A seemingly healthy person walked into The Iowa Clinic for a comprehensive executive health physical. By all appearances, they were healthy. And most of their tests came back normal — until the calcium score.
The next day, that “healthy” individual was in surgery, getting stents put into their arteries and saving them from a potentially life-threatening heart attack.
It was all caught in one quick test.
Calcium scoring serves as a highly effective screening tool, revealing how much calcific plaque is in the coronary arteries. It is easy to perform, cost-effective, and provides a strong indication of whether further investigation is needed to prevent potentially catastrophic events.
Scary! How does calcium scoring work?
Calcium scoring is a computed tomography scan of the heart — a specialized X-ray — that checks for cardiovascular disease and determines its severity. A radiologist reviews the heart CT scan and circles all the areas where calcium has built up. That information is put into a computer algorithm that delivers your calcium score on a scale of 0 to over 400.
It’s like golf. The lower your score, the better. The higher you get up the scale, the greater your risk for heart disease because there were more areas of plaque buildup found in the heart scan.
| Calcium Score1,2 | 1 Mayo Clinic Proceedings, March 1999, Vol. 74. Findings based on EBCT data. 2 Carr JJ. et. al., Evaluation of Subsecond Gated Helical CT for Quantification of Coronary Artery Calcium and Comparison with Bectron Beam CT.: AJR 2DDD: 174: 915-921 | ||
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The score just puts you into different categories. Zero means no plaque at all. Then there are mild, moderate and severe categories.
If you fall into the mild or moderate categories, you’ll have to monitor your condition with additional calcium scoring tests every five years to make sure your risk hasn’t increased. If you score over 400, you’ll need to have additional testing to figure out the severity of your blockage and consult a cardiologist to see if you have heart disease.
Do I need to take a calcium scoring test?
Only if you’ve hit middle age. Calcium scoring is not recommended for males under the age of 40 and females under 50. If you’re past that point, your physician may give you a risk assessment to see whether you’re at risk of atherosclerosis — a hardening and blockage of the arteries that can lead to stroke or heart disease.
Your atherosclerosis risk assessment will rank you on multiple factors:
- Cholesterol — Your physician will look at your own cholesterol levels and any family history of high cholesterol.
- Smoking habits — Smoking is a major risk factor for atherosclerosis, so your history or current habits play a major role.
- Gender — Men have a higher risk than women, which is why their screening starts a full decade earlier.
If your assessment puts you at a moderate risk for significant atherosclerosis — or above — that warrants calcium scoring to actually quantify how much cholesterol is built up in your blood vessels.
What if I score high — can I lower it?
Unfortunately, a high calcium score cannot be reversed. The calcium in question comes from fat and cholesterol that builds up in the arteries, hardens over time, and causes blockages. High cholesterol attaches to the walls of blood vessels, decreasing their size and limiting blood flow, which can lead to heart attacks.
And a lot of that build up is irreversible. You can make lifestyle changes, so you don’t add to it and increase your cardiac calcium score and risk for heart disease. But the only way to actually get rid of the calcium is through angioplasty, a surgery to unblock or widen your arteries.
Still, lifestyle changes can help you maintain your calcium score so you don’t progress into dangerous territory. Through healthier eating, cholesterol medications and decreasing controllable risk factors — like quitting smoking — you can keep your score at the same level.
Where do I get a calcium scoring test?
Start with your primary care provider. If you’re concerned about your heart health or cholesterol, talk to them about a risk assessment to see if your results warrant further testing.
If you’re an executive, calcium scoring is a core service in the comprehensive exams provided by the Executive Health Clinic. In addition to a calcium score test, you’ll get a range of tests, screenings and exams that give you a clear picture of your overall health and wellness.