Capital Heart Health Screening

Heart (or cardiac) screening involves detailed history, physical examination and  non-invasive tests that help recognise cardiac abnormalities that would otherwise go undetected because there are no obvious symptoms yet. It helps an individual assess his or her risk of developing future cardiac events, and identify risk factors that can be mitigated by early detection and treatment.

Capital Heart Centre offers 4 tiers of customised heart screening packages for heart-health assessment. These are:

• Essential screening — this consists of basic tests for a heart health assessment, from various blood investigations to assess cardiovascular risk factors, to electrocardiography (ECG) and exercise treadmill ECG test.
• Comprehensive screening — this consists of comprehensive heart health and risk assessments. In addition to ECG and exercise treadmill ECG, a detailed transthoracic echocardiography looks at the structure and function of the heart. It is also suitable for NS pre-enlistment screening and sports programme screening.
• Executive screening — this package is advised for those aged 40 and above, and/or those who have one or more cardiovascular risk factors. In addition to ECG, exercise treadmill ECG and transthoracic echocardiography, a CT calcium score assesses the individual’s risk of future heart attack.
• Premium screening is a complete risk assessment recommended for persons aged 50 and above, and/or those who have one or more cardiovascular risk factors and/or a family history of cardiovascular issues. In addition to ECG and transthoracic echocardiography, a CT coronary angiography detects cholesterol plaque deposits causing coronary artery disease and assesses for narrowings and blockages.

Each screening package involves a pre-screening clinical assessment with the cardiologist, which involves a detailed walkthrough of your past medical and family history, and a physical examination.

Cardiovascular risk factors are best assessed by taking a clinical history, anthropometric measurements, blood pressure readings and performing specific blood tests.

Specialised cardiac tests assess different aspects of the heart function, hence there is no single best test. The common cardiac tests performed for heart screening are:

• Electrocardiography (ECG)
• Exercise treadmill ECG test
• Transthoracic echocardiography (TTE)
• CT calcium score
• CT coronary angiography

This ultimately depends on the type of heart screening package you’ve chosen. Certain tests, like an electrocardiogram (ECG), may take as little as 1-2 minutes to complete, while others, such as an exercise treadmill ECG test may take about half an hour.

Some tests can be done on the same day, however other tests that require specific preparation may need to be carried out on separate days. Your cardiologist will advise you on the best ways to carry out these tests in order to get efficient and accurate results.

Symptoms arising from blockages in the heart arteries usually do not manifest until the arteries have narrowed so much that blood supply to the heart muscle is affected. If you suspect you have Coronary Artery Disease (CAD), your cardiologist may recommend a combination of the following tests:

• Electrocardiogram (ECG) — used to measure the electrical activity in your heart.
• Exercise treadmill ECG — a test that measures electrical activity in your heart while under exercise stress, and may detect signs of severe coronary artery blockages.
• Echocardiography — an ultrasound test to assess the heart movement and function. Sometimes combined with exercise stress using a treadmill or pharmacological stress using a medication called dobutamine, these may uncover signs of heart artery blockage.
• Nuclear stress test — a test that uses a radioactive tracer to visualise the amount of blood your heart muscle receives while your heart is both under stress and at rest.
• CT Calcium score — a CT scan to assess the amount of calcium deposited in the coronary arteries

• CT Coronary Angiogram — a CT scan that uses contrast dye to visualise the coronary arteries to detect any narrowings or blockages caused by cholesterol plaques.
• Invasive coronary angiography — this is a minimally invasive procedure that uses a contrast dye injected directly through a catheter to visualise the coronary arteries under live X-ray to detect any narrowings or blockages.

Not all the above tests are suitable for heart screening purposes. Your cardiologist will decide which tests are most suitable for you based on your symptoms and risk factors, and this will help in an accurate diagnosis of CAD and planning of future treatment.

Ideally, men should go for heart screening if they are over 40 and women as they approach menopause, and with one or more cardiovascular risk factors such as smoking, diabetes, high cholesterol or high blood pressure, family history of coronary artery disease, overweight or obese, or lead a sedentary or stressful lifestyle.

It is best to undergo a heart screening before any symptoms arise, as early detection allows your cardiologist to start treatment before your condition worsens.

Your cardiologist will advise you on how best to prepare for your cardiac test to ensure efficiency and accurate results.

Most heart screening tests should be performed every 2-4 years if you do not have any symptoms. However, this may change if you suffer from a heart condition, in which case your cardiologist may schedule more frequent tests to follow up on your condition.

Men should go for heart screening if they are over 40 and women as they approach menopause and beyond.

One should check for cardiovascular risk factors such as high blood pressure, high cholesterol or diabetes as early as 30 years old, and start treatment early with lifestyle changes or in combination with medications to prevent long-term complications.

In certain circumstances, a heart screening may be performed at a much younger age if you have a family history of heart disease, at risk of an inheritable heart condition, or if you plan to participate in a high-intensity sports programme.

Heart screening tests are generally safe as they are non-invasive, and are vital to the early detection of any heart disease. Do ask your cardiologist for recommendations on a suitable heart screening package.

Cardiac screening packages cannot be claimed by Medisave or insurance.