If You’re Dizzy Should You Get CT Scan in ER?

A head CT scan means radiation to your brain, so if you’re dizzy in the emergency room, when and when not should you have this?

Kaiser Foundation Hospital researchers report that less than 7.1 percent of patients in the ER complaining of dizziness benefited from a head CT. About only 6.4 percent of patients with faintness benefited.

The CT scan is fast and easy, but apparently much overused.
Doctors want to make sure they cover all their bases when dealing with dizziness and fainting in patients—which could have both benign and serious causes.

Loss of consciousness can result from causes other than fainting, and under these circumstances, a CT scan is recommended by the researchers. Unless there’s evidence of impairment of the central nervous system, the CT scan should be avoided in cases of simple fainting or feeling faint (called “syncope”).

However, says the report. CT scans are common for patients in the ER complaining of fainting or syncope.

"Most patients with mild symptoms of dizziness or syncope do not require a head CT," points out Myles M. Mitsunaga, one of the researchers. He adds that if there are no “neurologic signs” present, along with a physical examination and careful history having been taken of the patient, then only a next-day follow-up is likely all that’s necessary.

Source: sciencedaily.com/releases/2015/01/150126112438.htm


Suicide Attempts by Bullied Teens: Do Parents Contribute?

Find out how parents could unwittingly contribute to the desire of bullied teens to attempt suicide.

This isn’t about blaming the parents. It’s about explaining how the parents fit into the equation of kids attempting suicide (whether they succeed or not) as a result of bullying.

There are people who insist that when a teen or adolescent becomes suicidal “because of” bullying, there has to be much more to it—namely, bad parents who make their kids’ lives miserable. The bullying at school or online only compounds things.

“This has become a popular idea,” says Israel (Izzy) Kalman, MS, nationally certified school psychologist; director of Bullies to Buddies; and author of numerous books and publications on bullying and relationship problems.

“But this is because most people, even those who take a hard line against bullying, protesting about what a horrible, intolerable problem it is, and demanding the harshest punishments for bullies, have a hard time believing that kids will actually kill themselves for no other reason than that they are being bullied. They assume the parents must be making them miserable as well.

“I strongly disagree with this. Of course this can be the case, but it is not a necessary condition. I have worked with a number of kids who were suicidal because of being bullied, and as far as I could discern, the parents were positive and supportive.

“But as kids come closer to adolescence, relationships with peers become increasingly important to them. If they feel their peers don’t accept them, it far outweighs the benefits of parental support.”

I’m going to stop here for a moment and remind you of a phenomenon you may have learned in a psychology class called “learned helplessness.” There are famous studies done with rats and monkeys that demonstrate this. But learned helplessness happens in humans all the time.

Bullied Teens Learn to Be Helpless from the Parents
Kalman says that in most cases of bullying, “the parents become as depressed as the kids because they suffer their children’s pain. They will often try hard to make their kids feel better, getting them professional help and pressuring the school to make the bullying stop.

“But the parents’ misery only compounds the kids’ misery, and the parents’ helplessness in trying to make the bullying stop reinforces the kids’ sense of helplessness as well. They feel so hopeless because even their parents and the school cannot make the bullying stop. So they feel they have no way out, and they take their own lives.

“The truly sad thing is that such kids can be saved quite easily. However, the adults who are trying to help them do not know how to teach them to solve their problems. Many of my bullied clients had been in counseling or therapy and it did nothing to help them stop being bullied.”


Acid Reflux in Nose (LPR): Cause, Solutions, Long-Term Effects

An ENT doctor explains all about acid reflux burning in the nose as part of LPR, plus cause, how to prevent and long-term effects if it keeps happening.
Acid reflux can shoot up into the nose. After this happened to me, stinging my nasal cavity, as a result of eating too much too quickly, I decided to write an article about it.

My expert source is Dr. Stacey Silvers, MD, of Madison ENT & Facial Plastic Surgery in NYC, who is board certified in otolaryngology—specialty of the ears, nose and throat. ENT physicians deal a lot with LPR (laryngeal pharyngeal reflux). LPR is acid reflux that makes it up to the throat—and sometimes…the nose.

Acid Reflux and the Nose
“Acid reflux is very common, indicted by the isle of medicines in the pharmacy devoted to it,” begins Dr. Silvers. 

“Many of us have it and are unaware that our symptoms are reflux related. Throat clearing, hoarseness and dry cough are amongst the most common symptoms of ‘silent reflux’ or laryngopharyngeal reflux (LPR).”

LPR can be episodic (occasional or periodic), frequent or ongoing/chronic.

“Many of us, however, do experience acid or burning in the chest and back of the throat which are classic symptoms of GERD or gastroesophageal reflux disease,” continues Dr. Silvers. 

“Some people may even experience the stomach acid contents reaching the back of the nose. When this happens, especially if the body is not prepared, one experiences significant burning and pain in the back of the nose.

“Hydrochloric acid (stomach acid) has a pH of 2 which is very acidic.  These and any reflux incidents can happen when eating too much, too fast and increasing activity soon after.”

In my case, I wolfed down a lot of food, and immediately after, experienced a little reflux spurting up my esophagus, up my throat and higher, into my nasal cavity. I instantly felt the burning. It was really weird.

But this is NOTHING to be scared of. It’s just stomach acid. It won’t stay there forever. In my case it persisted for a few minutes, then suddenly was gone.

But what if you get acid reflux in your nose on a frequent basis?
Dr. Silvers explains, “If these occurrences become frequent the body can learn to protect itself by producing a thick mucous in the throat and we will experience ‘post-nasal drip’ (a symptom, not a diagnosis). 

“This is a frequent symptom of chronic silent reflux [LPR].  These reflux episodes in the throat and nose explain why refluxers are more prone to bronchial infections, throat infections and sinus infections.”

You don’t have to worry about getting cancer in your nose from acid reflux going up there. 

“The acid changes our healthy protective bacterial flora, making us more susceptible to unwanted infectious bacteria,” adds Dr. Silvers.  “Chronic GERD sufferers should work with a gastroenterologist to assure that the acid has not caused stomach and esophageal problems.”

I mentioned that acid reflux going up into the nose won’t cause cancer. However…chronic GERD can increase the patient’s risk of esophageal cancer. This is a condition called Barrett’s esophagus.

Prevention of Acid Going into the Nose
“Chronic LPR sufferers should see an ear, nose and throat specialist to have the throat examined.  Most importantly, avoid late night eating, eat slower, avoid excessive highly acidic and processed foods.  Medications are available if these conservative regimens fail.”


Child Says Fidgeting Burns Calories Years Before Research

A teacher blew off a 13-year-old’s proposition that fidgeting burns calories, which, many years later, was proven by research to be true.
When I was 13, I was a freshman at a Catholic high school. There was a nun, Sister Jeane Francis. She one day commented that I had a tendency to fidget while seated in her class. The fidgeting consisted of moving a crossed leg up and down repeatedly, or just repeatedly flexing my foot—that is, lifting the heel off the floor repeatedly.

The fact that this nun couldn’t think of anything more earth-shaking to comment about, speaks volumes about her character.

I told her that fidgeting burns calories.
She thought this was ridiculous. I think she then asked why I thought that fidgeting burns calories. I explained that even though the movement was small, it had a cumulative effect; over time, all that fidgeting would add up to a good number of calories burned.

Sister Jeane Francis thought this was absurd. I don’t remember the words she used, but I DO remember the impression she left on me: That the idea that fidgeting can burn enough calories over time to affect body weight was absolutely stupid.

Not in my wildest dreams could I ever have predicted that MANY years later, a study would come out, showing that the amount of calories burned from fidgeting was, over time, remarkable. That study was like a snowball rolling down a hill; more studies suddenly popped up—with the same results: Fidgeting burns calories, and lean people tend to fidget more.

Some of the studies:
Mayo Clinic (Levine et al)
School of Kinesiology and Health Studies (McGuire et al)
National Institutes of Health in Phoenix, Arizona (Ravussin et al) 

In fact, so compelling was all this research that at least one book was written on how to lose weight by fidgeting. And by the way, the cumulative effect has been identified as up to several hundred calories PER DAY. Since there are 3,500 calories in one pound of fat, let’s do some simple math:

Let’s suppose fidgeting consumes 300 calories a day. Now, 300 x 365 days per year = 109,500 calories per year. Divide by 3,500 to see how many pounds of fat that is: 31 pounds! If this sounds too incredulous to believe, read the studies. Not only that, but fitness experts typically agree that fidgeting throughout the day will burn hundreds of calories that you would not burn if you “sat tight and still” like some teachers order their students to.

Of course, if the family is playing Scrabble and one of the kids can’t stop fidgeting, it can be annoying. The person sitting behind you on an airplane, who can’t keep their legs still, will annoy you by “kicking” your chair. Yes, fidgeting can be very annoying to those nearby.

HOWEVER…this doesn’t change the fact that it burns enough calories in one year to either cause weight loss in those who take up fidgeting, or, prevent weight GAIN in those who’ve done it all along. And that was my point with Sister Jeane Francis…and this biology teacher, who thought she knew everything, turned out to be clueless, while I, at age 13, was ahead of my time.

As a 13-year-old, and at no point after that, I never told anyone else about my theory that fidgeting contributes to calorie burning. What really riles me, however, is that the biology teacher thought this was poppycock.

I wonder if she lived long enough to become aware of the studies and mounting media support of this newly discovered accessory to a weight loss program.

Another point that must be made is the sorry fact that many teachers—and parents—are quick to dismiss ideas simply because they come from kids.

Usually, kids haven’t lived long enough to feel suppressed by expectations and pressure to blend into the herd mentality. Kids tend to be more free-spirited than adults, less inhibited with expressing their thoughts, more inclined to think outside the box. But over time, if they’re around the wrong people, they WILL become silenced. Hopefully, such kids will one day rediscover the power of bold expression and embrace it.

Meanwhile, keep moving those feet, twirling the hair and tapping the pencil—as long as your fidgeting isn’t getting on the nerves of the person sitting next to you.

Bullied Kids & Suicide: Depression vs. Rational Choice

Perhaps the bullied teen or adolescent who dies by suicide was thinking rationally rather than suffering from clinical depression or mental illness.

When yet another story breaks of a child who dies by suicide as a result of bullying, many people attribute this to a mental illness, namely depression, and the event spurs a lot of discussion about the stigma of mental illness—a stigma that keeps the depressed victim from seeking counseling.

But is it really a hallmark of mental illness when a young person sees suicide as the only escape from the bullies who make her feel worthless and defective?

This isn’t about “getting” a thicker skin or being overly sensitive. Humans—the very social, emotionally needy creatures we are—by nature respond in a predictable way to emotional abuse and social rejection.

We see the parents of bullied kids who died by suicide communicating to the media. We see what appear to be wonderful parents.

But like the man who batters his wife several times a week behind closed doors, but then in public presents himself as the perfect husband, is it even remotely possible that many bullied kids (who die by suicide or attempt it) had abusive parents?

And when I say “abusive,” I don’t necessarily mean physically or sexually. Remember, words can strike a developing mind with the impact of a hot brick on flesh.

This is evident in the flood of comments that pop up when the teen bully suicide story makes it to a major news outlet. You’ll find plenty of posts by adults who were bullied at school and had zero sanctuary at home. Namely, they faced humiliation and scoldings from parents who blamed them for the bullying.

The posts are deeply disturbing, telling of the emotional abuse that these posters suffered at the hands of their parents, creating in them an internal fragility that the bullies at school feasted upon.

School ends late in the afternoon, but going home is the second and third shift of bullying. The situation is inescapable. Suicide becomes inviting. Mental illness or logical thinking?

When bullied kids see suicide as a solution, this isn’t the same kind of “crazy” thinking that, for instance, went on in the case of the Heaven’s Gate cult, in which the 39 brainwashed participants ended their lives because they believed suicide would take them to a space ship following a comet.

With parents who demean and dis-empower their kids, crushing any dreams in life they may have, these kids feel hopeless despair and see suicide as the only way out. Hardly seems like “mental illness.” It almost makes a lot of sense. Again, read those posts of the former bully victims who grew up, which are found on any big article about this topic. The posts are chilling.

It’s a lot easier to blame mental illness as the driving force to youth suicide, and perhaps this IS the case when the teenager who takes his life actually had everything going for him: lots of friends, great parents, popular at school, athletic and talented.

But suppose a teen, let’s call him Greg, faces ongoing belittling by his booming father and popular “mean boy” older brother. By the time Greg reaches high school he feels disgusting on the inside.

He has great dreams but believes he’s not good enough to succeed (thanks to relentless discouragement from his father and brother—while Mum remains emotionally weak on the sidelines).

Greg is naturally introverted and awkward, so this makes him get picked on by teachers who favor more engaging, extroverted students.

Kids make fun of him daily and nobody wants him at their lunch table, so he eats lunch sitting on a toilet in the restroom because it’s too humiliating to be seen eating alone in the cafeteria.

Greg feels like a total loser and knows he’ll be saddled with lifelong psychological baggage. Would it really be a sign of mental illness or wayward brain chemistry that Greg would one day take his life?

Izzy Kalman, author of Bullies to Buddies: How to turn your enemies into friends, concurs. In an article in the online Psychology Today, he exposes that the same anti-bullying organizations, that work hard to raise awareness that the horrible effects of bullying can lead to suicide, still have trouble accepting that bullying is responsible, and that there must have been an underlying depression. Yes, it is so hard to accept that suicide can be seen as the only solution by a rational person who is suffering abuse at the hands of others.


Dense Breasts: Cancer Detection Breakthrough with New Imaging

A new imaging procedure has been developed that remarkably increased cancer detection in dense breasts.

A report in the American Journal of Roentgenology describes molecular breast imaging as a supplemental tool for detecting cancer in dense breasts.

Conventional mammograms can miss cancer because malignancies and the fibrous tissue of dense breasts appear alarmingly similar.

The study, led by Deborah Rhodes, MD, of the Mayo Clinic, says that the detection rate of invasive breast cancer was increased by over 360 percent, when combined with a regular mammogram.

Dr. Rhodes points out that the rate of false positives is lower that that incurred by MRI and ultrasound. She also mentions that 20 U.S. states are required by law to alert women that their mammogram revealed dense breasts.

My question is why are all the other states lagging behind? Why does not Kaiser Permanente recognize the growing evidence that density is a significant risk factor for breast cancer? And compounding this issue is that the tumor is difficult to distinguish from the fibrous breast tissue (both appear white on the mammogram).

The report says that automated whole breast ultrasound leads to a detection rate of breast cancer of 1.9 per 1,000 women. With digital tomosynthesis it’s 1.2 to 2.8 per thousand. With MBI it’s 8.8 per thousand.

How long will it be before MBI becomes the standard for women with dense breasts, no matter what state they live in, no matter whom their medical carrier is?

This reminds me of an experiment on TV with a mouse that I, my father and brother once watched. A mouse was placed at one end of a “tunnel,” held by the researcher’s hand. At the other end was cheese.

Midway down the path was a plastic partition. The mouse could see and smell the cheese, and when the researcher released it, it would run towards the cheese, but get stopped by the partition. The mouse would attempt to climb the partition and grew frustrated with every trial run.

After many runs, the partition was removed. The mouse was released and ran towards the cheese…but midway…stopped dead in its tracks, even though the partition was gone. The mouse behaved as though the partition was still there, up on its hind legs, sniffing about, unable to get past that point.

My father commented, “What a DUMB mouse!”

My brother replied, “People are just as dumb. You could shove a piece of evidence right under someone’s nose and they’ll STILL deny it!”

Hmmm…this certainly sounds like what’s going on with this dense breast and cancer thing, such as with Kaiser Permanente. The evidence is well out there that dense breasts is a big risk factor for breast cancer, PLUS makes it difficult for radiologists to see it on mammograms. Too many doctors are acting like the mouse.

“MBI fills an important gap for supplemental screening in women with dense breasts who are not otherwise at high risk," states Amy Conners, MD, co-author of the study.


Slow Walking Speeds Up Aging & Disease

Years before the studies started coming out that slow walking is linked to increased mortality and disease, I already knew this, but other people thought I was just impatient and rude. But I was onto something…

I’ve always wondered why people move like drugged cattle in crowds. They shuffle in groups at crosswalks, moving like snails. 
They filed out of the workplace I used to be employed at, like sloths. Every minute counts on a lunch break that’s only 37 minutes. 

Yes, believe it or not, at one workplace our lunch break was precisely 37 minutes. I didn’t want to waste a minute being stuck behind slow walkers as they lumbered out of the department. 

They thought I was rude, while I thought they were raising their mortality risk due to such slow walking.

(And don’t get me started on how slowly people file out of elevators and board them.)

I’d be stuck behind the coworkers because their workstations were right near the exit, and mine was on the opposite side of the department. I’ve always had this intuition that slow walking set people up for early death or disease.

My sister once said to me, “What’s your rush?” when I told her to speed it up as we were walking together somewhere. I replied, “What’s your sluggish?”

I find it difficult to walk slowly or “leisurely” unless I’m searching for something. I even push shopping carts at a brisk pace. I’m sure some people think I’m neurotic or in a hurry. The reality is that my body just doesn’t like moving slowly. My hands move very fast on a keyboard and handle a mouse very fast. It’s just the way my body is.

If you know someone who always walks “impatiently” or you see someone at a store moving at a good clip, it’s not right to assume anything negative about them. They COULD be pressed for time, but maybe it’s just their natural pace. And maybe they’re aware of all the research that slow walking is heavily linked to health ailments.

If I would have told this to the snail-paced coworkers, they all would have laughed and waved their hands down at me. But years later…the research speaks for itself:

“Slower walking speed forecasts increased postoperative morbidity and 1-year mortality across surgical specialties” (Robinson et al, AORN J. 2014 Dec; 100(6):702-8. Epub 2014 Nov 22)

“Slow Walking Speed and Cardiovascular Death in Well Functioning Older Adults: Prospective Cohort Study” (Dumergier, et al, British Medical Journal 2009;339:4460)

"How fast you walk and your grip in middle age may predict dementia, stroke risk" (Camargo, American Academy of Neurology's 64th Annual Meeting in New Orleans April 21 to April 28, 2012)

There’s more research, but three examples should be sufficient to convince you that slow walking correlates strongly to health problems and mortality. Does walking slowly directly affect the body, leading to sickness? Or is the correlation mostly because people who already have illness or frailty usually walk slowly?

Could the link be due to fast walking in the activities of daily living contribute to better health? Could it be that physically fit people who like to exercise are more inclined to move fast no matter what they do?

Don’t over-analyze. Just accept it: Walking speed correlates to health and longevity. Pick up your pace. Don’t mutter something under your breath just because someone surpasses you in a store aisle…like a man once did when my walking speed eclipsed his.


Child Bullying Younger Sibling: How Mom Should NEVER Respond

Find out what parents should never do in response to a child bullying a younger sibling; the way the parents respond in an attempt to “fix” the problem can make the situation far worse. 
This article actually also applies to dads, but it’s usually the moms who catch a child in the act of bullying a younger sibling. Has a child of yours been picking on, harassing or bullying a younger sibling for what seems like months on end, maybe even years?

This is a tip-off that whatever tactics you’re employing, in an attempt to end this problem, aren’t working. 

Oddly, most mothers and fathers will continue using the same approach, even though it fails miserably; instead of detouring and trying a new tactic, they stick with the old, useless one—perhaps because straying from it would mean straying from a comfort zone.

But you know that famous saying: Insanity is doing the same thing over and over yet expecting a different outcome.

Don’t be insane!

What should mothers NEVER do in response to a child bullying a younger sibling?
First, never put your best interests ahead of the bully’s and the victim’s. Next, never base your response or reaction on how easy it is for you to do. In other words, it’s rather easy for a mother to blow up at the instigator and unleash a diatribe of criticism to that older child, slinging hurtful comments and all.

Yes, it’s actually quite easy to react this way because it requires no planning, creative problem solving, patience, rationale or logic. It’s pure raw, primal emotion. And it will backfire, because when a parent reacts this way to the bully of the younger sibling…she (or dad) is exhibiting the very behavior that they’re denouncing!

A reaction of disgust and anger does NOT teach or show the bully how to love and respect the younger sibling. Chastising with, “You’re older! You should know better!” will not cultivate love for the younger sister or brother. 

Instead, it shows the instigator your anger. Well gee…if the older child feels compelled to belittle and invalidate the younger…how is a display of your anger going to stop that?

A threat of punishment won’t work. Again, this tactic won’t address the root cause. It won’t magically make the instigator feel kindness towards the victim. Ask yourself how on earth your fury and threats will make the bully feel warm and fuzzy towards the victim.

Secondly, the threat of punishment will only make the bully try harder not to get caught the next time, or to develop an ingenious way of getting away with the “crime.” This reminds me of the 11-year-old boy who drank a glass of chocolate milk after being told by his mother not to (the mother didn’t like her kids filling up on sugary items).

The 11-year-old knew he’d get in big trouble for this. The knowledge of his mother’s anger, however, did not stop him from disobeying a rule. How many times have you heard kids say things like, “If my mom found out I (fill in the blank), she’d kill me.” Or, “If my dad finds out I (fill in the blank), I’ll be ground meat.”

The threat of punishment will only produce a more clever child, as was the case of the 11-year-old boy. Some way, somehow, this nasty adolescent manipulated his nine-year-old brother (whom he regularly bullied psychologically) into admitting that HE had drank the chocolate milk (the mother discovered the chocolate-smeared glass in the kitchen). The younger sibling ended up taking a lot of heat from the mother.

So you see, threat of punishment or knowledge of what the parent will do, will not stop sibling bullying. It will only make the perpetrator more cunning.

Other Responses to Sibling Bullying that will Fail
Don’t go into rants about how the siblings are “blood sisters” or “he shares your flesh and blood,” etc. One woman would go into the same furious spiel every time she caught her two young sons “going at it.” She’d fume: “You two both come from the same womb! You make me so ashamed!”

One day I said to her, “Do you really think they care they came from the same womb? Can they even remember being in there?”

Her only defense was pointing out that (at the time) I didn’t have any kids, so what did I know? Yet if she had all the answers, why then, after years of this same angry spiel, were her boys continuing to fight? Her words struck like a fist and did nothing to make these boys love each other. As adults, they are estranged from each other.

Another Thought on Sibling Bullying
“When the parents get in the middle trying to determine who are the real bully and the real victim, the kids start fighting over the parents,” says Israel (Izzy) Kalman, MS, a nationally certified school psychologist; director of Bullies to Buddies; and author of numerous books and publications about bullying and relationship problems.

“They each try to convince the parent to take their side against the other. This process intensifies hostilities between the kids, and whoever lost the parents’ judgment is mad not only at their sibling but at their parent as well. They continue to create fights over nonsense in order to get the parents to take their side, and the parents unwittingly establish a never-ending state of war.

“Ironically, kids learn to get along best when we refuse to get involved in their fights. Humans are social creatures and are hardwired to learn to get along.”

Sometimes it’s helpful for parents to get involved in a sibling bullying scene, continues Kalman. “But our role should be to teach them how to solve their problems with each other, not to try to solve the problems for them.

“There is a free manual on my website that explains in great detail how parents (and teachers as well) unwittingly cause their kids’ fighting to escalate, and how to dramatically reduce the fighting with little effort: A Revolutionary Guide to Reducing Aggression Between Children.”


Why Isn’t Corus CAD Test Done on All ER Chest Pain Patients?

Since the Corus CAD blood test can determine if chest pain is being caused by clogged arteries, why aren’t all patients with chest pain in the emergency room given this test?

Wouldn’t that more efficiently eliminate needless imaging tests that use radiation? Why isn’t this test a standard protocol in emergency rooms for people presenting with chest pain and other symptoms that are often caused by obstructive coronary artery disease (CAD) such as shortness of breath?

For this article I consulted with cardiologist David N. Smith, MD, Novant Health Heart and Vascular Institute, Huntersville, NC.

Dr. Smith explains, “In clinical trials, patients with acute chest pain suggestive of a heart attack (acute myocardial infarction) were excluded from the studies.  The Corus® CAD test is not indicated for patients experiencing a heart attack, as they need to be evaluated and treated quickly in the ER.

“The Corus® CAD test has been established for use in ‘stable’ patients with non-acute signs and symptoms suggestive of obstructive CAD. Additionally, the turnaround time for test results is 48 to 72 hours. This timeframe is not feasible for a quick emergency room diagnosis.”

In the ER, a person with chest pain receives a blood test to measure the amount of troponin in their blood. Troponin is a protein-enzyme that leaks into the bloodstream when heart tissue is damaged. The result of this blood test can be ready in about 15 minutes.

Often, a second such test is necessary, since the first test result might not be definitive for a heart attack. However, the second test is usually given about four hours later, which by then a diagnosis for sure can be made, as troponin levels continue rising after a heart attack.

More information on the Corus CAD test:

Chest Pain: Blood Test Can Tell if It’s Clogged Arteries

This blood test uses age, sex and gene expression measurements to safely & quickly determine whose chest pain is the result of obstructive coronary artery disease (clogged arteries).

Certain patients are candidates for this blood test, called the Corus CAD (coronary artery disease). They are: not diabetic; have not been diagnosed with a previous heart attack; are not suspected of having a heart attack at the moment; have not had coronary artery bypass surgery; are not currently taking chemotherapeutic drugs, immune-suppressing drugs or steroid prescription drugs.

Chest pain is a very common symptom of obstructive heart disease, the so-called clogged arteries. Another typical symptom is shortness of breath. The Corus CAD blood test results are available in 72 hours and can be done in a doctor’s office.

I wanted to learn more about this blood test for patients with chest pain who fear a heart related problem. So I consulted with cardiologist David N. Smith, MD, Novant Health Heart and Vascular Institute, Huntersville, NC.

Why isn't the Corus CAD test recommended for the general population of non-diabetics who experience chest pain? Being it's a simple blood draw, why not just give it to everyone as part of their physical as well?

Dr. Smith explains: “The Corus® CAD test is not a screening test, so it should not be used in the general population, but should be focused only in those patients with specific signs and symptoms suggestive of obstructive coronary artery disease.

"The diagnostic accuracy of this test has proven it is an exclusionary test that truly outperforms current noninvasive diagnostic testing such as nuclear stress test for helping rule out obstructive CAD in patients. 

“In symptomatic patients with scores 15 or lower, this test accurately rules out obstructive coronary artery disease in a greater proportion of people than any other current test, thus potentially saving patients with low scores from having to undergo unnecessary invasive procedures such as a cardiac  catheterization.

“A ‘non-low score,’ defined as greater than 15, corresponds to a higher likelihood of obstructive CAD.  But since the test was not designed to be a ‘rule-in’ test, it should not be used to rule in patients for obstructive coronary artery disease.” 

Other notable causes of chest pain are acid reflux, esophageal spasm and musculoskeletal issues (namely, a muscle spasm or inflammation of the cartilage near the sternum—the chest pain can be significant).