Medical Tests & Procedures Archive

Ask the doctor

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Q. I was recently diagnosed with aortic stenosis after my doctor heard a slight heart murmur and referred me for an echocardiogram. I don't have any symptoms, so the cardio­logist recommended that I get periodic echocardiograms to monitor the condition. Is there anything else I can — or should — do?

A. Aortic stenosis — also called aortic valve stenosis — occurs when the one-way valve inside the heart's largest vessel, the aorta, stiffens and becomes clogged with calcium deposits. As a result, the valve doesn't open as easily. During a heartbeat, as the heart's main pumping chamber (the left ventricle) contracts, pressure builds up behind the aortic valve. This creates the turbulent blood flow that a doctor can hear through a stethoscope.

Certain tests involve small amounts of radiation. Here's some perspective on the benefits and risks.

Cardiologists have many options for visualizing the heart, some of which involve exposure to radiation. Used appropriately, these tests can identify possibly life-threatening conditions, such as dangerous heart artery blockages. In recent years, the accuracy of many of these noninvasive tests has increased. They're also being used with increasing frequency.

Because ionizing radiation can damage cells, potentially raising the risk of cancer, experts acknowledge that imaging tests that involve radiation should be used judiciously. Earlier this year, the American College of Cardiology published a consensus statement on the best practices for safe and effective use of radiation in cardiac imaging tests.

This hormone, which helps the body manage water and sodium, is a focus of growing interest among researchers.

High blood pressure — which has no symptoms or warning signs — can harm your blood vessels, heart, brain, eyes, and kidneys. An estimated 46% of adults in the United States have this stealth condition. A combination of unhealthy habits, such as smoking, a poor diet, and lack of exercise, can contribute to a rise in blood pressure. While kidney disease may cause high blood pressure, for most people the underlying cause is unknown.

However, for about one of every 15 people with high blood pressure, an imbalance of the hormone aldosterone may be to blame. This problem may be even more common among people with poorly controlled high blood pressure (also called resistant hypertension). "Among those people, up to one in five may have too much aldosterone," says Dr. Gail Adler, chief of cardiovascular endocrinology at Harvard-affiliated Brigham and Women's Hospital.

On call

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Q. I'm 65 years old and have never had any bone health issues. Should I get a bone density test?

A. Bone density testing is a specialized x-ray technique used to diagnose osteoporosis (thin bones), a condition that increases the lifetime risk of fracture by six times in men.

Rates of the two most common skin cancers have more than doubled over the past decade. Here's how to protect yourself.

When it comes to skin cancer, there's good news and bad news. First, the bad news. A report published in the June 2017 Mayo Clinic Proceedings found that cases of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) skin cancers have risen 263% and 145%, respectively, over the past decade.

The good news? BCC and SCC are rarely life-threatening and they're usually easy to treat if they're caught early. Plus, there are simple ways to prevent them.

Heart tests help show artery blockage and assess the risk of heart attack

If you are at high risk for heart disease or have a symptom such as shortness of breath or discomfort in your chest, your doctor may order certain heart tests. But there's more to testing than simply finding out if you have heart disease. Your doctor may also want to determine whether the fatty plaques inside your blood vessels pose a high, medium, or low risk for a heart attack. The answer will help determine whether you need treatment, and if so, which type of treatment will be best.

No single test is better than another, and no test is appropriate for everyone. "The best test for an individual is the one that provides the information needed to guide management," says Dr. Ron Blankstein, a cardiovascular imaging specialist at Harvard-affiliated Brigham and Women's Hospital.

Machine learning may improve the way doctors detect heart disease.

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Imagine a world in which a photo of your eye — taken with your smartphone — could determine your risk of a heart attack, and your smartwatch could estimate your odds of experiencing a stroke. Sounds pretty futuristic, right?

In fact, preliminary studies showing the feasibility of both approaches have already been published. They're just two examples of the new wave of technology-based innovations (see "Transformative technologies") that are beginning to change health care as we know it.

Ask the doctor

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Q. I understand there's a genetic test that can tell you how well you might respond to antiplatelet drugs. Do you recommend this test?

A. The short answer is no, not yet. For now, I think it is best to wait for the results from studies looking at personalized antiplatelet therapy. Also known as tailored medical therapy, personalized therapy refers to treatments that are based on your own information, including genetics. But first, I will address two other relevant questions: (1) what is antiplatelet therapy, and (2) who needs it?

On call

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Q. I have recently been hearing a lot about getting tested for hepatitis C. I don't think I have any risk factors, but is this something I should consider?

A. Hepatitis C is a viral disease that causes inflammation of the liver. The CDC reports that 75% of all current cases of hepatitis C are in the baby boomer generation and many more are undiagnosed. The reason is that a vast majority of people have no symptoms, such as fatigue, muscle and joint pain, abdominal pain, and nausea.

Remember to take care of your hearing, like any other aspect of your health.

When you plan your next series of maintenance health tests, don't forget your ears. An ear and hearing exam is not something that needs to be done every year, but you should be aware of changes that could signal serious problems.

"At the very least, a baseline evaluation can help, so you can monitor changes if your hearing declines," says Dr. Stephen W. Hill, an audiologist at Harvard-affiliated Massachusetts Eye & Ear.