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— BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.

Q: My 45-year-old brother is a fireman. When he started getting short of breath, his GP sent him to a cardiologist. Everyone figured it was asthma, but he had a coronary calcium scan and an angiogram. He felt fine, but they spotted trouble and ended up putting a stent in his blocked heart artery. They said he dodged a near fatal heart attack. How can this happen when he’s so physically active and strong? -- Shelley M., Lyndhurst, Ohio

A: Sounds like your brother avoided a heart attack caused by the narrowing of what cardiologists call the “widow maker” -- the left anterior descending heart artery. That blockage often causes few or no symptoms and can drop someone in his or her tracks with almost no warning. “The Biggest Loser” trainer Bob Harper suffered such an event last year while working out at a gym. The Cleveland Clinic warns that those most at risk -- you can be thin and fit -- are those who:

• Have a family history of coronary artery disease.

• Were a past or present smoker.

• Have a history of high cholesterol, diabetes or high blood pressure.

• Are overweight.

• Have an inactive lifestyle.

Coronary calcium scanning should include a blood test, ultrasound and X-ray to help a cardiologist determine if a patient has a low, intermediate or high risk for heart attack. They’ll also tell your doc how much atherosclerotic plaque (made up of fats, cholesterol, calcium and other substances) has accumulated in the heart’s blood vessels. Then the doc can decide with you if surgery, medication, lifestyle modification or all the above is the best way to proceed. Sounds like “all of the above” is what’s on the plate (no more steak and eggs at the firehouse) for your brother.

If coronary calcium scanning finds a dangerous accumulation of plaque in a heart artery, the chances that more will follow is pretty high. The sooner it’s treated and the patient adopts a heart-healthy lifestyle, the better. Now that you know you have coronary artery disease in your family, Shelley, you should get checked, too.

Q: I have several tattoos and broke my arm. My doc wants me to have an MRI. Is it safe considering the metals in tattoo inks? -- Linda H., Oakland, California

A: The heavy metals found in the inks are (among others) lead, copper, zinc, chrome, arsenic, cadmium, barium, manganese, nickel, chromium and mercury. The more colorful your tattoo, the wider the variety of heavy metals in the ink.

There are a couple of possible, but rare, side effects from an MRI on tattooed skin. But they shouldn’t stop you from getting the scan. Most problems come in the form of first-degree (superficial) burns, and if you feel a burning sensation happening to you, you can press the hand-held signaling device they give you and stop the scan. Tingling in the skin has also been reported, but none of these side effects were permanent. Women who have tattooed-on eyeliner should be very careful, however, and be aware of these possible side effects.

The other problem with tattoo inks and an MRI is that the tattoos can contain pigments that are ferrous, and therefore magnetic. This can interfere with the readability of the scan. It’s not good news for the multitudes of professional athletes who plaster themselves with tats and then spend a fair amount of time during their playing careers getting MRIs, nor for anyone else who participates in an injury-prone profession or sport.

In general, it’s interesting to note that simply having tattoos indicates that you may engage in risky behaviors. Even so, the biggest health risks of tattoos come from the inks themselves. The Journal of Environmental Protection points out that exposure to tattoo ink metals “has been linked to tremors, liver damage, memory loss, cognitive loss and even death.” The smart move is to leave the toxic inks for your printer. But if you have a tat and need an MRI, go ahead and get it.

•••

(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. Distributed by King Features Syndicate, Inc.)

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