A coronary calcium scan is a test for people who have no symptoms of heart disease but may be at borderline or intermediate risk for getting it. The test uses computed tomography (CT) to check for calcium buildup (plaque) on the walls of the coronary arteries. Coronary arteries wrap around your heart and supply it with blood and oxygen. The presence of calcium in these arteries is a sign of heart disease.
Plaque in the arteries is made up of fats, cholesterol, calcium and other substances in the blood. Plaque deposits gradually over time on the walls of the arteries, long before there are any signs or symptoms of disease. Factors such as diet, genetics and lifestyle can influence how much or little plaque builds up in your arteries. These deposits can restrict the flow of oxygen-rich blood to the muscles of the heart. Plaque also may break off into the blood stream, triggering a blood clot that can cause a heart attack.
During a calcium scoring test, a CT scan takes pictures of your heart in thin sections. The result is a score based on the amount of calcium seen on the scan. The higher your calcium score, the higher your risk for a heart attack or other cardiac event. The test takes about 30 minutes.
“Cardiologists use this test to help patients decide what approach they want to take toward their health care to reduce risk,” said Steven J. Raible, M.D., cardiologist with Norton Heart & Vascular Institute. “Do they want to treat with medication? For instance, take a cholesterol-lowering medicine, like a statin? Do they want to make lifestyle changes? How aggressive do they want to be?” The doctor will help you learn the facts and choose the best plan of action.
Who needs the test? Who doesn’t?
“We don’t suggest a calcium score for everybody,” Dr. Raible said. “A coronary calcium scan usually is not performed in men younger than 40 or 45 years old or women younger than 50 to 55 years old. Younger people typically don’t have much plaque built up in their arteries.”
Your doctor may not suggest or recommend a calcium scoring test if you have a very low risk because there won’t be enough detectable calcium in your arteries. By the same token, if you have known high risk factors such as smoking, very high cholesterol or diabetes, a calcium scan will not add any information that would guide your treatment. “This test just gives us a little more data to work with,” Dr. Raible said. “It’s just one piece of the bigger picture.”
Most health insurance plans don’t pay for coronary calcium scanning. The cost can range from about $100 to $200. If you have the following risk factors, you may benefit from a coronary calcium scan:
- Men age 45 and older; women age 55 and older
- Family history of heart disease
- Past or present smoker
- High blood pressure
- High cholesterol
- Not physically active