Calcium scoring is a simple, painless way to measure your risk of sudden death from heart attack.
For too many Americans, the 1st sign of heart disease is a fatal heart attack. These same individuals had no warning signs, no symptoms and normal cholesterol levels and were nonsmokers. In other words, they had little reason to think there was anything to be concerned about.
Today, new technology allows doctors to determine a person's risk of heart disease. This means that coronary artery disease (CAD) can be detected in an early stage, when there are no symptoms. A cardiac calcium scoring exam determines the amount of calcium buildup in the coronary arteries of your heart. The amount of calcium present is related to your risk for a heart attack.
Who should be screened?
Cardiac calcium scoring is recommended for men over 40 years old and women over 55 who have 1 or more of the following risk factors:
- A family history of heart disease.
- High cholesterol levels.
- High blood pressure.
- Past or present smoking history.
- Sedentary (inactive) lifestyle.
- Obesity (20 percent or more over recommended weight).
Why should I have this test?
- To detect CAD at an early stage, before there are symptoms.
- To calculate future risk of CAD.
- To prevent a fatal heart attack.
- To determine a treatment plan if blockages are present.
Benefits of the test
The calcium scoring exam is a simple, painless, noninvasive screening that requires little or no preparation and usually takes less than 5 minutes to complete. Unlike other tests, there are no injections and there is no need to drink any special fluids. Unlike standard cardiac tests, this examination can suggest the presence of CAD even when the arteries are less than 50 percent blocked. Remember, more than half of all heart attacks occur with less than a 50 percent narrowing.
Your calcium score can lead you to make lifestyle changes that may be needed depending on the severity of disease, thus decreasing your chances of a future heart attack.
With this noninvasive diagnostic test utilizing a computed tomography (CT) scanner, calcium can be detected in the coronary arteries, making this test effective in early diagnosis of heart disease. With a 99 percent sensitivity rate, this test has become beneficial to patients who have not exhibited symptoms but may be at risk for heart disease.
How the procedure works
The CT scanner works very much like other x-ray examinations. But with CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate around you while the examination table moves through the scanner. A special computer processes these pictures, or slices, of your body to create 2-D, cross-sectional images, which are displayed on a monitor. The image slices are then reassembled by computer software, resulting in very detailed, multidimensional views of the body's interior.
Facts about calcium, cholesterol and plaque
Cholesterol is a substance made naturally by the liver. It can also be found in various foods we eat. Our bodies need cholesterol for many different functions, but when there is too much in your blood, cholesterol and other substances like calcium can build up in the body, including the walls of your arteries.
Calcium is also very important for our body. It is needed for strong bones and teeth; for our heart, muscle and nerve function; and for blood to clot. In other words, calcium is a vital substance that should be taken daily. But calcium can go places where it is not supposed to be.
The buildup of cholesterol and calcium is called plaque. Over time, plaque can cause hardening and narrowing of the arteries, causing a decrease in blood flow. This decrease in blood and oxygen can cause chest pain. When the blood supply is cut off completely by plaque, a heart attack can occur.
How to prepare for the procedure
- Wear comfortable, loose-fitting clothing.
- Take your usual medications.
- Avoid caffeine 4 hours before the exam. (If your heart rate is 90 beats per minute or higher, you may be given medication to slow it in order to obtain accurate images).
- Do not wear metal objects, including jewelry, eyeglasses, hairpins or dentures, as they can affect the CT images.
Women are advised to inform their physician or technologist performing the procedure of any possibility of pregnancy.
How the test is interpreted
A radiologist will analyze the images and send a signed report to your primary care or referring physician. Your physician will then share the results with you and interpret the findings.
A negative calcium scoring test, that shows no calcification within the coronary arteries, suggests that plaque is minimal and that the chance of CAD developing over the next 2 to 5 years is very low.
A positive calcium scoring test means that CAD is present, regardless of whether or not the patient is experiencing symptoms. The amount of calcification, known as the score, may help predict the likelihood of a heart attack in the coming years.
At this stage, you and your doctor can discuss treatment and preventive measures.
Risks and limitations of calcium scoring tests
- There is radiation exposure (the benefit of an accurate diagnosis far outweighs this risk).
- It is not recommended for pregnant women because of potential risk to the baby.
- It is not advised as a routine screening for CAD.
- Soft plaque cannot be detected by a CT scan.