Scan for heart-disease risk before symptoms

The coronary calcium scan is a screening test to evaluate risk for future coronary events. It uses a state-of-the-art computerized tomography (CT) scan to detect calcium deposits found in atherosclerotic plaques in the coronary arteries. It is a sensitive way to detect atherosclerosis before symptoms develop.

Main risk factors for coronary artery disease are:

• Personal/family history of coronary artery disease
• Males over the age of 45, females over 55
• History of smoking (past or present)
• Overweight
• High cholesterol
• Diabetes
• High blood pressure
• Inactive lifestyle

Your doctor can use the results of the scan to help make treatment decisions on how to lower your risk for heart disease. This test is most helpful for patients who do not have known heart disease but are at medium risk for disease after evaluating the main risk factors listed above.

Some studies have shown that a cardiac calcium scan might be a motivational factor for people at moderate risk to follow treatment plans and to make lifestyle changes.

The screening test is NOT for you, if

• you don’t have any risk factors for heart disease
• you are at high risk for heart disease
• you have already been diagnosed with heart disease – since the information obtained from the scan will not impact your recommended treatment.

The result of the test is a number called the cardiac calcium score, or Agatston score.

The score is calculated from the total area of calcium deposits and the density of the calcium.

• A score of zero means no calcium is present in the coronary arteries, which suggests a low likelihood of having a heart attack in the future.
• A score of 100-300 is indicative of moderate plaque deposition in the arteries and is associated with a relatively higher risk of heart attack or heart disease over the next three to five years.
• A score greater than 300, is considered very severe with high risk of heart attack or heart disease.

What are the concerns of getting a scan?

• You are exposed to a low dose of radiation.
• False positives are possible leading to further testing or treatment that you don’t need.
• Not all arteries with heart disease have calcium “soft plaque atherosclerosis,” so it is possible to get a low score and still be at risk.
• The scan is not covered under most insurance plans and Medicare, so the cost is out-of-pocket.

Many people do not know that they have heart disease until they have a heart attack. A coronary calcium scan is one way to find out if you have early heart disease, but other risk factors must be evaluated along with the score to give you a truer assessment of your cardiac risk. Your doctor can use your score to help you make lifestyle changes and/or to decide to treat high cholesterol or high blood pressure with medication.

SUSAN LOCKE is Healthnetwork Foundation’s medical director