stent, which is a cylindrical wire mesh tube, is placed in the artery to keep it open.

"It's important, particularly for those over 65, to be tested for PAD," said Dr. Rivera. "If PAD is caught early enough, aggressive treatment can significantly lower the risk of mortality."

Dr. Rivera is board certified in cardiovascular diseases, internal medicine, echocardiography and nuclear cardiology. He is one of 15 cardiologists at Legacy Heart Center in Plano. The Center has been in operation for more than 20 years and also treats patients at The Heart Hospital Baylor Plano, Baylor Regional Medical Center at Plano, Presbyterian Hospital of Plano, McKinney Medical Center of McKinney and Medical Center of Plano. Visit www.legacyheartcenter.com for more information.