When entering old age… it is common to experience easy fatigue and frequent shortness of breath, raising the suspicion of being at risk for coronary artery disease, the cause leading to… acute heart failure. Dr. Montri Charoenpanichsanti, Cardiologist at Phyathai Sriracha Hospital explained that the most accurate diagnosis is screening and heart health check-ups… which are also the best prevention methods for heart disease!!
Want to check the risk of “coronary artery disease”? Which method… is suitable for us?
1. Electrocardiogram (ECG) both at rest and during treadmill exercise (EST). Doctors diagnose by comparing changes in the ECG graph to normal individuals. Suitable for general screening, patients with low to moderate risk, but not suitable for the elderly, those with bone and joint problems, and may not be accurate enough for patients with heart-like symptoms or relatively high risk (accuracy 50-70%).
2. Coronary artery disease screening by CTA is a contrast injection through a CT scan machine, providing a 360-degree image of the coronary arteries. It is used to diagnose coronary artery stenosis or congenital vascular abnormalities. Suitable for those with moderate to high risk who cannot perform treadmill tests. The test takes a short time (accuracy 90%).
3. The gold standard for coronary artery disease is contrast injection through a cardiac catheter (coronary angiogram; CAG), showing moving images of the contrast agent through the three coronary arteries. Suitable for patients with acute symptoms or high risk such as older age, smoking, diabetes, etc. This test requires at least half a day of hospital observation (accuracy 100%).
The heart… can also be checked for abnormalities by MRI!
Currently, Phyathai Sriracha Hospital offers a new heart examination using MRI to diagnose ischemic cardiomyopathy from coronary artery disease, congenital heart defects, cardiomegaly, and heart failure. It guides treatment options such as medication, balloon angioplasty, or surgery. It is highly specific and can be performed even in patients with kidney disease or iodine contrast allergies.
Heart disease treatment in the elderly… patient safety is paramount
Elderly patients often have underlying diseases requiring multiple medications and may need treatment from several doctors. They often have age-related kidney impairment, necessitating dose adjustments, caution with drug interactions, and using the minimum necessary medications. Surgery in the elderly often carries a higher risk of complications. When avoidable… medication treatment or low-risk surgeries such as endoscopic or catheter-based procedures are recommended instead of major surgery.
Screening… the best prevention method for “acute heart failure”
To prevent acute heart failure in the elderly, it is recommended to bring them for screening, receive advice, and treat underlying conditions such as diabetes, hypertension, and high cholesterol. Do not just think that getting old means fatigue is normal because heart disease is preventable.
“If a patient is suspected of having acute heart failure, it is recommended to urgently transfer them to the nearest heart center as soon as possible. Phyathai Sriracha Hospital is a comprehensive heart center with extensive experience in holistic patient care, including medication treatment, cardiac catheterization, and cardiac rehabilitation, with a full team of specialized cardiologists.”
Dr. Montri Charoenpanichsanti
Cardiologist
Heart Center, Phyathai Sriracha Hospital
