Lifesaving Scan

Talk about being in the right place at the right time.

Last September, Jerry Chang, MD, a Board Certified Diagnostic Radiologist who specializes in Vascular and Interventional Radiology at Eisenhower Imaging Center, agreed to undergo a CT angiography (CTA) scan on a new piece of equipment recently acquired by Eisenhower Imaging Center. It was a decision that likely saved his life.

The Siemens NAEOTOM Alpha is the world’s first CT scanner with photon-counting technology. It counts individual X-ray photons rather than averaging them as conventional CT scanners do. This process - the first new major technological improvement for CT imaging to be cleared by the U.S. Food and Drug Administration in nearly a decade - improves image quality and gives doctors more usable data for diagnosis and treatment planning in areas including cardiology, oncology and pulmonology.

Eisenhower Imaging Center was the first institution on the west coast to have the Alpha and Eisenhower Health remains the only hospital in the desert with this advanced system.

“My colleague Dr. Mehran Elly and I have been the primary readers of the CTA coronary studies performed on the new scanner,” says Dr. Chang. “He suggested several times that I have the study performed just to make sure I didn’t have any significant blockage of my heart vessels.”

Dr. Chang, then 52, didn’t feel any sense of urgency about having the CTA scan.

“I never had any symptoms to suggest I had significant heart disease,” he says. “My father had coronary artery disease when he was in his 60s but he had been a smoker. So, I expected to see a fairly normal study in myself.”

Dr. Chang finally agreed to have the CTA scan.

“My mother-in-law had had a coronary artery stent placed about a year prior and needed a follow-up scan,” he says. “Since I was bringing her in for the test, I figured I’d have mine that day as well.”    

After his test, Dr. Chang returned home knowing he could access results remotely.

“I didn’t think my test would show much,” he says. “The arteries of a 52-year-old Asian guy are usually pretty clean.”

“But to my surprise, I found I had near-complete blockage of the left anterior descending (LAD) artery, also called the ‘widow-maker,’” he says, referring to one of two major branches of the left coronary artery that supplies blood to a majority of the heart muscle. “I also had severe blockage of the obtuse marginal artery, a branch of the left circumflex coronary artery,” he adds, identifying a problem with the other major branch of the left coronary artery.

These blockages were caused by the build-up of cholesterol-laden deposits called plaque.

Dr. Chang asked his wife to call Dr. Elly to take a look at the CT results. Within minutes, Dr. Elly arranged for Dr. Chang to be admitted to the hospital and seen by Andrew Frutkin, MD, FACC, FSCAI, Eisenhower Desert Cardiology Center. Dr. Frutkin, Board Certified in Cardiovascular Disease and Interventional Cardiology, scheduled an urgent cardiac catheterization for the next morning.

Cardiac catheterization involves inserting a thin, flexible tube (or catheter) into a blood vessel, typically the radial artery in the wrist or femoral artery in the groin, and navigating it to the heart under real-time X-ray guidance, enabling doctors to directly visualize the heart and blood vessels.  

“The catheterization confirmed what the CT scan had revealed,” Dr. Frutkin explains. “It showed 95% stenosis [blockage] within the proximal LAD, which supplies blood to 40% or more of the front part of the heart muscle. When such a large area of heart muscle is affected by a heart attack due to closure of the artery, it carries with it substantial risk of dangerous arrhythmia [heart rhythm irregularities], damage to the heart muscle, heart failure and death.”

“I was able to treat this blockage during the same procedure by performing a balloon angioplasty [a balloon at the tip of the catheter is inflated to compress the plaque against the artery wall] and placing a stent [an expandable metal coil] that serves as a scaffold to keep the artery open, improving blood flow to the heart and reducing his risk of having complete closure of the artery and heart attack.”

But what happened next was totally unexpected.

“His other narrowed obtuse marginal artery - which was 99% blocked - actually began to close completely while we were treating Dr. Chang’s first narrowed artery and he began to experience severe chest pain,” Dr. Frutkin continues.

Dr. Chang was beginning to have a heart attack. Dr. Frutkin quickly moved his focus to the obtuse marginal artery and he performed a balloon angioplasty and stent placement there to restore blood flow to the heart and minimize any damage to Dr. Chang’s heart.

“I can’t recall another experience like that with a patient,” Dr. Frutkin says. “The timeliness of Dr. Chang being diagnosed and getting appropriate treatment is just amazing.”

“I had that day off and my son was on break from school, so I’d been thinking I’d like to go deep-sea fishing with him,” Dr. Chang recalls, “but I scheduled that CTA scan the same day as my mother-in-law’s instead. That decision probably saved my life.”

While Dr. Chang’s experience was truly serendipitous, it underscores the importance of understanding the risk factors for cardiovascular disease and undergoing appropriate screening tests.

“While it’s not feasible at this time for every middle-aged person to undergo CT angiography with photon-counting technology - particularly if they have no symptoms - there are simple screening measures and other tests that can help patients and their doctors identify who’s at risk for cardiovascular disease and guide preventive and therapeutic interventions,” says Dr. Frutkin.

“Talk to your doctor,” Dr. Chang adds. “And if they think you need a test, get it done.”

To learn more about the services at Eisenhower Desert Cardiology Center, visit EisenhowerHealth.org/DesertCard.