A coronary artery calcium (CAC) score is a non-invasive diagnostic tool that detects calcium deposits in the heart’s arteries using a CT scan. Calcium in these arteries indicates atherosclerosis, a condition where plaque builds up. This assessment helps identify the extent of this buildup before symptoms appear.
What Calcium Scores Indicate
A calcium score measures calcified plaque in the coronary arteries. Its presence indicates underlying plaque accumulation, which can occur even without noticeable symptoms. This calcified plaque forms as a result of atherosclerosis, where fatty substances build up in artery walls. Over time, these deposits can harden with calcium, making the arteries stiff and less flexible.
A CT scan quantifies these deposits by measuring their area and density, yielding a score known as the Agatston score. This score provides insight into the amount of hardened plaque, which can narrow arteries and reduce blood flow to the heart.
Interpreting Your Score
Coronary artery calcium scores are typically reported as an Agatston score, which ranges from zero to over 1,000. A score of zero means no calcium is detected in the heart’s arteries, indicating a low likelihood of developing a heart attack in the future. Scores between 1 and 99 suggest mild plaque deposits and a low to mild risk of heart disease.
A score in the range of 100 to 300 (or up to 399) indicates moderate plaque and is associated with a relatively high risk of a heart attack. Scores exceeding 300 or 400 signify more extensive disease and a significantly higher risk of a heart attack. Specifically, scores above 400 are considered strong evidence of coronary artery disease.
Health Implications of a High Score
A high calcium score indicates a greater burden of calcified plaque in the coronary arteries, signifying an increased risk of future cardiovascular events. This includes heart attacks, strokes, and even death, irrespective of traditional risk factors such as cholesterol levels. It suggests that the atherosclerotic process is advanced and requires focused attention. While the calcium score itself does not directly show artery blockages, it strongly correlates with the potential for future cardiac events by revealing the extent of underlying plaque buildup.
Managing a High Score
A high calcium score typically requires aggressive management of cardiovascular risk factors. Lifestyle modifications are foundational and include adopting a heart-healthy diet rich in fruits, vegetables, whole grains, and healthy fats, while limiting saturated fats. Regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week, is also recommended. Quitting smoking, managing weight, and incorporating stress reduction techniques are additional steps that contribute to better heart health. While these interventions cannot reduce the existing calcified plaque or lower the calcium score itself, they can stabilize the plaque and significantly decrease the risk of future heart attacks. Medical consultation is important; a doctor may recommend medications like statins, blood pressure medications, or low-dose aspirin to mitigate risk.