Why Did The President Receive A CT Angiography Of The Heart?

The memo confirmed the President received a CTA of the heart that showed no arterial obstruction or structural abnormalities of the heart. Although very reassuring for the heart health of the President, a question the public should be asking is why Trump got this test in the first place.

A CT scan is an imaging test that uses x-rays and computer software to generate detailed images of the body. A CT Angiography of the heart is not a routine test offered to just anybody. This test uses iodinated dye to opacify the coronary arteries, the vessels that supply blood to the heart. This test would identify any blockage of the heart vessels and can aid cardiologists in identifying problematic vessels that may need intervention, such as a placement of a stent to restore blood flow in the case of a significant blockage.

This specific test is usually only recommended to patients if they are experiencing symptoms, like chest pain or shortness of breath. In addition, some patients with high risk for heart disease are offered this test, such as those with high cholesterol, high blood pressure or a family history of heart disease. Based on the physical exam assessment provided by Dr. Barbabella, President Trump does not have high cholesterol and his blood pressure was within normal limits. Whether or not he had symptoms was not clarified in the memo, and there is no indication that Trump has a family history of heart disease. Thus, an important question would be why President Trump got this test to begin with?

Of note, the test the President just received is different than a CT coronary calcium score, a test he received in 2018. A CT coronary calcium test is also a CT exam, but it quantifies how much calcium is present in the blood vessels that supply the heart. This study predicts one’s risk of having heart disease and is offered usually to patients who are not having any heart symptoms. President Trump received a coronary calcium score of 133 in 2018, which indicates a moderate burden of calcium in the heart blood vessels and a need to start cholesterol lowering medications.

Why Is The President On A High Dose Aspirin?

It is well known that President Trump takes a high-dose of daily aspirin, as opposed to the low- dose of aspirin that is generally recommended to help prevent heart disease and stroke. In the memo, Dr. Barbabella also states, “Preventive counseling was provided, including guidance on diet, recommendation to take a low-dose aspirin, increased physical activity, and continued weight loss.” An important question to consider here is why has the President been on a high dose of aspirin, since a higher dose significantly increases the risk of bleeding.

The bruising on Trump’s hands could certainly be attributed to aspirin use, as bruising indicates internal bleeding. A high-dose of aspirin is usually only given when a patient is suffering a heart attack acutely, after certain surgical interventions, or in certain inflammatory conditions such as rheumatoid arthritis. Further information on exactly why President Trump has been on a high-dose aspirin should be made available to the general public.

Why Was An AI-Enhanced Electrocardiogram Used?

According to the memo released by the White House, the President received an AI-enhanced electrocardiogram that estimated Trump’s cardiac age to be 14 years less than his chronological age. Currently, AI-enhanced electrocardiograms can be used to predict one’s risk of hidden heart disease or to help diagnose certain conditions such as arrhythmias, but using it to document cardiac age is not used clinically. This then begs the question— why was this statement about the use of AI-enhanced electrocardiogram included in the President’s health report?

President Trump’s health has been reported to be excellent, but many questions still remain to be answered.