Why Tamils are at higher risk
The American Heart Association says people of South Asian origin, including from India and Sri Lanka, are more likely to die of heart and artery disease than people of European or East Asian ancestry. Reasons include diabetes at a younger age, high triglycerides, low "good" HDL cholesterol, and narrowing in several places along the arteries. People who are slim and active can still have blockages, and for many the first symptom is the heart attack itself.
Heart attack warning signs: act at once
- Pressure, tightness, heaviness or pain in the chest that lasts a few minutes or comes and goes
- Pain spreading to one or both arms, the jaw, neck, back or upper stomach
- Shortness of breath, cold sweat, nausea or light-headedness
- Women, older people and people with diabetes may have milder signs. Don't wait it out as "gas"
Call emergency services right away, and don't drive yourself.
Step 1: the basic checks
Regularly from your 30s (your doctor will say how often): blood pressure, blood sugar (HbA1c), a cholesterol panel (LDL, HDL, triglycerides) and waist size. Ask about a lipoprotein(a) [Lp(a)] test at least once in your life. If anyone in your family had a heart attack young, tell your doctor. Your doctor uses all of this to estimate your 10-year heart risk.
Step 2: tests that look at the arteries
Coronary calcium score
A CT scan that takes a few seconds and needs no dye injection. It shows hardened, calcified plaque in the heart's arteries. A score of 0 means no hardened plaque; 1–100 is mild; 101–400 moderate; above 400 high risk. US guidelines say it's reasonable when your risk is in the middle and the treatment decision isn't clear, and they count South Asian ancestry as a factor that raises risk. In 2025, Chennai's Omandurar Government Multi-Specialty Hospital was reported to offer the scan for ₹500; private centres charge more. Note that it doesn't show soft (non-calcified) plaque, so if you have symptoms, a score of 0 alone is not an all-clear.
CT coronary angiogram
A CT scan taken while a contrast dye is injected into a vein in your arm. It shows where the heart's arteries are narrowed, by how much, and whether there's soft plaque. The scan takes seconds, and the whole visit about 30 to 60 minutes, with no catheter or surgery. In India it costs roughly ₹8,000 to ₹25,000 (about ₹10,500 to ₹22,000 in Chennai), far less than in many Western countries and usually with little waiting.
Who should get it? Your doctor may recommend it if you have symptoms such as chest pain or breathlessness on exertion, a high calcium score, diabetes, or a strong family history of early heart attacks. It isn't recommended as a first test for everyone who has no symptoms and low risk.
Things to know: it uses radiation, so pregnant women should avoid it. The dye can cause allergic reactions and can harm kidneys that are already weak, so bring a recent creatinine (kidney) test result. Avoid coffee and tea for 12 hours and food for 4 hours before the scan. You may be given a tablet to slow your heart rate.
Other tests: don't mix them up
An ECG records the heart's electrical activity. An echocardiogram (echo) is an ultrasound that shows how well the heart pumps and how the valves work, but it does not show blocked arteries. A treadmill stress test (TMT) checks how the heart copes with exercise. To actually see blockages you need a CT angiogram or a catheter angiogram.
Getting checked during a trip to India
- Before you leave, ask your family doctor for a letter with your history, medications and recent blood test results.
- See a cardiologist at an NABH-accredited hospital, and let them decide which test you need.
- Get the report in English, and ask for a copy of the scan images (CD or download link).
- If a blockage is found and it isn't an emergency, get a second opinion before agreeing to a stent or surgery. Many blockages are managed with medication and lifestyle changes.
- When you get home, show the results to your family doctor and plan the follow-up together.
The bottom line
Feeling fit is not protection. Know your numbers, ask your doctor about your risk, and if it's warranted, get a calcium score or CT angiogram. It's one of the best investments you can make for your family.
Sources
- American Heart Association scientific statement: Atherosclerotic cardiovascular disease in South Asians (Circulation, 2018)
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease (Circulation)
- Heart360: CT coronary angiography cost in India, by city
- ETV Bharat: CT calcium scoring launched at Omandurar Government Hospital, Chennai
- American Heart Association: 2025 High Blood Pressure Guideline, top things to know
Facts and prices checked on: 2026-10-27