A Cardio Res-Q assessment has four parts: you choose an assessment, have fasting blood drawn at least a week before your visit, complete imaging if you chose the Enhanced option, and then meet Dr. Varano for a 1-hour consult. At the consult he evaluates your history, reviews your results and goes through your written plan. The Comprehensive Assessment is $775. The Enhanced Assessment is $999.
The assessment is complete on its own. Ongoing care afterward is optional. Below is each step in order, including the parts that happen outside our office and the details you should confirm with our team when you book.
Key takeaways
- There are four steps: pick an option, fasting labs a week or more ahead, imaging if you chose Enhanced, and a 1-hour consult with Dr. Varano.
- You fast for 10 to 12 hours before the blood draw and should not stop any prescribed medication on your own.
- With Enhanced, the calcium scan is done at an outside imaging center and is typically a separate $100 to $200 charge.
- Ongoing care after the assessment is optional, and you can take your results to your own doctor.
- The assessment is for people without symptoms and is not emergency care.
Before you come in: choose an assessment and plan your fast
Your first decision is which assessment to book. Both include the clinical evaluation, the advanced labs, the Cleveland Heart cardiac panel, a lifestyle and risk evaluation and a personalized heart protection plan. The Enhanced Assessment adds a CIMT ultrasound and a coronary artery calcium (CAC) score. If you are unsure, read how the two assessments compare first.
Then plan your fast. You need to fast for 10 to 12 hours before your labs so the lipid and insulin results are accurate. Many people find it easiest to fast overnight. Ask our team whether to take your usual morning medications and what you may drink while fasting. Do not stop any prescribed medication on your own.
It also helps to gather a few things ahead of time:
- A list of your medications and supplements.
- Recent lab results and any earlier heart tests, such as a calcium score or stress test.
- Your family history: which relatives had heart disease or stroke, and at what age.
- Home blood pressure readings, if you have them.
The lab work
The blood work goes well past a standard cholesterol panel. It covers:
- Cholesterol particles: ApoB and lipoprotein(a), also written Lp(a).
- Inflammation and vessel markers: hs-CRP and homocysteine.
- Metabolic function: insulin, glucose and A1c.
- The Cleveland Heart cardiac panel: a proprietary panel that looks at markers of arterial inflammation, clotting risk, oxidative stress and vessel lining function. It reports Lp(a), ApoB, hs-CRP, oxidized LDL and small dense LDL, plus other proprietary markers. Your provider goes through the results with you.
Lp(a) is largely inherited and is measured once as a baseline. Current US lipid guidance recommends measuring Lp(a) once in all adults.1
Schedule your labs at least a week before your visit, so Dr. Varano has the results to review at your consult. Ask our team where the blood draw takes place.
The clinical evaluation and lifestyle review
Both assessments include Dr. Varano's full clinical evaluation, at a 1-hour consult. It is where your history and risk factors are reviewed in detail. The lifestyle and risk evaluation covers:
- Family history
- Blood pressure patterns
- Weight and metabolic indicators
- Sleep quality
- Stress
- Nutrition patterns
- Exercise and recovery
- Sexual function, because erectile dysfunction can be an early sign of blood vessel trouble
Honest answers matter more than good ones here. The plan you receive is built from this conversation as well as from your numbers.
Imaging, if you chose the Enhanced Assessment
The Enhanced Assessment adds two studies.
CIMT ultrasound. This is a painless ultrasound of the carotid arteries in your neck. It measures the thickness of the artery wall and can show early plaque. There are no needles and no radiation. It is performed by Jessica Brown in our Conshohocken office. You should know its limits: the 2013 ACC/AHA risk assessment guideline does not recommend routine CIMT measurement for predicting a first heart event.2 We use it as a baseline to compare against over time, not as a stand-alone verdict.
Coronary calcium (CAC) score. This is a low-dose CT scan of the heart. It is not done in our office. Your provider orders the study, and you find a local imaging center and schedule it yourself. Check with the imaging facility about booking and how fast results come back. The scan takes less than 15 minutes, with no injections, no contrast dye and no recovery time. Patients have reported a separate self-pay fee of $100 to $200, paid in addition to the $999.
The radiation dose from a calcium scan is small, averaging about 1 to 1.5 millisieverts.3 The scan also has a blind spot: it shows calcified plaque only, so plaque that has not calcified does not appear on it.4
The results review and what comes after
Dr. Varano reviews your results with you at the consult. You receive three things:
- A full review of all laboratory and imaging findings.
- A detailed explanation of your cardiovascular risk profile.
- A clear, structured, personalized plan.
Our article on what you leave with covers the plan in detail. If you see a cardiologist or primary care doctor, we are happy to share your results and work alongside them.
After the review, you decide what happens next. Ongoing care is optional. Patients with active risk factors are typically advised to continue with monitoring, which means the YoungerMeMD membership at $279 per month and, for ongoing cardiovascular management, the Cardio Res-Q Specialty Treatment Plan at $125 per month. Lower-risk patients may choose periodic reassessment instead. You can also take your results and plan to your own doctor.
How to book your assessment
Go to the Cardio Res-Q program page, select the Comprehensive ($775) or Enhanced ($999) assessment, and pay online. Both are direct-pay and are not billed to insurance. Patients are welcome to try an HSA or FSA card, but the clinic cannot confirm it will be accepted, and it does not provide insurance reimbursement forms. If you would rather talk to someone first, contact our team.
One caution. This assessment is for people without symptoms. It is not emergency care. If you have chest pain, pressure, shortness of breath or fainting, do not wait for a screening appointment. Call 911 or see a doctor now.
Are You a Candidate for Cardio Res-Q?
Three quick questions about the risk factors we screen for. Your answers stay between you and the clinic.
Frequently asked questions
How long does the assessment take?
The consult with Dr. Varano is 1 hour. Your labs are drawn at least a week before it, so the results are ready to review at that visit. The calcium scan at the outside imaging center takes less than 15 minutes, and the facility can tell you when its report will be ready.
Do I really have to fast?
Yes. Fast for 10 to 12 hours before your labs so the lipid and insulin results are accurate. Ask our team about water and your regular medications when you book.
Is any part of the assessment painful?
The blood draw is a standard needle stick. The CIMT is a simple ultrasound and the calcium score is a quick CT scan with no injections and no contrast dye. Neither needs recovery time.
Do I have to join a membership afterward?
No. The assessment is complete and stands on its own. The membership ($279 per month) and the Cardio Res-Q Specialty Treatment Plan ($125 per month) are optional choices for people who want ongoing management.
Can I do this if I already take a statin or blood pressure medication?
Yes. Many patients use the evaluation to see whether their current treatment is controlling their risk well enough. Bring a full list of what you take.
Related reading
This article is for general education and is not medical advice. Decisions about testing and medication should be made with your clinician. If you have chest pain or other symptoms of a heart attack, call 911.
