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Penn State/Wilkes-Barre Crime Scene Lab is open to public

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Business seminar set for April 3 at Greater Hazleton Chamber of Commerce

<p>No, this is not a &#8220;Dear Abby&#8221; column. Today&#8217;s advice is not about THAT type of broken heart. Besides my wife, Mary, is better at that sort of thing then I&#8217;ll ever be &#8230; I&#8217;m the guy though if we&#8217;re talking about your &#8220;lub-dub&#8221; heart.</p><p>Remember that we&#8217;ve been focusing for a few weeks on screening for diseases and illnesses. And we&#8217;ve defined screening as doing tests of any sort in an effort to identify problems based on predisposing factors, BEFORE symptoms or signs develop.</p><p>So, concerning heart screening, the first issue is to decide what tests are appropriate for what people. Not all tests are reasonable in all people, since false positive tests (those that say something is wrong when more elaborate studies show it&#8217;s really not) and false negative tests (those that say everything&#8217;s OK when it&#8217;s really not) do occur if tests are used indiscriminately.</p><p>So first, as a newborn, a careful physical exam, especially listening for abnormal heart sounds and a measurement of the blood&#8217;s oxygen levels with a non-invasive light device called a pulse oximeter is standard.</p><p>During childhood, well baby and well child visits focus on, among many other things, heart sounds, pulses, exercise tolerance and heart disease risk factors like diet, exercise, family history and second hand smoke exposure.</p><p>School age kids should be screened with a questionnaire developed by the American Heart Association before participating in competitive sports, and a small percentage would get an EKG and perhaps an echocardiogram (&#8220;SONAR&#8221; like test of heart structures.) Several local colleges and healthcare systems sponsor these events throughout the year.</p><p>Young adults should start lifelong surveillance of their blood pressure, cholesterol and blood fat (lipids) levels, as well as continue heart healthy eating, exercise and stress management.</p><p>As we approach our 40th birthday, more elaborate, and more costly, testing MAY be appropriate for those of us at either higher than normal risk because of genetic predisposition or personal past events.</p><p>The AHA has developed a questionnaire that estimates the risk of a heart event within 10 years. If that prediction is greater than 10 percent, a cardiac calcium score, calculated from a CAT scan of the heart, may be right for you. Depending on that score from zero to over 400, your medical advisors can reassure you that there&#8217;s an insignificant risk of heart trouble in the next 10 years, all the way to deciding if preventative steps should be intensified or even that invasive diagnostic tests (no longer screening!) are needed.</p><p>But remember that the CAT scan needed requires exposure to radiation that&#8217;s the equivalent of 10 chest X-rays &#8230; and radiation should be avoided unless the expected benefit exceeds the small lifetime risk of cancer.</p><p>In addition to cardiac calcium scoring, cardiac stress testing is another way to screen for atherosclerosis, that is hardening of the arteries. This test involves getting your heart rate up to quite high levels either with medicines or exercise and watching the EKG pattern its electric activity causes. During the test either an echo image documents the heart&#8217;s function, area by area, or a picture of a radioactive dye&#8217;s distribution in the heart muscle shows blood flow.</p><p>Now there are other types of heart disease besides atherosclerotic heart artery blockages.</p><p>Echo tests can help define valve or other structural problems with the heart but are rarely recommended as SCREENING tests in the absence of some abnormality that is suspected because of a physical exam, symptoms or another worrisome test.</p><p>Likewise, although a basic EKG recording of the heart&#8217;s electrical activity and rhythm is a cheap, reasonable screen, elaborate recordings of heart activity for days to weeks, can be done to investigate suspected problems.</p><p>So, again, we&#8217;d see that the magic isn&#8217;t in the test. It&#8217;s in the choice of the right test for the right person and the careful interpretation of the test&#8217;s result in light of your total health picture and history.</p><p>Special thanks to a new friend Tom T. Tom wrote to remind me that the screen tool I wrote about last week has TWO wheels, one on each end, the one with a concave edge pushes the spline (the correct name for my &#8220;piping&#8221;) into the groove, but the OTHER wheel, with a convex edge helps push the screen material into the groove in the first place. Thanks for keeping me honest Tom! I learn something everyday &#8230; and I did go and find my &#8220;spline roller tool.&#8221; Now, to choose the right screens &#8230;</p><style>
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<div class="metaInfo"><bylineMeta><p>By Alfred Casale</p><p>To Your Health</p></bylineMeta></div><div class="metaInfo"><shirttailMeta><p>Dr. Alfred Casale, a cardiothoracic surgeon, is associate chief medical officer for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via ae@www.timesleader.com.</p></shirttailMeta></div>

Screening for heart problems