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What is Coronary Artery Calcium Scoring?
The coronary artery calcium score (heart scan, calcium score, cardiac scoring, CAC Scan, Mammogram of the Heart) is a measurement of the amount of calcium in the walls of the coronary arteries (the vessels that supply oxygen-containing blood to the heart muscle) using a special non-invasive computed tomography (CT) scan of your heart—commonly referred to as a Coronary Artery Calcium (CAC) Scan.
This scan shows the amount of hardening or calcification of the artery wall (a disease called atherosclerosis). Calcium is a reliable indicator of the overall load of atherosclerosis in a person’s arteries, and it is this calcium that the coronary artery calcium scan measures, and reports as a score. A high calcium score does not necessarily mean that you are more likely to have a heart attack than someone with a low score.
How does the Coronary Artery Calcium (CAC) Scan detect Heart Disease?
The CAC Scan does not determine whether or not you are going to have a heart attack. Rather, the heart scan detects calcified plaque in the arteries of the heart. Calcified plaque is an indicator of heart disease. Soft plaque or non-calcified deposits are also predictors of heart disease; however, these cannot be detected by a Heart Scan or any other non-invasive test. So even if the Heart Scan determines that you do not have any calcified plaque there is still a risk that you have soft plaque or non-calcified plaque.
Heart disease and heart attacks are caused by a process called atherosclerosis, often referred to as "hardening of the arteries". As we grow older, cholesterol particles deposit themselves in the walls of our blood vessels. This gradual buildup of cholesterol is collectively referred to as "plaque". When plaque gets big enough, it can obstruct blood flow or it can become unstable and the plaque can rupture and cause a heart attack. The process of forming plaque occurs in almost everyone, often starting as early as the teen years. However, it usually takes many years before the plaques are large enough to actually cause a problem.
Heart Disease is the #1 cause of death and disability in the United States. Unfortunately, in many cases, the first sign of heart disease may be a heart attack and possibly death.
Is a Coronary Artery Calcium Scan Used for Early Disease Detection?
Yes. A CAC scan is used as a "screening" for heart disease and cancer. In medicine, "screening" means looking for a medical condition in a person showing no symptoms in the hope of identifying problems early, when treatment can be most effective. There are many screening tests that look for different abnormalities. For example, a very popular screening test for women is the mammogram. Most mammograms are done on women who do not have a lump in the breast or other evidence of breast cancer; it is done as a preventive measure in hopes of catching breast cancer at an early stage. The same reasoning can be applied to another commonly used screening test—the colonoscopy. The CAC scan is based on the same theory- early detection.
What is the Benefit of Having A Coronary Artery Calcium Scan?
You will have valuable knowledge about your relative risk for having a heart attack or stroke in the future. By having this information you can proactively work with your doctor to develop strategies for reducing your risk—if your doctor determines that it is high. Coronary calcium scores are most informative in a woman between the ages of 35-70 and a man between the ages of 40-60.
How Do I Interpret My Scan Results?
Your doctor will discuss your score with you and, if necessary, a plan to minimize your risk for heart attack or stroke.
Below is a general description of score results.
- Score 0: No evidence of plaque, which means there is a less than 5 percent chance you have coronary artery disease (CAD). Your risk of a heart attack is very low.
- Score 1-10: A small amount of plaque is noted, which means there is less than a 10 percent chance you have CAD. Your risk of a heart attack is low. You may want to improve your diet, get regular exercise and/or quit smoking.
- Score 11-100: Plaque is present, which means you have CAD, but you have only mild hardening in the coronary arteries. Your risk for heart attack is moderate. Talk with your physician about this result.
- Score 101-400: Plaque is present in a moderate amount, which means you have CAD and plaque may be blocking an artery. Your risk for heart attack is moderate to high. Your physician may recommend additional testing.
- Score over 400: Plaque is extensive, which means there is more than a 90 percent chance plaque is blocking one of your coronary arteries. Your risk for heart attack is high. Your physician will recommend additional testing.
Where are Coronary Artery Calcium Scans Done?
There are many centers across the U.S. that provide the special equipment and computer software necessary to be able to scan the heart. We encourage you to ask your general doctor for a referral or contact your local private scan center. You can find a directory of scan centers here: http://www.scandirectory.com
Is the Coronary Artery Calcium Scan covered by insurance?
Unfortunately, the scan is not currently covered by insurance - although they do cover most other screenings. Therefore patients are responsible for the cost - which can range from $75.00 to $250.00 depending on the facility.
What if my doctor doesn't recommend the scan?
See another doctor! Be you own advocate! Visit the No More Broken Hearts Resources page for more information about why this scan CAN save your life.
What Happens During a Coronary Artery Calcium Scan?
The scanner has a round opening in the x-ray machine through which a table moves. You will lie on this table and the table moves through the opening during the scan. EEG wires will be attached to the patches which are placed on the front of your chest. There are no injections, or drinks to take and many times you can remain full clothed.
You will then hold your breath as the table moves into the scanner and pictures of the heart will be taken. The actual CT scan is very quick but it requires you to hold your breath between 3 and 30 seconds depending on the individual scanner. In general you can expect your visit to last a total of 20-40 minutes (from start to finish).
What How Do I Prepare for a Coronary Artery Calcium Scan?
On the day of the CT scan of your heart that will measure your calcium score, you are asked not to smoke, drink tea, coffee, cola, or other caffeine-containing drinks. No other preparation is needed.
Are There Any After-Effects from a Coronary Artery Calcium Scan?
There are no after effects. You will be able to carry on with your normal day immediately after the scan.
What Are the Risks of Coronary Artery Calcium Scans?
As in all X-ray scans, radiation is used. The radiation does is small, about one tenth of a diagnostic CT scan. This scan should not be done on women who are pregnant or are trying to get pregnant.
What is the difference between a Coronary Artery Calcium Scan and an Echocardiogram?
Most doctors will recommend a stress test or Echo Cardiogram to determine the risk of a heart attack by measuring any blockage that is present in the coronary artery. A Coronary Artery Calcium Scan can identify the calcified plaque before a blockage is present, giving the individual the opportunity to manage the disease before a blockage is present.
Unlike the standard Stress Echocardiogram, Coronary Artery Calcium Scan can identify the presence of disease even with the arteries are less then 50% blocked.
It’s important to know that half of all heart attacks occur with less then a 50% narrowing. Heart disease is identifiable, measurable, and manageable with early detection.
Why is the Coronary Artery Calcium Scan recommended for men at 45 and women not until 55?
“Heart disease and the risk of heart attack increase significantly after women reach menopause. Estrogen helps keep artier pliable and when it declines blood pressure and LDL "bad" cholesterol increases”, says Deborah Kown, MD, a cardiologist at the Cleveland Clinic in the September 2016 issue of O Magazine.
In addition, late peri-menopause and post-menopause are associated with greater fat deposits around the heart, which has been linked to an increase in heart disease, according a 2015 study quoted in the September 2016 issue of O Magazine.
NOTE: This information is not intended as a substitute for professional medical advice. It is for informational purposes only, and should not take the place of any medical recommendations from a licensed medical professional.
Please visit the website for our partner Irish Heart Disease Awareness to see a detailed video that provides an overview about the scan experience. We also recommend their video explaining calcification.
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