High-tech cath labs improving care

BOULDER — If you want to have your heart and arteries scanned to see if you may have heart disease, area hospitals have the latest technology to see what’s going on inside your body.

If you have a heart attack, those hospitals also have the latest high-tech equipment and expertise to treat it.

If you think having a heart attack can’t happen to you, remember that heart disease remains the No. 1 cause of death in adults in the United States.

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More people than ever are surviving heart attacks these days, but 50 percent of all attacks still are fatal, according to national statistics compiled from participating doctors across the nation.

In Colorado, the incidence of heart disease is about 2 percent to 5 percent across all age groups, a rate similar to many other areas of the nation, according to the Colorado Department of Public Health and Environment. Some areas in the South have an incidence of heart disease of as high as 7 percent.

The region’s four hospitals – Avista Adventist Hospital in Louisville, Boulder Community Hospital in Boulder, Exempla Good Samaritan Medical Center in Lafayette and Longmont United Hospital in Longmont – all have cardiac catheterization laboratories that have capabilities to look for heart disease and treat it.

Equipment for such labs often range in price from $2 million to $5 million, according to industry statistics.

Digital scanners are able to show more details of the human body than ever, including plaque build-up in arteries, according to cardiologists.

One of the most common heart scans is a CT, or computerized-tomography angiogram, which can be done at any cardiac catheterization laboratory, known as a “cath lab.” A catheter is threaded either through the femoral artery in the groin or the radial artery in the wrist and then to a chamber or vessel of the heart. Dye is injected into the body to highlight potential plaque build-up in the patient’s arteries. Plaque that blocks arteries shows up as a dark shadow, doctors say.

Doctors at Boulder Community Hospital now recommend that patients with a family history of heart disease start getting heart check-ups around age 35, said Dr. Nelson Trujillo, a cardiologist at Boulder Heart, a cardiologist practice at Anderson Medical Center, which is part of Boulder Community’s Foothills campus.

Boulder Heart doctors also commonly use nuclear stress tests to search for heart disease, Trujillo said.

Patients can sit in a chair for six minutes while the procedure is done, Trujillo said. New cameras are able to take higher-quality pictures more quickly than ever; the procedure used to take 20 minutes with a patient trying to lie completely still to allow the cameras to take sharp photos, Trujillo said. The heart is stimulated with medicine in one version of the test.

Doctors also continue to use the electrocardiogram, or ECG, stress test, in which cameras take internal pictures while patients walk on a treadmill. The heart is stimulated through exercise, which can show any abnormal blood flow to the heart’s muscle tissue.

The test is used to diagnose heart disease as well as to check patient prognosis after he or she already has had a heart attack.

At Longmont United Hospital, Dr. Murry Drescher at Milestone Medical Group most commonly uses the CT angiogram scans as his diagnostic tool of choice.

Drescher said he also emphasizes heart attack prevention to his patients – often prescribing medicines to combat high cholesterol and high blood pressure after doing simple blood tests. Longmont United runs the Healthy Ambitions exercise program, a preventive exercise program, said Karen Logan, a hospital spokeswoman.

“We’re very focused on preventive care,” Drescher said.

Boulder Community Hospital also focuses on prevention, Trujillo said. Patients with family histories of heart disease often are prescribed drugs to treat high cholesterol and high blood pressure. Doctors also remind those patients to exercise and to eat diets heavy in fruits and vegetables, he said.

Still, the cath lab has capabilities to see exactly what’s going on in a patient’s body – especially one that offers three-dimensional pictures, said Dr. Juan Weksler, a cardiologist practicing at the hospital. Avista’s three-dimensional pictures “can be instrumental in diagnosis and treatment,” he said. Exempla Good Samaritan also is proud of its three-dimensional imaging capabilities, said Dr. Jeanette Smith, director of cardiology at the hospital in Lafayette.

“It’s all about seeing, and the (improved) image quality is seeing what we’re doing,” Weksler said.

Heart-disease patients often seem to be in denial about the potential that they might have a heart attack, Weksler said.

“You don’t think it’s going to happen to you, or you think you can just have this one heart attack,” Weksler said. “Unfortunately, we can’t escape the disease every time.”

When a patient has a heart attack, every second counts toward survival, doctors say.

At the Good Samaritan cath lab and others, doctors are focused on getting their treatment times to be as short as possible. Exempla is focused on achieving the national high-level standard of 90 minutes from when a patient contacts emergency personnel to when the treatment is complete, Smith said.

“For certain kinds of (heart disease) you get an improved outcome if you can get the vessel opened up sooner rather than later,” Smith said.

Heart doctors now use stents and balloons to open patient arteries – procedures in which they often can take advantage of the cath lab’s equipment as well.

Separately, Exempla and Boulder Community Hospital have electrophysiology laboratories in which doctors can treat patients with heart arrhythmia, which can be life-threatening in certain cases. Such electrophysiology equipment also is used to diagnose and treat a patient who might need a pacemaker implanted in the heart, or a defibrillator.

Exempla’s electrophysiology laboratory has been used for 15 heart arrhythmia cases since April 1. The laboratory is expected to get even busier in the wake of a new agreement in which Kaiser Permanente physicians who previously had done their electrophysiology work at Exempla St. Joseph Hospital in Denver will come to the Lafayette hospital, Smith said.

Even with all of the technology available, the best lesson still is to take care of your body, said Dr. Jeff Reed, director of cardiology at Boulder Community Hospital.

“There’s great heart care in Boulder County,” Reed said. “The biggest thing you can do to stay healthy is to get screened, stay active and don’t smoke. If you do have a problem with blood pressure or cholesterol, the less damage there is over your life (to your arteries), the better.”