Current heart attack screening tools may miss nearly half of at-risk patients, experts warn
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Heart experts are raising concerns that common screening tools may be failing to detect a large number of people who quietly develop dangerous plaque in their arteries.
According to new findings, relying mainly on symptoms and traditional risk scores may leave many patients unknowingly vulnerable to a heart attack.
Health professionals emphasise that warning symptoms such as chest pain, breathlessness, or fatigue often appear very late — sometimes just hours or days before a cardiac event. By then, the plaque may already be unstable and on the verge of rupturing.
This underscores the importance of focusing on early detection and the silent progression of atherosclerosis rather than waiting for symptoms to manifest.
Traditional assessments like cholesterol levels, blood pressure readings, lifestyle factors, and family history are still essential, but experts say these alone do not always capture the true health of the arteries. More advanced tests — especially imaging-based evaluations such as coronary calcium scans — can help identify plaque build-up much earlier, offering a chance to intervene before it becomes dangerous.
The new research suggests that broader use of such imaging could significantly strengthen preventive care.
The study, published in JACC: Advances and led by researchers from Mount Sinai, found that the commonly used ASCVD and PREVENT risk scores would have missed 45–61% of patients who went on to have a heart attack.
Researchers say these findings highlight the limitations of current tools and point to the need for earlier, plaque-focused screening.