4D-CT for Heart Disease Diagnosis

 

Feb. 3, 2023 

It was time for teacher and principal Ken Nell to learn some lessons of his own. 

For about two months, Ken, a 70-year-old Adams County resident, had been having chest pain, pain that got worse with movement, even just quick walking. His grandfather had died of heart attack, one of his brothers suffered a heart attack at a relatively young age, and both of his parents had high cholesterol. Ken knew he probably had heart problems but was putting off seeking treatment. 

Fortunately, when he finally did, Ken benefited from a new method of care at WellSpan York Hospital that diagnosed and treated his heart blockages within about five hours, sending him home the same day with a healthier heart and feeling much better. 

"That was amazing," said Ken, who was able to go back to the classroom after just one day of rest and, most importantly, avoided a potentially fatal heart attack. "I should not have put it off. I didn't realize how serious I really was. I'm thankful for another lease on life." 

The fast, directed treatment came thanks to WellSpan's experienced cardiology team members and their use of a new machine called a 4D cardiac CT machine – which adds time as the fourth dimension to traditional three-dimensional imaging. The 4DCT allows WellSpan cardiologists to record multiple images of the heart over time and see the internal physiology and movement of the heart. The machine is in the cardiac catheterization lab, making it easy to quickly move the patient into treatment. 

Ken's first step toward treatment came at his mother's funeral, when he had a heart-to-heart conversation with another brother, Jim, the chief nurse anesthetist at WellSpan York Hospital, who knew that Ken had been having chest pain. 

"Jim said, 'Ken, you are my older brother, and I would like to have you around a little while.' He had figured out that I needed help," Ken recalled.

Ken first had a virtual visit, sharing his symptoms and family history with Dr. Stewart Benton, interventional cardiologist and director of the cardiac catheterization lab at WellSpan York Hospital. Based on the visit, Benton was fairly sure Ken had blockage, a supposition that was confirmed a week later by a 4DCT scan that showed one of Ken's arteries – the one nicknamed the "widow maker" – was 99 percent blocked.

"I was able to quickly move from diagnosing Ken to treating his blockage," Dr. Benton said. "Before the 4DCT scan, we already had prepped him for treatment in the cath lab, anticipating he would require it. We saw the blockage on the scan and immediately transitioned him to treatment, where I ended up placing two stents."

This method of treatment speeds up the process for patients, who sometimes have to go through several visits over several weeks, first seeing their physician, then being sent for a noninvasive cardiac stress test, then going to the cath lab to be treated, Dr. Benton says. The 4DCT machine allows doctors to see the problem more quickly and be prepared to treat it, all in one day.

The 4DCT scans are helpful for more than just diagnosis. They also allow cardiologists to see heart disease that would not be caught in a traditional stress test. Dr. Benton compares the testing to a mammogram or a colonoscopy, in that it allows cardiologists to see disease very early and take steps to treat it.

"We can tell patients, 'Your scan shows you are starting to have a buildup of cholesterol and plaque in your arteries that puts you at a higher risk for a heart attack. Now is the time to address it.' This gives them time to change their diet and lifestyle and take medications to lower their blood pressure and cholesterol," Dr. Benton says. "They can take steps to prevent the heart attack."

For Ken, the fast treatment helped him safely get back on the road to a healthier life and enjoy his family, which includes eight children and 23 grandchildren.

Learn more about WellSpan's game-changing heart care.