The graying Airway Heights prisoner complaining of chronic chest pains certainly looks like a candidate for heart trouble.
Paul Kollen is 64 and overweight.
But after an eight-minute chest scan using breakthrough technology, doctors said the inmate’s arteries are clean. His gripes probably are groundless.
“This is the real beauty,” said Dr. C. Harold Mielke Jr., who watched a computer flip through cross sections of Kollen’s chest like a deck of cards. “With this scan, he can’t play that game anymore.”
The electron beam computed tomography scanner spills into several rooms at the Shields Cine CT Center on Spokane’s Fifth Avenue, resembling a playground toy tilted on its side.
It’s like a giant X-ray tube that surrounds the patient. The ultra-fast scanner snaps pictures every 3 millimeters from the top to the bottom of the heart.
The technology has been around for several years. Now it’s being validated. Recent studies show the relatively low-cost scans accurately can predict heart attacks, even in young people.
At-risk people can be targeted before they ever suffer heart trouble. They can take medicine, exercise and change their diets. Patients with little risk can stop fearing heart attacks when they have only heartburn.
“Everything we do in medicine is after the fact,” Mielke said. “We need to find out which people are likely to have chest pain before the chest pain happens.”
In Spokane, the scan costs $230 - almost half as much as it does in other cities nationwide.
A study published last month in Circulation, the American Heart Association journal, found the scanner to be 10 times more effective in predicting heart attacks and blockages than standard non-surgical techniques.
For the first time, the new technique measures calcium deposits in the heart and its arteries. Research has shown a strong link between the deposits and heart disease.
Dr. J. Paul Shields, who runs the Spokane clinic, sounds as if he’s looking at a crystal ball when talking about a 52-year-old man whose scan showed no calcium spots.
“I can tell you his chances of having a heart attack: practically zero,” Shields said. “You don’t have to rush him down to the emergency room every time, saying, ‘Is this the big one?”’
Only about 40 of the $1.8 million scanners are in use in the United States. People are coming to Shields’ clinic from Denver, San Francisco, Alaska and British Columbia to take the test.
Insurance companies used to cover the cost but have started to balk after it was dubbed experimental.
Convinced otherwise, Shields’ staff and Washington State University researchers are documenting the scanner’s worth. They’re studying results by tracking stressed-out professionals, starting with firefighters and police officers.
Early findings from the 10-year study, started two years ago, were presented to a biomedicine convention in Washington last May. Calcium deposits were discovered in nearly one-third of the 181 people being tested.
“My mother died of congenital heart disease,” Spokane Police detective Andrew Pavlischak said in the study. “I thought this was good because I had high cholesterol when I first came on the police department.”
Pavlischak, 46, still has high cholesterol, hovering near 300. But after two scans, he knows there’s no evidence his arteries are being plugged.
Shields and Mielke, an associate dean at WSU, are expanding their study to other Spokane-area law enforcement agencies, including the U.S. Drug Enforcement Agency and FBI.
William Hardin, agent in charge of the Spokane DEA office, said the whole office plans to participate.
He pointed to a 47-year-old DEA agent from San Francisco who died last June, reportedly because of blocked arteries leading to his heart.
“He had no symptoms,” Hardin said. “To my knowledge, he had no history. It was totally, I think, unknown to him. As a result, he’s dead.”
, DataTimes ILLUSTRATION: Color Photo
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