Meet Dr. Hafiz Tariq, a certified cardiologist practicing in Pennsylvania. We recently had the opportunity to interview Dr. Tariq and get his expert opinion on some common concerns addressing the symptoms and various tests one can take to detect the disease early on. Read on to learn in-depth and valuable information about the heart, various diseases, and also what one can do to enjoy a healthier and longer life.

Please introduce yourself to our readers?

My name is Tariq Hafiz and I am a Board Certified Cardiologist currently practicing clinical cardiology in northeastern Pennsylvania. I completed my Cardiology Fellowship from Hahneman University Hospital in Philadelphia.

Tell us about your background - where you grew up, your family and education.

I grew up in Karachi where my schooling consisted of St. Patrick's High School, DJ Science College and finally, Dow Medical College/Civil Hospital. My parents as well as my two brothers and sister also reside in Pennsylvania. I am married to Sarwat Hafiz, and have two teenage boys named Harris and Danial.

You are a cardiologist by profession, what made you decide to specialize in this field?

As a medical student, I was always intrigued and fascinated by the complexity and function of the heart. I was also interested in the diagnosis, the treatment as well as the prevention of the heart diseases.

Heart disease is a fairly common among men, but more and more women are also faced with the problem. Are our genes, diet or over all health responsible for this?

Yes, there are many misconceptions about women and heart disease. Every year more that 500,000 women in US die of heart disease which translates to about 1 death every minute. Mention the term "heart attack" and most people imagine an obese middle aged man sitting on the floor clutching his chest and drenched in sweat and this picture gives the public a wrong impression that heart disease is a "man's disease". However, nothing could be farther from the truth and it must be stressed that heart disease is the leading cause of death and unfortunately takes the life of twice as many women in the US than all types of cancers combined, including breast cancer. According to a recent survey, only about 15% of women think that heart disease is a threat to there health compared to 70% of women who fear dying from breast cancer. Just to give our readers an idea, 1 in 27 women will die of breast cancer, versus 1 in 2 die due to heart disease. It must be emphasized that not only the presentation of heart attacks in women are different but also the severity of heart disease is worse when compared to men. About 65% of women who die suddenly of heart disease have no previous symptoms and worst, after a suffering a heart attack, about 45% of the women die within a year. It seems that many young women are not connecting there symptoms with heart disease and are not aware of the fact that they are at risk for a heart attack. We as physicians have to convey this critical message across that even younger females are at risk for a heart attack and they must remember that they may only experience atypical symptoms.

What is Cardiac Computed Tomography, who should be the ideal candidate to get this done? Who should avoid this?


The Cardiac CT (Computed Tomography) is a relatively new technology that utilizes a 64-slice multiple detector camera which has allowed for high definition imaging of the moving heart. There are two types of the Cardiac CT; Calcium Scan and CT Angiogram (CTA). Let's talk about the CTA, which is the latest fascinating test available to diagnose CHD (Coronary Heart Disease). During this test a detailed 3D model of the patient's heart is generated so that the cardiologist can rotate, zoom and move through the heart's anatomy with great detail. The CTA has revolutionized cardiac imaging to the point that now there is a separate society of Cardiovascular CT called www.scct.org. Ideally, this test should be performed in patients at high risk for developing coronary disease such as cigarette smokers and patients with diabetes, hypertension, high cholesterol and family history. If the CT scan is normal, then it reliably excludes a significant coronary artery blockage. Conversely, if the CT scan indicates a significant blockage, then the patient is referred for Cardiac Catheterization with plan for angioplasty, stent placement or bypass surgery.

What side effects if any, are linked with this procedure? How long does the procedure last?

The entire test usually last 10-15 minutes, but the majority of the time is spent in the preparation like IV-line placement in the arm because this test requires a contrast-dye injection. The actual time under the donut shaped camera is only about couple of minutes, so you can imagine that this is a very quick and safe imaging test. CTA is a very low risk procedure but occasionally the patient can experience adverse reaction to the dye like itching or a rash which can easily be treated. Therefore it is important to inform your Physician if you have any history of dye allergy. The CT scanner use x-rays and for your safety, the amount of radiation exposure is kept to a minimum. Due to the fact that the x-rays can harm a developing fetus, this test is not recommended in pregnancy. This test is also done with precaution if you have kidney disease and therefore you may require a routine blood work prior to the test to ensure proper renal function.

If one has a history of heart disease in their family, at what age should they get checked and does the CT scan determine if a particular person will be at risk of heart disease in the future?

First it's very important to understand what should be considered a family history of heart disease. A person is considered to have a family history if ones father had heart disease (heart attack, stent, or bypass) at an age less than 55 years or the mother at age less than 65 years. If indeed someone has a family history, then they need to be checked for heart disease at age 45 for a man and age 55 for a woman. This work-up can include blood cholesterol test, blood cardio CRP, EKG, nuclear or echo stress test and Cardiac CT namely Calcium Scan and CT Angio. The decision about the appropriate test should be made by the primary care physician or preferably by the cardiologist depending upon the individual's cardiac symptoms and risk factors.
The Cardiac CT called Calcium Scan is exceptionally beneficial. A Calcium Scan as the name implies, looks for deposition of calcium in the walls of the coronary arteries (the blood vessels that supply the heart muscles). The idea behind this test is that the higher the calcium score, the higher the chance of atherosclerosis, which is the hardening of the arteries caused by high blood pressure and high cholesterol that can eventually cause blood vessels narrowing and blockage. The calcium scan is easily and quickly performed within couple of minutes and does not even require an IV line or a contrast dye. A normal artery should not have any calcium deposition and therefore the calcium score should be zero. An abnormal calcium scan is reported as mildly abnormal if the calcium score is less than 100 and highly abnormal if the score is greater than 400. The higher your calcium score, the more cholesterol plaque you have in your heart arteries, thus significantly increasing your chance of having a future heart attack. I personally think that a simple and a quick test like the calcium scan can safely predict the future for heart attack.

What are the early signs or symptoms of heart disease? What can one do to keep their heart healthy and enjoy a healthy life?

Coronary heart disease is the leading cause of death in the US and worldwide. About 1 million Americans suffer from a heart attack each year and close to 400,000 die. Unfortunately, half of these deaths occur within an hour of the start of symptoms and before the person can reach the hospital. The signs of heart attack can be typical or atypical .The typical or classic warning symptoms are usually seen in men and include crushing chest pains radiating to the left arm or the jaw with associated breathlessness and sweating. Other symptoms called atypical, which are mostly seen in women, include feeling of indigestion, nausea, upper back pain, light-headedness and severe anxiety. Women do not necessarily have the classic or typical symptoms of a heart attack and therefore it sometimes gets overlooked even by the doctors. So, the best protection against heart disease is prevention as much as possible by educating yourself of the common risk factors which include as I have already mentioned; hypertension, high cholesterol, diabetes, obesity, cigarette smoking, and sedentary lifestyle.

Where can we get more information about the CT scan, and where should we go to get ourselves checked?

The best resource is your primary physician who will refer you to the nearby cardiologist office or the nearest hospital that offers this facility and has a 64 Slice CT Scan Camera. You may want to visit www.webmd.com and www.americanheart.org for further information.

How is a stress test different than the cardiac CT?

This is a very important and interesting question, the various types of stress tests including exercise stress test, nuclear stress test and echo stress test will only be abnormal if there is a large blockage present in the coronary artery but if the blockage is less than 70%, then the stress test will be reported as being normal and this obviously creates a sense of false reassurance. It should be emphasized that more than half of all of the heart attacks occur with less than 50% of the blockage that can suddenly rupture and cause a blood clot formation that leads to a complete obstruction. One such unfortunate person was the famous TV Journalist Tim Russert who had undergone a normal stress test just about six week prior to suffering a massive heart attack that caused his untimely demise. On the other hand, the small hidden coronary artery blockage that does not obstruct the blood flow enough to affect a stress test can be very clearly and easily seen and detected by the Cardiac CT.

Lastly, what is your message to the readers of The Saturday Post?

Eat healthy, exercise and educate yourself about YOUR risk factors for heart disease.