Calcium test a valuable tool for assessing risk of heart disease

Calcium-score screening heart scans, also called coronary calcium scans, provide very useful and cost-effective information to help evaluate a person’s risk of coronary artery disease and heart attack. The early stages of CAD often cause no symptoms. This non-invasive test can be used before significant symptoms develop so that preventive actions and treatments can be done to reduce the risk of heart disease.

In CAD, plaques of fat and cholesterol develop within the heart’s arteries. Chronic inflammation in the body is involved in this disease process. Calcium accumulates in the plaques as part of the repair of inflammation damage. As plaques get larger, they can obstruct blood flow in these vessels, resulting in symptoms such as chest pain and shortness of breath. Compete blockage of a heart artery can cause a heart attack. Heart failure and arrhythmia are other conditions that can be caused by CAD.

Coronary calcium scans detect the presence of calcium deposits in these plaques. Older plaques contain more calcium and become hard. Higher amounts of calcium can indicate an increased risk of CAD and heart attacks. A numerical score is calculated based on the amount and sizes of calcium deposits present in the cardiac blood vessels. The locations of any calcified areas are also identified. A score below 10 usually shows very low risk. A score above 400 indicates a high risk.

This coronary calcium score is not absolutely predictive. It is a screening test and must be considered with an individual’s medical history, physical examination and other risk factors to evaluate the risk of heart attack in the next few years.

A limitation of this test is that it cannot detect soft plaque, which has not yet calcified and can rupture to cause blockages.

So who should have a coronary calcium scan? For younger people at low risk of CAD, it is probably unnecessary. For those already at high risk (those with 20 percent or greater chance of a heart attack within the next 10 years), your doctor already knows that you should be actively monitored and treated with medications as needed and lifestyle changes. A calcium score would not change the treatment plan.

This test is most useful for people at moderate risk of CAD and heart attack based on age, family and medical history and risk factors. People older than 40 with known risk factors such high blood pressure, diabetes, obesity, sedentary lifestyle, unhealthy diet, smoking or strong family history of heart disease could benefit from this information. An elevated calcium score indicates a need for more diligent effort and attention to medical treatment and lifestyle improvements.

A coronary calcium scan is a very short procedure. The test is done with a computed tomography scanner. It is non-invasive – no IVs or dye injections are needed. A few electrode patches will be used to record an electrocardiogram during the test. The person will hold his or her breath and lie as still as possible during the few seconds of testing. Because a CT scanner uses X-rays to create images, there is a small exposure to radiation.

Being a screening test, the cost of a coronary calcium scan is not covered by most insurance plans and Medicare. However, the cost is very low compared to that of a traditional heart catheterization and avoids the risks associated with an invasive procedure.

Coronary calcium scans provide valuable information to physicians and their patients that can be used to optimize the prevention and management of CAD. Advanced medical technologies and treatments are often life saving, but healthy lifestyle choices are also very important ways to improve health and reduce disease risks.

For more information about coronary calcium scoring, visit wesleymc.com.

This story was originally published February 9, 2015 at 5:13 PM with the headline "Calcium test a valuable tool for assessing risk of heart disease."