What is Calcium Scoring?
Cardiac calcium scoring uses a special X-ray called a computed tomography (CT) scan to check for the buildup of calcium on the walls of the arteries of the heart (coronary arteries). Calcium is a marker of coronary artery disease (CAD). This screening is used to identify heart disease in an early stage and to determine how severe it is. Cardiac calcium scoring is also called coronary artery calcium scoring.
Calcified plaque in the coronary arteries can narrow the arteries and affect blood flow to the heart and can result in painful angina or a heart attack. Calcium scoring is the most effective non-invasive method currently available to accurately identify the presence of early coronary artery disease.
Who should have a Calcium Scoring Screening?
The goal of a cardiac CT for calcium scoring is to detect coronary artery disease (CAD) at an early stage in individuals who do not yet have any symptoms, but are at risk for the disease. The overall risk for CAD increases with age. Calcium Scoring is most often suggested for males aged 45 years or older, and for females aged 55 and over.
Other significant risk factors for CAD include:
- A family history of heart disease
- Diabetes or a family history of diabetes
- High blood pressure
- High blood cholesterol levels
- Cigarette smoking
- Being overweight or obese
- Being physically inactive
How does the procedure work?
The CT scanner is a large, square machine with a circular opening. The patient lies on their back on the exam table which moves into the center of the machine. The scanner does not enclose the entire body and the patient's head remains outside the unit. Electrodes (small metal discs) will be attached to the chest and to an ECG machine that records the electrical activity of the heart and makes it possible to scan at times when the heart is not actively contracting. The patient may be asked to hold their breath for 20 to 30 seconds while images are recorded. Within the machine, a rotating gantry moves around the patient's body taking x-rays to produce the images, which are reconstructed by a computer in an adjoining room using special software. The CT scan does expose the patient to a same amount of radiation, but the risks of cardiovascular disease largely outweigh the risks of this limited exposure.
Who interprets the results and how do I get them?
Not all calcium deposits in the arteries mean that there is a blockage, and not all blocked arteries contain calcium. A cardiologist experienced in CT will analyze the heart images and will send a report to the referring physician. Please contact the referring physician for the results of your screening.
What will the screening show?
The detailed heart images allow cardiologists to determine the amount of coronary calcium present in the heart. Calcium Scoring can suggest the presence of CAD even when the coronary arteries are less than 50 percent narrowed. Other cardiac tests may not reliably detect this level of blockage, and more than half of all heart attacks occur with less than 50 percent narrowing.
A negative cardiac CT scan that shows no calcification within the coronary arteries suggests that atherosclerotic plaque is minimal, and that the chance of developing coronary artery disease over the next two to five years is low. A positive test means that coronary artery disease is present even if you have no symptoms. The amount of calcification - expressed as a score - can be an indication of the probability of a heart attack (myocardial infarction) in the coming years. Based on screening results, a physician can help the patient determine the best course of action to manage the disease and reduce cardiovascular risks. Options may include clinical interventions, medications and/or lifestyle modifications. Early detection offers the opportunity to reverse the blockage of arteries and lower the risk of a future heart attack.
How do I schedule this procedure?
Patients need a prescription from either their primary care physician or a cardiologist to schedule a Calcium Scoring screening. No special preparation is necessary in advance of a cardiac computed tomography (CT) examination. Pre-menopausal women will need to present the results of a urine pregnancy test performed no longer than 2 weeks before the procedure. Patients may continue to take usual medications, but should avoid caffeine and smoking for four hours before the exam. At the time of the exam you will be asked to disrobe above the waist, put on a gown, and remove any jewelry that could interfere with the scan. If your heart rate is 90 beats a minute or higher, you may be given a drug to slow the rate in order to obtain accurate CT images.
Because this is a considered an elective screening and not a diagnostic procedure, most insurance providers do not cover Calcium Scoring. Patients with a physician's script for Calcium Scoring are requested to call Centralized Scheduling at 215-710-2208 to schedule this screening.