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Eye exam could help determine heart disease

Shirley Kaswinkel is a spry 75-years-old, but her heart has sent her racing to the hospital one too many times. Her problem was finally diagnosed at the University of Florida College of Medicine. "They told me I would have to have a stress cardiogram done, which I had done many times. So when the doctor did it and I just jokingly said, 'Nothing wrong?' He said, 'No, you're not getting enough oxygen'," said Shirley.

Shirley is a case in point: Women don't always have the "classic" heart attack symptoms but they still have a lot of pain. According to Dr. Handberg, "One of the difficulties with women is that they tend to have chest pain in the presence of coronary arteries that don't have blockages. And it's difficult for us to understand exactly why that is."

So Dr. Handberg's research is focusing past the large coronary arteries to the microcirculation of the heart. She says the small circulation disorder and the disorder of the lining of the blood vessel walls is probably the earliest marker of atherosclerosis."

One way to examine the smallest vessels is by using retinal photographs. Dr. Handberg says arteries appear to narrow with hypertension, while veins get bigger with inflammation. Ultimately, she'd like to see if the retinal photographs could replace high cost cardiac stress tests in select cases.