Checking your cholesterol levels is still a good (standard) way to screen for heart disease. However, it’s really not that simple anymore. It turns out the number of the good (HDL) and the bad (LDL) cholesterol does not give us enough information as to what is really going on with your heart. So, just because someone has high cholesterol, it doesn’t mean they are at greater risk for a heart attack. Same goes for those who have low cholesterol. It doesn’t mean that it’s healthier. It’s much more complex than that.

What tests should I ask my Doctor for?

You want to ask your doctor (especially if you have other risk factors, like family history, overweight, sedentary lifestyle, inflammation) to check the different particle sizes, especially a marker called Lp(a), lipoprotein-a, which in of itself is an independent risk factor for heart disease. Do you remember Bob Harper? He was America’s fittest man and host of The Biggest Loser, a few years back. Bob ended up having a heart attack at 50 years old. It turned out that his Lp(a) marker was very high prior to his heart attack. Something as simple as this screening may have prevented this from happening. There are many other blood markers that can also be discussed with your doctor. All you have to do is ask your physician if there are any other screening tests you can do for heart disease? Just be aware that some testing may not be covered by your insurance. You can always speak to your doctor about it and they should be able to tell you which ones are covered and which are not.

There is one more screening test that I use very often, in my practice. It’s called a coronary calcium screen. It’s a quick cat scan that uses no dye or contrast. It measures the amount of calcium in your heart arteries. If your calcium score is zero, it is extremely unlikely to have plaque in your arteries. If it is higher than zero, then you may have an increased risk, which you should pursue further testing. Here in NYC the test will run about $100 at a local hospital and currently is not covered by insurance.

I recently had a very healthy patient in her mid 60’s who had several risk factors. I ordered a coronary calcium score on her, and it was around 1400, which is extremely high. I referred her to a good cardiologist and she is currently undergoing appropriate treatment.

I just received an email from her and it said “I have to share you saved my life. No physician has ever put all the dots together to send me for the testing you ordered. So thank you so much!”

One main thing to always remember: Insist on being heard if you are having symptoms and insist on getting screened. It just may save your life.