Heart and stroke preventative screening
Modern medical treatment is so effective in this field that screening is really worthwhile. Coronary disease and stroke account for nearly 35% of all deaths. At 90 Sloane Street we believe in being proactive with regard to vascular and coronary screening.
Nearly a third of first heart attacks occur in people with no risk factors such as diabetes, smoking, family history, cholesterol or high blood pressure. Therefore, we advise the importance of screening, even in the absence of risk factors. There are several types of screening to be considered.
Coronary Calcium Score screening is a simple test which may be considered in patients 35-45 years old. It gives a total score for the amount of fatty plaque which is calcified and also picks up early disease which would be too mild to be found at a routine treadmill test. This allows early preventative treatment where necessary. There is minimal exposure to radiation.
However, it does not detect soft uncalcified plaque, and does not say where exactly the plaque is in the vessel and if it is causing a significant narrowing to the vessel.
In most patients with a high level of risk factors or patients aged around 50 and above,
a CT coronary angiogram is preferable. An injection in the arm of a contrast agent is followed by a non-invasive scan which gives a detailed picture of all the coronary arteries. These scans are a significant step forward against coronary disease.
A myocardial perfusion scan or Rubidium scan is another very useful test used for assessing coronary arteries, but due to the level of radiation is not recommended as a first screening test.
Video: (Below-left) Nearly totally occluded right coronary artery angiogram pre ballooning of narrowing.
Above: (Left) Pre balloon angioplasty to right coronary artery.
(Right) Post balloon angioplasty to right coronary artery.
1 in 19 of us develop colon cancer but Colon cancer deaths can be reduced by 75% with colonoscopy screening. All patients over 45 should have a colonoscopy every 10 years, starting younger if genetic risk factors are present.
Colon cancer nearly always starts from a precancerous polyp. There is a long phase-lag from when polyps are visible at colonoscopy to the later development of cancer. If precancerous polyps are found, they can simply be removed at the colonoscopy.
Colonoscopy polyp removal (above)
CT Colonography (above)
An ultrasound of the carotid neck vessels is used to pick up early arterial disease. This enable us to implement stroke risk prevention.
Abdominal and Pelvic screening
An abdominal ultrasound examines the liver, gallbladder, kidneys, spleen, pancreas and lymph nodes as well as the blood vessels within the abdomen. It has no ionising radiation and is useful for assessing the kidney, liver, pancreas or gallstones as well as spleen and bladder. Screening for abdominal aortic aneurysms (the ballooning of the main artery with the risk of a fatal rupture), has been shown to save lives. We recommend this for patients over 50 years of age.
Pelvic ultrasound screening in particular ovarian screening may save lives.
Radiation and screening
We take radiation seriously when we advise on tests. CT scans are potentially harmful radiation whereas MRI is non-ionising radiation, i.e. non-harmful which to the best of our knowledge, does not have any cancer inducing risk.
At 90 Sloane Street we can advise where the latest machines which use the minimum
radiation dose are located.
Ultrasound investigations do not use ionising radiation and are therefore safe and can be
used in pregnancy. Ultimately, the decision as to the best test involving radiation needs to be based upon the individual.