Mark A. Steiner, MD
Cardiology
Orlando Health
If you’re wondering about your chances of having a heart attack over the next five years, a calcium score screening test could offer important insights. These tests, which have been around for more than a decade, measure the amount of calcium that has accumulated in your coronary arteries. They are quite good at predicting risk for heart attack and other cardiac problems. Most importantly, they can help your doctor recommend lifestyle changes and medications to reduce your risk.
When Should You Learn Your Calcium Score?
This isn’t one of those tests – like a colonoscopy, for example – that everyone is urged to get by a certain age. It’s based more on your individual health situation.
Consider these general guidelines:
- If you don’t have any risk factors for heart disease and have normal cholesterol levels, you don’t need to get a screening.
- You don’t need a calcium score if you are already receiving high-level care for potential heart problems. This group includes patients who have heart disease or those with diabetes and vascular disease.
- If you are at lower or intermediate risk for heart disease, a screening can determine your risk for heart problems.
Calcium score tests can be particularly valuable for patients who don’t have many obvious risk factors but still have reason to worry. For example, your risk factors might only be elevated cholesterol and a family history of heart disease. You may be weighing whether to start taking cholesterol-controlling medication.
With a calcium score of zero, it’s reasonable for you to focus on lifestyle modifications, including diet and exercise. But a higher calcium score could suggest that medications also are needed.
The scores also help your doctor decide how aggressively to approach other conditions – diabetes and high blood pressure, for example – that make you more vulnerable to heart disease. Scores higher than zero could prompt your doctor to suggest medications in addition to lifestyle changes.
In many ways, this test offers a way to look five or 10 years down the road to see what’s coming and then avoid it, if necessary.
What Happens During the Procedure?
This quick and painless procedure is done with a CT (computed tomography) scanner that takes a series of images of your chest. The images create cross-sectional views of your coronary arteries, allowing your doctor to gain a detailed look at what’s happening inside your arteries.
Before the procedure, you may be asked to change into a hospital gown. You’ll lie on a table and have a few small electrodes attached to your chest. The table will then slide into a doughnut-shaped opening, where high-speed scanning will capture multiple images, synchronized with your heartbeat.
The scan itself will take less than a minute, and the entire procedure – from start to finish – is typically over in less than 15 minutes.
What Does Your Score Mean?
The test will measure calcium accumulation in each of the three main heart arteries to give a total calcium score.
What the scores mean:
- Zero is the normal score. It suggests a low chance of developing a heart attack in the future.
- Less than 100 is considered mild.
- 100 to 400 is considered moderate, with relatively high risk of a heart attack in three to five years.
- Greater than 400 represents extensive calcium buildup and very high risk of heart attack and the likely presence of coronary disease.
- Sometimes, patients come in with much higher scores – even as high as 3,000. These patients usually have significant obstructive coronary disease.
And while it may sound surprising, it’s not uncommon for patients to have high calcium scores without having strong symptoms of heart disease or other complications. But that’s not unusual when you consider that for roughly a third of heart attack patients, the heart attack is the first symptom. That’s one of the reasons the calcium score is such a valuable screening tool.
For more information visit OrlandoHealth.com.
