Parameters used for heart disease

prediction
Angina (Chest Pain)
Angina is chest pain or discomfort caused when your heart muscle doesn't get
enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The
discomfort also can occur in your shoulders, arms, neck, jaw, or back. Angina pain
may even feel like indigestion.
But, angina is not a disease. It is a symptom of an underlying heart problem,
usually coronary heart disease (CHD).There are many types of angina,
including microvascular angina, Prinzmetal's angina, stable angina, unstable angina
and variant angina.
Types of Angina - Knowing the types of angina and how they differ is important.

Stable Angina / Angina Pectoris(typical type1 angina)

Unstable Angina (typical type2 angina)

Non angina pain

asymptomatic Angina

If doctor thinks that you have unstable angina or that your angina is related to a
serious heart condition, they may recommend the following tests and procedures:

EKG (Electrocardiogram)

Stress Testing

Blood Tests

Chest X-Rays

Coronary Angiography and Cardiac Catheterization

Computed Tomography Angiography

Fasting Blood Sugar

Study shows a fasting BG of above 100 increases risk of heart disease by

300%. >People with a fasting blood sugar level of 100-125 mg/dl had an adjusted
nearly 300% increase higher risk of having coronary heart disease than people with
a level below 79 mg/dl. This information was compiled from a cross-sectional study
of nearly 2500 people.

A fasting blood sugar level of more than 125 mg/dl is the current threshold for
identifying patients with diabetes. But the new finding suggests that patients with
high levels of blood sugar in the nondiabetic range face a substantial risk of coronary
heart disease.
The Cleveland Clinic Foundation now uses a fasting blood sugar of 90 mg/dl
or higher as a biomarker of coronary heart disease risk.

Resting ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the
heart.

ECG is used to measure the rate and regularity of heartbeats as well as the
size and position of the chambers, the presence of any damage to the heart, and the
effects of drugs or devices used to regulate the heart
An ECG is very useful in determining whether a person has heart disease. If a
person has chest pain or palpitations, an ECG is helpful in determining if the heart is
beating normally. If a person is on medications that may affect the heart or if the
patient is on a pacemaker, an ECG can readily determine the immediate effects of
changes in activity or medication levels. An ECG may be included as part of a
routine examination in patients over 40 years old.
1. ST-T and U wave abnormalities
the specificity of ST-T and U wave abnormalities is provided more by
the clinical circumstances in which the ECG changes are found than by the particular
changes themselves. Thus the term, nonspecific ST-T wave abnormalities, is
frequently used when the clinical data are not available to correlate with the ECG
findings. This does not mean that the ECG changes are unimportant! It is the
responsibility of the clinician providing care for the patient to ascertain the
importance of the ECG findings.

Exang
This is known as exercise induced angina. Angina is generally caused from
not getting enough blood through the arteries to supply the walls of the heart with
enough blood flow to adequately pump. Angina can be caused by blockage, injury or
spasms. It can be particularly irritating when it comes on with exercise. Here are
some things to know about symptoms you might experience when exercising.
There is a difference in stable and unstable angina. Stable angina is
predictable. It can be triggered by emotional stress, exercise, exposure to cold air,
after eating large heavy meals. It is relieved with rest, and doesnt usually have other
symptoms such as shortness of breath, profuse sweating, nausea associated with it.
Unstable angina is angina that is different as it can occur at rest or wake you
from sleep. It is a change in the stable angina symptoms meaning the symptoms are
more frequent, more intense may require more nitro than usual to relieve
symptoms. It may be paired with other symptoms, profuse sweating, nausea,
shortness of breath, weakness, a feeling of doom, lightheadedness. If you are

experiencing symptoms of unstable angina you must contact your medical provider
ASAP. Time is muscle and you dont want to risk losing heart muscle.

Slope:The ST segment shift relative to exercise-induced increments in heart rate,

the ST/heart rate slope (ST/HR slope), has been proposed as a more accurate ECG
criterion for diagnosing significant coronary artery disease (CAD). Its clinical utility,
with the use of a standard treadmill protocol, was compared with quantitative stress
thallium (TI) and standard treadmill criteria in 64 unselected patients who underwent
coronary angiography. The overall diagnostic accuracy of the ST/HR slope was an
improvement over TI and conventional ST criteria (81%, 67%, and 69%). For
patients failing to reach 85% of their age-predicted maximal heart rate, its diagnostic
accuracy was comparable with TI (77% and 74%). Its sensitivity in patients without
prior myocardial infarctions was equivalent to that of thallium (91% and 95%). The
ST/HR slope was directly related to the angiographic severity (Gensini score) of CAD
in patients without a prior infarction (r = 0.61, p less than 0.001). The ST/HR slope
was an improved ECG criterion for diagnosing CAD and compared favorably with TI
imaging.

CA number of major vessels colored by fluoroscopy

Fluoroscopy is an imaging technique that uses X-rays to obtain real-time

moving images of the interior of an object. In its primary application of medical
imaging, a fluoroscope allows a physician to see the
internal structure and function of a patient, so that the pumping action of the heart or
the motion of swallowing, for example, can be watched. This is useful for
both diagnosis and therapy and occurs in general radiology, interventional radiology,
and image-guided surgery.
It is a medical imaging technique used to visualize the inside, or lumen, of
blood vessels and organs of the body, with particular interest in the arteries, veins,
and the heart chambers. This is traditionally done by injecting a radioopaque contrast agent into the blood vessel and imaging using X-ray based
techniques such as fluoroscopy.
Five great vessels enter and leave the heart: the superior and inferior vena cava,
the pulmonary artery, the pulmonary vein, and the aorta.
The superior vena cava and inferior vena cava are veins that return
deoxygenated blood from circulation in the body and empty into the right atrium.
The pulmonary artery carries deoxygenated blood from the right ventricle into
the lungs for oxygenation.
The pulmonary veins carry oxygenated blood from the lungs into the left atrium to
be returned to systemic circulation.
The aorta is the largest artery in the body. It carries oxygenated blood from the
left ventricle of the heart into systemic circulation.

Blood pressure:
High blood pressure is the number one risk factor for stroke and a major risk
factor for heart disease. High blood pressure is when the blood pressure in your
arteries is elevated and your heart has to work harder than normal to pump blood
through the blood vessels. It is important that you have your blood pressure checked
regularly by your healthcare provider. Read on to learn about blood pressure and
how it can be managed.

What is blood pressure?

Blood pressure is a measure of the pressure or force of blood against the
walls of your blood vessels (known as arteries). Your blood pressure reading is
based on two measures called systolic and diastolic. The systolic (top) number is the
measure of the pressure force when your heart contracts and pushes out the blood.
The diastolic (bottom) number is the measure of when your heart relaxes between
beats.

The table below defines varying blood pressure categories: low risk, medium
risk, high risk. See your doctor or healthcare provider to get a proper blood pressure
measurement.

Cholesterol
High levels of cholesterol in blood serum are associated with a high risk
of CHD mortality in the different cohorts of the Seven Countries Study. Serum
cholesterol levels in middle-aged men are a strong predictor of CHD risk mortality
after 10 and 25 years offollow-up. Both past and recent serum cholesterol levels
are related to 35-year CHD mortality, although the strength of the
association diminishes with increasing age.
Coronary heart disease (CHD) is the leading cause of death in most
industrialized countries, and its importance as a major public health problem is
increasing in developing countries. 1 2 3 The role of serum cholesterol as one of the
main risk factors for CHD, along with smoking and high blood pressure, was
established in the 1960s and confirmed later by a large body of data from
biochemical and epidemiological studies, as well as by clinical trials. 4 5 6 7 It was also
shown that a high use of saturated fat is the main determinant of serum cholesterol

concentration, both in a population and in individuals. 8 9 Major approaches used for

the reduction of serum cholesterol and subsequent prevention of CHD are the highrisk strategy and the population strategy.

ST depression
The diagnosis of coronary artery disease in patients with chest pain
syndromes is a major application of the exercise electrocardiogram (ECG). Although
several variables have been reported as useful in the analysis of
electrocardiographic results, depression of the ST segment below baseline has
received the most attention. Experts agree concerning the importance of ST
depression in the diagnosis of coronary disease. However, disagreements occur
concerning the quantitation of ST segment depression measurements.1-3
Furthermore, exercise ECG protocols differ markedly as to number of leads used,
type of exercise (e.g., bicycle, treadmill), computerization of results, and treatment of
equivocal or nondiagnostic tests.
To determine the accuracy of the exercise ECG for the prediction of coronary
disease, clinical investigators have performed numerous studies comparing
exercise-induced ST depression with results of coronary angiography. Though
excellent research has been accomplished, little agreement has been reached
concerning the optimum protocol and method of interpretation or even the accuracy
of this test.

Thal
Thal is the iron content in the heart.
As the level of iron goes up in your bloodstream, so apparently does your risk
for heart attack and stroke. A new study by Japanese researchers shows that highlevel iron injections can cause almost immediate constriction of blood vessels. In
fact, the scientists believe the iron damage could be the first step in a cascade of
events leading to the thickening and hardening of the vessels.
Serum ferritin, better known as iron, is vital to human life because it stimulates the
production of hemoglobin, the red blood cell pigment that carries oxygen to our cells.
Without it, we couldnt survive. However, research suggests that iron overload, or
hemachromatosis, is a risk factor of heart disease. Hemachromatosis is an
acquired or hereditary defect of iron metabolism in which excess iron is deposited in

tissues and not available for oxygen transport. Unless iron is lost through
menstruation or donating blood, over the years, toxic blood iron levels can
accumulate in your system.

Thalach
It is the maximum heart rate achieved by the heart.