Tests in the emergency department didn’t reveal the source of Dan English’s chest pain. A noninvasive way to measure blood flow around the heart later showed Dan was at risk of a ‘widow-maker’ heart attack.

Story by: David S. Martin on October 31, 2022

Dan English got the kind of scare no one wants.

He was on a construction site when his vision became blurry and his arms went numb. He had to step back to brace himself on a big piece of equipment — and then drove himself to a local hospital emergency room.

Dan underwent extensive tests in the emergency department. Doctors ruled out a heart attack but didn’t see anything more than slightly elevated cholesterol.

“They didn’t find anything, but there was something going on that wasn’t right,” Dan said.

Dan, who owns a construction company, is 58 and in good shape. The former professional football player swims 1 1/2 miles five days a week and lifts weights three times a week.

As an athlete, Dan said his approach when something hurt was to find out what was wrong and to fix it. So, he went to see his doctor, who referred Dan to Craig L. Tucker, M.D., a Norton Heart & Vascular Institute cardiologist who specializes in advanced cardiac imaging.

Dr. Tucker suggested several options, including a noninvasive test that produces color, 3D images of blood flow around the heart. It reveals whether arteries have narrowed and whether blood flow is affected.

The technology, computed tomography-fractional flow reserve (CT-FFR), uses conventional CT images and analyzes them to provide more revealing information about reduced blood flow that could cause chest pain or a heart attack.

It’s the kind of information that’s similar to what a traditional angiogram delivers. But an angiogram is an invasive procedure, using dye and a thin flexible tube called a catheter that is guided through an artery to get a closer look at blood vessels around the heart.

Since it’s noninvasive, the CT-FFR is available to more patients.

Test reveals the makings of a possible “widow-maker” heart attack

In Dan’s case, he said the CT-FFR imaging showed a slight narrowing of his left anterior descending artery, which has the nickname “the widow-maker” because a large blockage can be fatal. A stress test or other tests would not have given him this information, according to Dan.

Dan described the test as “nothing,” quick and painless. He said the dye used for the test created a warm sensation as it moved through his bloodstream, but that passed quickly.

As a result, the married father of three has made improvements in his diet and started taking a cholesterol-lowering statin. According to Dan, it’s better knowing what’s wrong so he can do something about it before his symptoms become more serious.

“We caught everything in the beginning stages of being really bad,” said Dan, who played quarterback for the for the Louisville Fire, a minor-league Arena Football League team, and in NFL Europe.

“The [CT-FFR] test was absolutely amazing. Without the test, it would have been just go on with life,” Dan said. “This way, I can take care of not having major issues down the road.”

Norton Heart & Vascular Institute was first in the region to offer this advanced imaging analysis to patients and was using it more than three years ahead of a recent American College of Cardiology/American Heart Association guideline strongly recommending it as a first-line tool for evaluating patients.

Dan has advice for people who have symptoms — chest pain, discomfort in one or both arms, shortness of breath, lightheadedness, nausea or cold sweats — that can be signs of heart disease:  Get checked out with a CT-FFR test.

“If there’s anybody who says, ‘I don’t need this,’ Yea, you do. There is no other test that would have told me what’s going on except for that one.”