A Treatise on the “Mammogram of the Heart”

The enormous toll that coronary heart disease takes on our population merits serious consideration of all possible approaches toward early detection and prevention. It is pedestrian to the knowledgeable epidemiologist to state that coronary disease will kill more than twice as many women this year than will breast cancer. Coronary disease kills men at an even greater rate. If we had an effective preventive strategy involving early screening for one disease, why not find and apply a similar strategy for the other? Its vocal proponents have touted the coronary computed tomographic scan for calcification as the mammogram of the heart. However, unlike the breast mammogram, there are no studies showing that those tested fare any better than those who forego testing, in other words, that the test actually improves prognosis. Furthermore, the results regarding the prognostic value of computed tomographic screening are far from completely conclusive and will not be until the ongoing Multi-Ethnic Study of Atherosclerosis (MESA) trial (available at: http://140.142.220.3/mesa/) is completed.