By Robert Bazell Chief science and health correspondent
NBC News
updated 9/17/2004 8:06:34 PM ET 2004-09-18T00:06:34

What if you could know your coronary arteries are getting clogged before symptoms strike? It has been a major goal of cardiology for years.

Stress tests can miss serious heart disease, as they did in Bill Clinton's case.

Angiograms show the blockages. But since they involve inserting a tube into the arteries, they carry some risk and doctors reserve them for people who already have symptoms.

Thomas Langel got the test most people think has the greatest promise. It is a fast CT scan — a computerized X-ray of the heart.

Test yourself

As Dr. Elliot Fishman of Johns Hopkins can attest, it produces vivid pictures. But even though many hospitals and doctors offer the scans, Fishman says it is not yet a tool for routine screening.

"The one thing we do not encourage and we discourage, is people deciding on their own, 'I'm going to get a scan.' Even if it's out-of-pocket and you're willing to pay, that's bad medicine," says Dr. Fishman.

One problem: the scan exposes the patient to as much radiation as 20 regular chest X-rays.

The other problem is technical. To be truly effective, a scan must look inside the coronary arteries — which are about the size of spaghetti strands — while the heart beats 60 times a minute. Machines do not have enough computer power yet to do that.

As a result, what the current scans can show is a buildup of calcium which can go along with the heart disease — but is not a perfect indicator.

Within a few years, researchers predict, the computers will be powerful enough to make the scans an effective tool for detecting heart disease before it is deadly.

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