Coronary calcium scans are a valuable tool for assessing heart health. These non-invasive imaging tests provide a direct view of calcified plaque in the heart’s arteries. This information is relevant in preventive cardiology, helping healthcare providers and individuals make informed decisions about managing cardiovascular risk. The insights contribute to a personalized approach to heart health.
Understanding the Coronary Calcium Scan
A coronary calcium scan (Heart Scan or Cardiac CT for Calcium Scoring) is a non-invasive medical imaging procedure. It uses computed tomography (CT) to create detailed images of the coronary arteries, which deliver oxygen-rich blood to the heart. During the scan, a patient lies on a movable table that slides into the CT machine. Electrodes are placed on the chest to monitor the heart’s electrical activity, synchronizing image acquisition with heart motion for clearer pictures.
The primary purpose of this scan is to detect and measure calcified plaque within the coronary arteries. Calcium deposits in these arteries are a marker for atherosclerosis, a condition where fatty and cholesterol deposits (plaque) build up inside the artery walls. This accumulation can lead to hardening and narrowing of the arteries, potentially restricting blood flow to the heart. The entire CT scanning process is quick, typically taking 10 to 15 minutes, and does not require the injection of contrast dye.
The Accuracy of Coronary Calcium Scans
Coronary calcium scans demonstrate high accuracy in identifying the presence and extent of calcified plaque in the coronary arteries. They are effective at detecting calcified atherosclerosis, providing a direct measure of the disease burden. A score of zero, indicating no detectable calcium, is associated with a very low cardiovascular risk. Conversely, higher scores indicate a greater amount of calcified plaque and a progressively higher risk of future cardiovascular events.
While accurate for detecting calcified plaque and predicting future events, these scans do not show soft, non-calcified plaque, which can also contribute to heart disease. They do not show immediate blockages or current blood flow. Their strength lies in their predictive value for future risk, rather than diagnosing acute blockages that might cause an immediate heart attack. The scan identifies individuals at intermediate risk who could benefit from preventive therapies.
Interpreting Your Calcium Score
The Agatston score quantifies the total area and density of calcium deposits in the coronary arteries. A higher Agatston score indicates a greater amount of calcified plaque and a correspondingly higher risk of future heart events.
A score of zero indicates no detectable calcium, suggesting a very low risk of developing a heart attack in the future. Scores between 1 and 99 signify a small amount of plaque and mild calcification, indicating a low to moderate risk. A score ranging from 100 to 300 (or 399) represents moderate plaque deposits and an increased risk of a heart attack or other heart disease over the next three to five years. Scores above 300 (or 400) signify extensive calcification, indicating a high risk of significant coronary artery disease and a substantially elevated chance of a heart attack. This score is interpreted with other individual risk factors, such as age, sex, cholesterol levels, and blood pressure, for a comprehensive risk assessment.
Who Should Consider a Scan and What Comes Next
Coronary calcium scans are considered for individuals with an intermediate risk for heart disease, particularly men aged 40-70 and women aged 50-70. This includes people with risk factors who do not yet experience symptoms, such as:
- Strong family history of early heart disease
- High blood pressure
- High cholesterol
- Diabetes
- Obesity
- Sedentary lifestyle
The scan can help refine their risk assessment, especially when traditional risk calculators yield unclear results. It is not recommended for individuals already diagnosed with heart disease, those at very low risk, or those experiencing acute symptoms, as it may not provide additional useful information.
After a coronary calcium scan, results are reviewed by a healthcare provider. The Agatston score is integrated with other health information and risk factors to determine an individualized prevention plan. This plan may involve lifestyle changes like dietary adjustments, increased physical activity, smoking cessation, or the initiation or modification of medications. Regular follow-up with a healthcare professional monitors health and adjusts management strategies.