Why Should You Get A Comprehensive Cardiovascular Screening?
Get to know your heart — It has a lot to tell you!
You love exercise. That’s great!
You are part of a growing number of Americans who seriously care about their health. You may already be engaged in sports activities, or maybe you plan on doing so in the near future. Whether you are a competitive athlete or a week-end warrior, physical activity immensely benefits your health, mental and physical — including cardiovascular health.
Image attribution: Mike Baird
You are probably aware, however, that even with the best health habits, cardiac and vascular complications can and do occur. Despite its tremendous health benefits, exercise does not always prevent heart disease. At times, physical activity can actually trigger a heart attack, vascular injury, or sudden cardiac arrest in susceptible individuals. Sudden cardiac death is a national epidemic that is the leading cause of death among athletes, even those who are entirely asymptomatic until tragedy strikes. In fact, unsuspected cardiovascular disease is the No. 1 cause of exercise-related fatalities in all age groups, causing more death than trauma.
We are here to complement your healthy embrace of life. We offer our expertise to reduce the chance of unforeseen complications. We go beyond the standard approach to cardiovascular prevention, which is usually limited to a routine physical and a blood cholesterol level.
We aim to answer the following two questions you may have:
1) Is it safe for me to exercise or play sports?
2) How healthy is my cardiovascular system?
Our approach focuses on trying to detect heart and vascular conditions in their early stage, before complications occur. We employ robust non-invasive tools that provide invaluable information about the health of your heart and arteries. In addition, we give hands-on attention to your needs, taking into account your individual circumstances, so we can cooperate as a team to optimize your health and well-being.
What Patients Say About Our Cardiology Service...
"Very easy, comfortable, and professional experience. Dr. Accad is very personable and knowledgeable. The services provided are a welcome dose of early screening and prevention. I would much rather focus my efforts on staying healthy than on correcting imbalances after they occur."
Randy Salim, 48, Los Altos
What is the standard approach for preventing sudden cardiac death?
Standard Approach in Adults
In adults, the current approach to screening is limited to a routine physical, measuring blood cholesterol levels, and promoting healthy diet and exercise. Unfortunately, blood cholesterol levels poorly predict one’s risk of sudden death, and diet is not a silver-bullet approach to prevention.
3 out of 4 patients hospitalized with coronary disease have normal cholesterol levels.
American Heart Journal, 2009
Standard Approach in Youth
In athletic youth, the current standard is a simple physical examination. Specific cardiac tests are not routinely obtained, even though most conditions that lead to sudden cardiac arrest in high school and college athletes can be detected by non-invasive diagnostic tests.
Most young athletes who die suddenly have undiagnosed structural heart disease.
European Heart Journal, 2012
Our Comprehensive Approach to Cardiovascular Screening
While the medical, public health, and insurance communities continue to debate the health care costs of the standard approach to screening for heart disease, a growing number of specialists and grassroots organizations are advocating more comprehensive cardiovascular screening. Such is the approach the Athletic Heart of San Francisco also advocates.
We offer reasonably-priced, individualized, in-depth screenings to detect unsuspected cardiac problems and promote the safe practice of sports!
Our cardiac evaluations are performed under the direct supervision of our founding cardiologist, Dr. Michel Accad, who brings to the evaluation his personal, hands-on attention. Tests provided may include:
Cardiovascular history and physical examination
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Advanced heart rhythm monitoring
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Pulse wave analysis
Additionally, we may order tests conducted at other facilities, such as:
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Coronary calcium scoring
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Cardiac MRI
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Cardiac angiography (CT or invasive)
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Genetic testing
In case of need, we can refer for treatment of serious cardiac disease at the best medical centers locally or nationwide.
Why See A Sports Cardiology Specialist?
"Victims of SCD are often entirely asymptomatic before their initial presentation and demonstrate only subtle abnormalities on investigation. It is therefore recommended that cardiac evaluation of an athlete is performed by trained cardiologists and sports physicians familiar with the conditions capable of causing SCD and the impact of demographic factors associated with the individual athlete."
Dr. Sanjay Sharma, Journal of the American College of Cardiology, March 12, 2013
"Given the cardiovascular demands of exercise, training-related cardiovascular adaptations, and the interactions of the heart with internal and external athletic environments, sports and exercise cardiology is a natural and obvious step in the evolution of the sports medicine subspecialties... Athletes are 'different' from the general population from a physiological and/or medical perspective."
Dr. Christine Lawless, Journal of the American College of Cardiology, April 22, 2014
Sport-specific Knowledge for Individualized Cardiology Care
While training and exercising, you are frequently pushing your body to the limit. Because your heart is "smart," it undergoes specific adaptation to the demands of physical activity. Such adaptations can be subtle and must be carefully distinguished from similar changes that occur as a result of heart disease.
The American College of Cardiology (A.C.C.) has created a Sports and Exercise Cardiology Section to promote core clinical competency in this new field, which includes a sport-specific knowledge-base to facilitate specialized individualized care. Dr. Accad is both a fellow of the A.C.C. and a member of its Sports and Exercise Cardiology section.
The good news is that most conditions that lead to exercise-related cardiac complications can be detected by a comprehensive, non-invasive evaluation. If we detect such a condition, then we can take the appropriate measures to avoid or reduce the chance of future problems. In such cases, our goal is to assist you in making short- and long-term return-to-play decisions.
Additional Reasons for Cardiac Evaluation
What Heart Conditions Are We Talking About?
The cardiovascular disease and conditions below can be discovered before they cause any symptoms. Some of them are present at birth but remain silent for years. Others are acquired. They can be present even without a family history of heart disease.
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Hypertrophic Cardiomyopathy
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Arrhythmogenic Right Ventricular Cardiomyopathy
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Aortic Stenosis and Bicuspid Aortic Valve Disease
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Dilated Cardiomyopathy
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Congenital Heart Defects
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Long QT Syndrome and Ion Channelopathies
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Hypertension
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Valvular Heart Disease
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Wolff-Parkinson-White Syndrome
Most of these conditions can be detected with the non-invasive tests we offer. In the majority of cases, a firm conclusion can be reached on the basis of the examination, ECG, echocardiogram, and/or treadmill stress test. In adults, we frequently also recommend a simple and relatively inexpensive cardiac CT scan that can detect the presence of early plaque build-up in the coronary arteries.
We do our best to come up with a definitive conclusion that will not unnecessarily constrain your activity nor expose you to excessive risk of complications. Rarely, if the initial tests are inconclusive, additional tests or perhaps a period of observation may be required
Valuable Online Resources for Your Heart Health
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The Society for Heart Attack Prevention and Eradication (S.H.A.P.E.) aims at raising awareness among doctors and hospitals about the value of a screening strategy to detect cardiovascular disease early, before complications occur.
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Heartfelt Cardiac Projects is a Southern California non-profit organization that offers low-cost community-based cardiac screenings. It was established by Holly Morrell and dedicated to her 6 family members who lost their lives to hypertrophic cardiomyopathy.
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The EP Save a Life Foundation is a San Diego-based organization that offers free community-based cardiac screenings. It was established in memory of Eric Paredes, a teenager who died of sudden cardiac arrest in 2009.
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Cardiac Athletes is an online support group for athletes with heart disease. It includes a very large forum where athletes from around the world compare notes.
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Simon’s Heart is a non-profit organization in the Philadelphia area dedicated to raising awareness about sudden cardiac arrest in children. Simon’s Heart promotes community screening programs.
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Via Heart Project is a California-based organization that equips schools with automated external defibrillators (AED’s) and provides ongoing training and maintenance to ensure that proper and prompt response is available in the event of a cardiac arrest. The organization also promotes community-based cardiac screenings for youth.
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The Sudden Cardiac Arrest Foundation is a national non-profit organization dedicated to raising awareness and educating the public about sudden cardiac arrest.
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Parents Heart Watch is a national network of parents, families, and organizations dedicated to reducing sudden cardiac arrest in youth.
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Hypertrophic Cardiomyopathy Association (H.C.M.A.) is a grassroots organization focused on preventing sudden cardiac arrest through early detection of this condition which is a common cause of death among athletic youth and young adults.
"Significant evidence supports that athletes are 'different' from nonathletes from the epidemiological, physiological, evaluation, and management perspectives, with significant heterogeneity among athlete subgroups. Combined with the need to consider the effects of cardiovascular conditions and treatments on sports performance and to incorporate return-to-play into medical decision-making, these differences render the athlete a unique cardiovascular patient who is deserving of tailored cardiovascular care."
Dr. Christine Lawless, Journal of the American College of Cardiology, 2014