A coronary calcium scan, also referred to as a Coronary Artery Calcium (CAC) scan or a heart scan, is a non-invasive imaging procedure. It uses a specialized computed tomography (CT) scanner to detect and measure calcium deposits within the walls of the coronary arteries. The presence of these calcified plaques indicates atherosclerosis, a condition where plaque builds up and can restrict blood flow to the heart muscle, and the scan assesses an individual’s risk of future cardiac events.
Determining if a Scan is Right for You
A coronary calcium scan is considered for individuals at intermediate risk for heart disease who do not yet show symptoms. Guidelines suggest its use when there’s uncertainty about treatment decisions after an initial risk assessment. This test helps reclassify an individual’s risk, guiding decisions on preventive measures like statin therapy.
Common risk factors that might lead a healthcare provider to recommend a CAC scan include a family history of early coronary artery disease, high cholesterol, high blood pressure, diabetes, current or past tobacco use, and an inactive lifestyle or obesity. The scan is not recommended for low-risk individuals, those already diagnosed with heart disease, or symptomatic patients, as it does not replace conventional diagnostic workups for chest pain. Consulting a primary care physician or cardiologist is important to determine if a coronary calcium scan is appropriate for you.
Types of Facilities Offering Scans
Coronary calcium scans are performed in various medical settings. Hospitals often feature dedicated imaging departments equipped with advanced CT scanners capable of performing these specialized heart scans. These departments are staffed by experienced radiologists and technologists.
Outpatient imaging centers specialize in diagnostic imaging services for procedures like the CAC scan. These centers emphasize efficiency and patient convenience, sometimes allowing for direct scheduling without a referral, though insurance coverage may vary. Some larger cardiology clinics or practices may also have their own imaging capabilities or established affiliations with nearby imaging centers, providing integrated care.
When selecting a facility, consider accreditation from reputable organizations like the American College of Radiology (ACR) or the Intersocietal Accreditation Commission (IAC), ensuring rigorous standards for equipment, personnel, and quality control. Cost and insurance coverage are also important, as some scans may not be fully covered. Facilities employing advanced CT technology, such as high-speed scanners or artificial intelligence algorithms, improve image quality and diagnostic accuracy.
Preparing for and Undergoing the Scan
Preparation for a coronary calcium scan is straightforward and non-invasive. You will be asked to avoid caffeine, energy drinks, and tobacco products for four hours before the scan, as these can elevate your heart rate and make it challenging to obtain clear images. It is also recommended to avoid eating food for four hours prior to the exam, though drinking water is permitted.
Upon arrival, you may be asked to change into a hospital gown and remove any metal objects, such as jewelry, eyeglasses, or items with zippers or underwires, as metal can interfere with the CT images. During the procedure, small, sticky electrode patches are placed on your chest to monitor your heart’s electrical activity using an electrocardiogram (EKG). This allows the CT scanner to synchronize image acquisition with your heartbeat, ensuring precise measurements of calcified plaque.
You will lie on your back on a movable table that slides into the donut-shaped CT scanner. The scan itself is quick, taking only a few minutes, though the entire procedure, including preparation, may last 10 to 15 minutes. You may be asked to hold your breath for short intervals, 5 to 20 seconds, to minimize motion blur. After the scan, there is no downtime, and you can resume your normal activities immediately.
Understanding Your Results
The results of a coronary calcium scan are presented as a numerical value known as the Agatston score, which quantifies calcium deposits in your coronary arteries. A score of zero indicates no detectable calcium and suggests a very low cardiovascular risk. Scores ranging from 1 to 99 are considered mild calcification, while scores between 100 and 299 signify moderate calcification and a moderately increased risk.
A score greater than 300 indicates extensive calcification and a higher risk of heart disease. Some facilities may also provide a percentile rank comparing your calcium amount to others of the same age and sex. The Agatston score is just one piece of information; it should always be interpreted by a healthcare provider in the context of your overall medical history, lifestyle, and other risk factors.
Following the receipt of your results, your doctor will discuss the implications of your Agatston score and determine the appropriate next steps. This may involve recommendations for lifestyle modifications, such as dietary changes, increased physical activity, or smoking cessation. In some cases, medication like statins may be considered, especially for scores above 100 or if the score places you in a higher percentile. Further diagnostic tests may also be recommended if the results indicate a significant plaque burden.