The Heart Attack That Gives You No Warning

A calcium score of zero is real reassurance. For about 9 in 10 people it means exactly what they hope it means. For about 1 in 10 it does not, and the people most likely to fall in that gap are the ones who assume they are safe.

Dr. Georgine Nanos sits down with Dr. Milind Parikh, board-certified cardiologist and Director of Preventive Cardiology and Cardiac CT at the Cardiovascular Institute of San Diego and Image One, to talk about what coronary imaging can and cannot tell you, and why he thinks cardiology should look inside the arteries before it starts guessing from risk factors.

Dr. Nanos shares her own case on air: no symptoms, excellent fitness, and a more than 50 percent obstruction found on a coronary CT.

In this episode:

• Why calcification is the healing stage, and why younger patients with real plaque often score zero
• The difference between a calcium score and a full coronary CT angiogram, down to the slice thickness
• What the SCOT-HEART trial actually showed, and who was in it
• What the CONFIRM2 registry found about women and plaque
• The cardiac fingerprint: imaging plus biomarkers, in that order
• Why scanner generation, protocol and radiation dose vary so much between centers
• Where AI plaque quantification is genuinely useful, and where it is not yet

Dr. Milind Parikh: ctheartscan.com

This episode is educational and is not medical advice. Coronary CT screening in people without symptoms is not covered by current guidelines, and Dr. Parikh says so himself on air. Talk to your own physician about whether imaging makes sense for you.