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Coronary Calcium Scoring

 

What is coronary calcium scoring?

A coronary calcium scan, also know as a cardiac CT calcium scoring exam, is a noninvasive, painless CT scan that measures the amount of calcium or hard plaque deposits in your coronary arteries. Calcified plaque in the arteries shows you have coronary artery disease. Many people call this “hardening of the arteries.” As more plaque builds up, arteries get narrower and the risk of a sudden heart attack can increase. 

The coronary calcium scoring test takes into account risk factors (like age, family history, lipid profile, cholesterol, etc.) as well as the total load of hardened (calcified) plaque in your arteries. The exam typically takes less than 15 minutes.

It is important to note that most health insurance plans and Medicare do not reimburse for this procedure as it is considered a screening exam. For The Iowa Clinic, this exam is performed in Medical Imaging and is only available at the West Des Moines Campus.

Who needs coronary calcium scoring?

Your provider may recommend you get a calcium score exam if you are at moderate risk for coronary artery disease but have no symptoms. If you have three or more of the following risk factors, you should ask your doctor for more information about the Cardiac Calcium Scoring Exam: 

  • Men: Age 45 or older
  • Women: Age 55 or older, or you have passed menopause
  • Family history of heart disease
  • Smoking
  • High cholesterol
  • High blood pressure
  • Inactive lifestyle
  • Overweight

The American College of Cardiology has found that Coronary artery calcification (CAC) is an excellent cardiovascular disease risk marker and can help guide the decision to use cholesterol reducing medications such as statins. A negative calcium score may reduce the need for statins in otherwise eligible patients. 

A calcium scan is not recommended as a general screening test, so you should ask your doctor if it is right for you.

What are the risks of coronary calcium scoring?

The risk for a cardiac calcium scoring exam is low. There is some exposure to radiation, but the amount used by a cardiac calcium scoring exam are considered safe.

How do I prepare for coronary calcium scoring?

As with most heart-related tests or procedures, you should not smoke or ingest caffeine before your procedure. Your provider will give you instructions prior to your appointment. The day of the test, please come prepared in comfortable clothing that is easy to remove. Plan to leave any metal such as jewelry, glasses, piercings, etc. at home or with a loved one during your test as they may interfere with the imaging being completed.

If you tend to get nervous for procedures, your provider may ask that you take medications that lower your heart rate or calm your nerves. Your provider will communicate to you in advance if this is something they would recommend so you have time to obtain the prescription prior to your procedure.

Any questions or concerns should be discussed with your provider prior to your procedure.

What should I expect after coronary calcium scoring?

Used as a screening tool for people to identify their risk of heart disease, the coronary cardiac calcium scoring exam doesn’t use medication or injections. During a coronary calcium scoring exam, the nurse or technologist will place electrodes on your body to monitor to your heart during the test. They will have you lie down on a table that moves into the CT scanner. Your head will remain outside the machine throughout the duration of the test.

While the images are being taken, the technologist may ask you to lie still or hold your breath to ensure clear images are being captured. The test takes about 10-15 minutes.

After the procedure, you can resume normal activities.

How do I read my coronary cardiac calcium score?

Your results are typically reported as a number or score. This numeric value reflects the amount of calcium found and how dense the calcium is within your coronary arteries.

If calcium plaque is detected, it may indicate some coronary disease. Your doctor will be able to recommend the right treatment plan for you. If no calcium plaque is detected, you probably do not have significant coronary artery disease, and your risk of heart attack is very low. Of course, you should still work to reduce your risk factors by eating right, exercising and avoiding smoking.