The Executive Health program combines Cleveland Clinic Abu Dhabi’s traditional diagnostic expertise with recent developments in preventive medicine, offering you a complete, yet efficient medical evaluation.

• Executive Health Consultation

• Full Lab Profile

• Spirometry (breathing test)

• Audiogram (hearing test)

• Electrocardiogram (ECG)

• Retinal Fundus Photography (eye test)

• Nutritional Consultation

• Abdominal Ultrasound

• Exercise Cardiac Stress Test

• Bone Densitometry

• Non-Invasive Vascular Imaging

• Calcium Heart Score Scan

• Cancer Screening (e.g. Colonoscopy)*

• Chest X-Ray

• Stress Echocardiogram

• Dermatology Clinic Consultation

• Plastic Surgery Consultation

• Ophthalmology Clinic Consultation

*as clinically indicated

SERVICES FOR PATIENTS UNDER 50

FULL LAB PROFILE

COMPLETE BLOOD COUNT

Hemoglobin

The protein that carries oxygen to all body tissues and is present in red blood cells. A low value may indicate anemias or inherited blood disorders.

Hematocrit

A ratio (expressed as a percent) of red cells to the total volume of blood, this is reduced in anemias, and increased in chronic lung conditions.

White Blood Cell Count

A high white blood cell count may indicate inflammation or infection, or that the patient is a smoker. When elevated, a more detailed analysis of specific types of white blood cells may be needed. A low white blood cell count may result from certain medications, viral illness or in non-specific fluctuations.

MCV (Mean Corpuscular Volume), MCH (Mean Corpuscular Hemoglobin), MCHC (Mean Corpuscular Hemoglobin Concentration)

This test measures the size and hemoglobin content of red cells and is useful in evaluating subtypes of anemia. An increased level of MCV may indicate deficiencies of vitamin B12 or folic acid, or excessive smoking or alcohol use. A decreased level may result from iron deficiency.

Platelet Count

Platelets are blood products critical for normal clotting. Abnormal values (either high or low) may be clues to an underlying blood disorder. Platelets are also affected by certain medications, alcohol, infection, liver disease, and, in women, the menstrual cycle.

CHEMISTRY PROFILE

Total Protein

This test measures the combination of albumin and globulin in the blood. Abnormal values may occur due to kidney, bowel or liver diseases or malnutrition. Proteins characteristic of certain conditions, such as multiple myeloma (bone marrow cancer), can also be detected. Through electrophoresis (a lab test), proteins in blood and urine can be further analyzed.

Albumin

This is a blood protein manufactured by the liver, which makes up two-thirds of total protein. Marked changes may be related to kidney, bowel or liver diseases or to poor nutrition.

Calcium

A mineral, found primarily in bones, may be elevated in the blood because of bone injury (fractures), cancers that spread to the bone, and certain endocrine abnormalities, such as overactive parathyroid glands. Low values occur with poor dietary intake, lack of vitamin D or kidney disorders.

Magnesium

This mineral activates the body’s enzyme systems. Abnormal results could stem from alcohol abuse, diabetes, certain endocrine and kidney disorders, bowel disease and diuretic usage.

Bilirubin, Total

The test measures the level of bile pigment in the blood. Elevated levels occur with liver disease or an accelerated breakdown of red blood cells (hemolysis). Slight increases frequently occur in a benign condition, called Gilbert’s syndrome, and are of no clinical significance.

Uric Acid

Uric acid is the final breakdown product of nucleic acid metabolism. Elevated levels of uric acid occur most commonly with gout but can also be elevated with certain malignancies, excessive alcohol intake, kidney disorders, insulin resistance syndrome, a high protein diet and certain medications.

Alkaline Phosphatase

This enzyme manages certain liver or bone functions. Levels increase with various liver diseases in which bile ducts are blocked. Elevated levels also can be seen with certain bone disorders.

GGT (Gamma-Glutamyltransferase)

This liver enzyme is highly sensitive for liver disorders. Levels can rise in response to excessive intake of alcohol and/or high cholesterol or triglycerides, excess body weight and insulin resistance syndrome.

ALT (Alanine Aminotransferase)/AST (Asparate Aminotranferase)

These enzymes are found in the liver and muscle. Increased levels in the blood may indicate damage to these tissues. Liver disease tends to increase ALT relatively more than AST. Elevations of these enzymes need to be interpreted in the context of other liver function test results. AST is also found in muscle cells, including the heart, and may be elevated if these tissues are damaged.

Glucose

This is the blood sugar level and is frequently elevated in diabetes. It can also be influenced by diet (inadequate fasting) and certain medications. A single elevation, particularly of a mild degree, does not necessarily mean that diabetes is present. Low levels, called hypoglycemia, can be due to excessive medications, or certain medical conditions (such as endocrine disorders, liver disease or rare tumors) or a prolonged fasting state.

Hemoglobin A1C (Glycosylated Hemoglobin)

This measure reflects the average blood sugar level over the preceding three months. Elevated levels may indicate impaired glucose tolerance and an increased risk of diabetes.

BUN (Blood Urea Nitrogen)/Creatinine

These kidney function tests measure how well certain metabolic waste products are excreted from the body. BUN is frequently elevated with dehydration.

Sodium

This mineral and electrolyte helps maintain fluid balance and volume. Blood sodium levels can be abnormal in kidney disorders, certain endocrine diseases, dehydration or over-hydration.

Potassium

This mineral and electrolyte is important in nerve impulse conduction and body fluid balance. Potassium levels can be low because of diuretic therapy, diarrhea and certain endocrine diseases. They can be increased with kidney disease, potassium-sparing diuretics, certain other medications such as ACE inhibitors, and certain endocrine diseases. Mild evaluations of no clinical consequence frequently occur with the breakdown of red blood cells (hemolysis) in the blood drawing process.

Chloride

This mineral helps maintain electrolyte balance. Low levels are seen after prolonged vomiting or excessive use of diuretics. Mild increases are common and may not be due to any clinically significant condition.

CO2 (Carbon Dioxide)

This is a measure of the bicarbonate buffer system in the plasma. CO2 levels are increased in conditions of alkalosis from excessive ingestion of antacids or prolonged vomiting. They are decreased in acidotic conditions such as chronic respiratory failure, diabetes or kidney failure.

Anion Gap

This calculation is used by physicians to determine the likely cause of excessive acid in bodily fluids (acidosis). An increased anion gap is seen in acidosis from diabetes, aspirin intoxication and kidney failure. Acidosis from diarrhea occurs with a normal anion gap.

Iron/TIBC

These tests evaluate iron metabolism. In iron deficiency anemia, iron levels are typically low and TIBC (total iron binding capacity) is high. In iron overload states such as hemochromotosis, iron levels are typically high.

Ferritin

This blood test measures serum ferritin levels. Iron levels can be elevated by underlying inflammatory conditions such as arthritis.

LIPID PROFILE

Total Cholesterol

This blood fat is a significant factor in the development of atherosclerosis and is made up of HDL, VLDL and LDL.

HDL (High Density Lipoprotein)

As a combination of fat and protein, it is considered a “good” type of cholesterol because it removes excess cholesterol from the blood and takes it to the liver.

LDL (Low Density Lipoprotein)

This is another “bad” type of cholesterol because it picks up cholesterol from the blood and takes it to the cells.

Triglycerides

This blood fat contributes to the development of atherosclerosis. Blood levels can be increased by consuming alcohol or sugar, such as fruits and unsweetened juices, certain medications, and in thyroid and liver disease.

Apolipoprotein B

This protein is present at a 1:1 ratio with all atherogenic or bad lipid particles in the blood. A high level of this protein suggests increased risk of coronary atherosclerosis, particularly in men.

Lipoprotein (A) [Lp(a)]

This is a fraction of the LDL cholesterol that has been linked to an increased risk of cardiovascular disease and is frequently present in families with premature vascular disease. If elevated, a physician may employ a more aggressive approach to lowering LDL cholesterol level. Underlying inflammatory processes or poorly controlled diabetes can transiently elevate Lp(a). Aerobic exercise, weight reduction and, in women, estrogen therapy may also decrease Lp(a).

URINALYSIS AND URINE TESTS

With our streamlined process, urinalysis and urine tests measure urological and kidney health, in only one day.

Glucose

This may be present when blood sugar is too high (as in diabetes) or, rarely, in unusual disorders of the kidney, or from a low kidney glucose threshold without disease.

Ketones

These are often present in urine because of the fasting state when the urine was collected and may be present in diabetics, with thyroid disorders, fever, excess alcohol intake or significant dieting.

Protein

Generally, protein should not be present in urine beyond a trace amount. It may be present in inherited or acquired kidney diseases, prostate diseases or systemic diseases (including various infections, collagen-vascular diseases, diabetes) or a reaction to drugs. It may also be found due to jogging or excessive exercise prior to the test, or in women if urine is contaminated with vaginal secretions.

Blood

This can be present normally in small amounts in urine. It may be present with infection, kidney stones, malignancy, diseases of the kidney or prostate, or contamination of the urine by vaginal secretions. After intense physical exertion, blood can be present in the urine.

Leukocyte Esterase

A positive result may indicate infection of the urinary tract or contamination of the urine by vaginal secretions.

Urine Albumin/Creatinine Ratio

This test determines the amount of protein (albumin) present in the urine. In diabetics, the presence of albumin in the urine (indicated by an increased albumin/creatinine ratio) is suggestive of early diabetic kidney disease. In both diabetics and non-diabetics, an elevated urinary albumin/creatinine ratio has also been found to be a predictor or marker for the presence of cardiovascular disease.

OTHER LAB TESTS

TSH (Thyroid Stimulating Hormone)

This hormone is secreted by the pituitary gland and regulates the production of thyroid hormones. When increased, it may indicate reduced function of the thyroid gland (hypothyroidism) or a failing thyroid gland. When decreased, it may indicate hyperactivity of the thyroid gland (hyperthyroidism) or pituitary gland malfunction. This is also used to determine appropriate dosing of thyroid replacement medication.

Free T4

This is a test of the thyroid hormone produced by the thyroid gland and can reveal an underactive or overactive thyroid state, or pituitary (master gland) dysfunction.

Vitamin B12 (Cobalamin)

An essential growth factor that plays a role in the metabolism of cells, this vitamin is particularly important for the gastrointestinal tract, bone marrow and nervous tissue. A low vitamin B12 level stops DNA synthesis and affects cell growth and repair. A deficiency may lead to memory loss, and problems of the nervous system, anemia or skin changes. Strict vegetarians, the elderly and people with inflammatory bowel disease are at an increased risk of deficiency.

Hepatitis A/B

This test determines immunity to viral hepatitis and if a vaccination is required.

High Sensitivity-CRP (hs-CRP)

CRP is a well-documented clinical marker of general and cardiac-related inflammation. Elevated hs-CRP is associated with the risk of future adverse cardiovascular events.

Vitamin D

Vitamin D is important for adequate calcium absorption. Low vitamin D levels can lead to low bone density. Vitamin D levels are useful in making treatment recommendations for preventing osteoporosis or treating low bone density.

Testosterone

In men, this hormone is produced by the testicles, which are controlled by the pituitary gland and hypothalamus. It affects sexual function, muscle mass and strength, and is important in the maintenance of normal bone density, red blood cell mass and libido.

SPIROMETRY (BREATHING TEST)

This study of air capacity may identify breathing issues.

Borderline Restrictive Pattern

This suggests that the ability to take in and blow out a full breath (forced vital capacity – FVC) is lower than predicted for an individual of the same height and ethnicity. A decreased FVC can be associated with fibrotic lung disease, chest wall trauma or old chest wall surgery, excess body weight, scoliosis, or a suboptimal testing effort or technique.

Borderline Obstructive Pattern

This pattern can be seen in individuals who can inhale without difficulty but have a decreased ability to blow out a normal, predicted amount of air over one second. This finding can be associated with a tendency toward asthma or allergic bronchitis, smoking, resolving bronchitis, or a suboptimal testing effort or technique.

AUDIOGRAM (HEARING TEST)

This hearing test evaluates your hearing acuity.

ELECTROCARDIOGRAM (ECG)

An ECG records the electrical activity of the heart. It is a commonly used test to detect abnormal heart rhythms and other heart disorders.

Sinus Bradycardia

A slower than the average resting heart rate may be due to good aerobic conditioning or to certain medications. It is usually not of clinical significance.

Premature Atrial Complex (PACS)

This happens when extra beats originate in the lower chambers of the heart.

Sinus Arrhythmia

These are minor variations in the interval between heartbeats.

Bundle Branch Block and First-Degree AV Block

These indicate minor delays in the electrical conduction of the heartbeat.

Non-Specific T Wave Changes and Myocardial Changes

These show minor alterations in the shape of the ECG tracing.

Evidence of Prior Myocardial Infarction

Patterns on the resting ECG can suggest remote damage to part of the heart muscle. Such findings, particularly if new, may require further testing to determine their validity. Occasionally, patients may have suffered a heart attack without knowing it. Often, however, these ECG changes represent alterations in the patterns of electrical conduction in the heart and not actual heart damage.

RETINAL FUNDUS PHOTOGRAPHY (EYE TEST)

A color photograph is taken by means of a specialized retinal camera, which does not require dilating eye drops. The photo shows detailed images of the retina, and can show many abnormalities such as diabetic retinopathy, glaucoma, macular degeneration and the effects of high blood pressure.

Tonometry

This test measures the pressure inside the eye, which is called intraocular pressure (IOP). It is used to screen for glaucoma, which can lead to blindness.

NUTRITIONAL CONSULTATION

This consultation is an overall assessment of blood test results, physical activity, current dietary habits, dietary advice and specific dietary requirements (allergies, intolerances, healthy options).

InBody Test

Weight alone is not a clear indication of general health. InBody testing records the percentage of body fat, muscle distribution and lean mass measurement. The dietician uses these results during the nutritional consultation.

ABDOMINAL ULTRASOUND

This imaging test looks at the abdominal organs, which include the liver, gall bladder, spleen, pancreas and kidneys.

EXERCISE CARDIAC STRESS TEST

This test monitors cardiovascular health during exercise on a treadmill or stationary cycle. It is used to determine the risk of coronary artery disease or the effectiveness of treatment for it.

Predicted Maximum Heart Rate

This is the fastest heart rate expected at peak exercise based on age.

METS (Metabolic Equivalent)

This test measures exertion during exercise to assess fitness (or functional capacity). The higher the MET level achieved during the exercise test, the greater the level of fitness.

Duke Treadmill Score

This is a composite score based on several features of an exercise test: duration of exercise, the presence and severity of angina during exercise, and the maximal change in the ST segment on an electrocardiogram. The Duke Treadmill Score has been found to be an independent predictor of future cardiovascular risk and reduced life expectancy.

Heart Rate Recovery

This measures the difference between heart rate at peak exercise and at one minute into the cool down phase of the exercise test. The heart rate should fall by 12 beats per minute or more in this interval. Abnormal heart rate recovery has been shown to be an indicator of future cardiovascular risk and total mortality.

Chronotropic Response

This measures the ability of the heart rate to rise normally with exercise. A blunted or impaired chronotropic response to exercise has been linked to future cardiovascular risk and reduced life expectancy.

ADDITIONAL SERVICES FOR 50+

BONE DENSITOMETRY

This test is used to predict your potential bone fracture risk. It is only one of several factors that predict risk, in addition to a history of previous bone fractures, age, body and bone size, tendency to fall, and family history of early osteoporosis. Bone mineral densitometry scores are only suggestive of the possible risk of bone fractures and are not in themselves indicative of osteoporosis.

VASCULAR IMAGING

This non-invasive ultrasound checks the blood flow in the arteries and veins. These tests detect if there is decreased blood flow, which may indicate a blockage or identify other health problems.

Carotid Ultrasound Study

An ultrasound probe is applied to both sides of the neck to check for plaque and narrowing of the carotid arteries, particularly the internal carotid arteries that provide blood flow to the brain. Narrowing of the carotid artery is a risk factor for stroke.

Abdominal Aorta Ultrasound

An ultrasound probe is applied to the abdomen to measure the size of the aorta, the main blood vessel of the body that delivers blood to the vital organs and limbs. Enlargement of the abdominal aorta beyond three centimeters is suggestive of an abdominal aortic aneurysm.

Ankle-Brachial Index (ABI)

During this test, blood pressure is measured in both arms and ankles with a blood pressure cuff, and a Doppler device is used to listen to blood flow. The ratio of blood pressure in the legs compared to the arms is called the ABI. Reduced ABI in either leg indicates the presence of peripheral artery disease (PAD), which is due to plaque buildup in the arteries of the leg. An abnormal ABI is also a marker of increased risk for heart attack and stroke.

CALCIUM HEART SCORE SCAN

This scan detects calcium in the coronary arteries outside the heart, which supply blood to the heart muscle. When calcium, which is usually not found in these arteries, is detected, it suggests the presence of atherosclerotic plaque.

CANCER SCREENING

COLON CANCER

Colon cancer screening aims to detect early colon cancer or other abnormalities in the colon. A colonoscopy is an outpatient procedure in which the inside of the large intestine (colon and rectum) is examined. Colonoscopy reports may include the following terminology:

Polyp

This is a benign growth on the inside or lining of the colon.

Pseudopolyp

This appears to be a polyp but is not truly a growth. It is also benign and represents a fold of the lining of the colon.

Diverticulosis

These small outpouchings are commonly seen on the wall of the colon. When they become inflamed the condition is called diverticulitis.

Hyperplastic Polyps

This is the most common colon polyp. Most hyperplastic colon polyps are benign, small and not associated with an increased risk of colon cancer.

Adenomatous Polyps

This type of colon polyp has pre-malignancy potential. This growth is associated with DNA changes in the lining of the colon. Up to 10 percent of these polyps can become cancerous if undetected or ignored.

LUNG CANCER

If you are a current or ex-smoker, you are considered to be at risk for developing lung cancer. Those considered to be at high risk should be screened with a chest CT scan to ensure early detection.

PROSTATE CANCER

All males over 50, or males over 40 with a family history of prostate cancer, are screened for risk of prostate cancer through a consultation with a urologist and specific blood testing.

PSA (Prostate Specific Antigen)

This protein is produced by the prostate gland and rises in benign prostatic enlargement (a normal, age-related change), inflammation or infection of the prostate, and prostate cancer. Levels increase with age. This test is used in conjunction with the digital rectal exam to screen for prostate cancer.

ADDITIONAL PREMIER SERVICES

CHEST X-RAY

A chest x-ray may be performed to detect:

Nodule or Density

This is an area difficult for x-rays to penetrate and appear as a white or gray spot on the lung. The significance and need for further testing depends upon nodule appearance.

Granuloma

This is a small area of healed inflammation, often from a remote fungal infection.

Calcification of the Aorta

This is advanced hardening of the main artery leaving the heart.

Pleural Thickening

This is thickening of the lining that covers the lungs.

STRESS ECHOCARDIOGRAM

The exercise stress echocardiogram involves exercising on a treadmill or stationary cycle while being closely monitored. An echocardiogram (echo) is a graphic outline of the heart's movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart valves.

DERMATOLOGY CLINIC CONSULTATION

The dermatology clinic specializes in skin disorders.

PLASTIC SURGERY CONSULTATION

Specialists are available for consultation regarding reconstructive and corrective surgery.

OPHTHALMOLOGY CLINIC CONSULTATION

This clinic specializes in medical and surgical eye problems.

Please note: Your exam will not include every evaluation described in this guide, but rather a custom combination of test deemed appropriate by you and your Executive Health physician.