How high is your risk for cardiovascular disease? There are risk assessments that health care professionals use to estimate an individual’s odds of developing a heart attack over the next decade. They base the assessment on factors like family history, body weight, lipid levels, blood pressure, and more. But no matter how accurate the information we enter is, it still doesn’t give us an inside look at how clean our arteries are.
What is a Coronary Calcium Scan?
Cardiovascular disease comes from the build-up of calcium and fat inside the inner walls of arteries. The combination of calcium and fat hardens and becomes plaque. Over time, a portion of the plaque can break off and cause a clot to form that blocks blood flow to the heart. That’s what happens when you have a heart attack. Therefore, we want to limit plaque build-up to lower the risk of cardiovascular disease and heart attack.
How do you know if you have plaque build-up? Deposits of calcium and fat within an artery can accumulate with no symptoms at all. It’s only when the artery becomes narrow from the accumulation of plaque that you develop symptoms. It would be best if we can identify plaque in its early stages.
Fortunately, there is a way to look at how much calcium and fat build-up you have in your arteries. It’s called a coronary calcium scan and it can scan, visualize, and quantify how much calcium-containing plaque you have in your arteries. Based on the amount detected by the scan, you receive an Agatston score, also known as a coronary artery calcium score, or CAC. If your CAC score is zero, do a happy dance! This means they detected no calcium in your arteries. However, a score over 100 raises a red flag. Between 100 and 399 suggests moderate cardiovascular disease and 400 or above indicates severe disease.
The Pros of Coronary Calcium Scans
A calcium scan can give you an idea of whether you have cardiovascular disease and are at risk of having a heart attack. That’s helpful! Once you know you’re at higher risk, you may be more motivated to lower your risk through lifestyle changes. The more information we have about our health risks, the more proactive we can be. As you know, cardiovascular risk is strongly impacted by lifestyle. Even making simple changes like moving more, sitting less, eating a whole food diet, and avoiding heart unhealthy habits such as smoking and excessive alcohol can lower the risk of a heart attack or heart failure.
Another instance in which a coronary calcium scan can be useful is if you have a moderate risk of developing cardiovascular disease and you don’t know whether to take a statin medication. Your physician might recommend one but you’re on the fence If a calcium scan shows calcium build-up, getting on a statin may be in your best interest to reduce the risk of a plaque rupturing and causing a heart attack.
The cost of a coronary artery calcium scan isn’t prohibitive for most people either, assuming your insurance covers it, and some do. If that’s the case, you’ll only be out around $150.00 for the out-of-pocket costs. Another pro is how short the test is. It only takes 10 seconds to get a scan of your arteries. Unlike a CT angiogram, another test used to look at the coronary arteries, you don’t need to be injected with a dye.
The Drawbacks of Coronary Calcium Scans
By now you might think there are no downsides to scanning for calcium. Who wouldn’t want to know how much plaque they have in their arteries? However, there is a drawback: the test exposes you to radiation. In fact, one coronary calcium scan will expose you to the equivalent radiation of 23 chest x-rays. However, the amount of radiation exposure could be lower if the center that performs the scan uses the most advanced equipment.
Yet exposure to that amount of radiation isn’t insignificant. Some people at high risk of cardiovascular disease get a coronary calcium scan every 5 years to monitor for plaque, and that can lead to substantial radiation exposure. Radiation exposure is cumulative. The more CT scans and X-rays you have, the higher your risk of cancer, so we don’t want to overdo it.
Another factor is age. The benefits for young, healthy people aren’t significant. Unless you have a very strong history of cardiovascular disease, a scan wouldn’t be helpful if you’re under a certain age since most people don’t build up calcium plaques until after the age of 40 in men and after 50 in women. So, getting screened at 30 won’t be that helpful. Also, if you already have cardiovascular disease, the knowledge you gain from a coronary calcium scan won’t add additional information. You already know you have it and what you need to do to prevent further damage and getting a scan would only expose you to radiation.
In addition, there’s no clear evidence that treating an elevated calcium score through lifestyle lowers the risk of heart attack. Plus, a calcium score of zero doesn’t mean you have no risk of a heart attack. The scan only picks up firm, hard calcium deposits and plaques. The scan can’t pick up softer plaques that could still cause problems.
Should You or Should You Not Get Scanned?
Since there are pros and cons of determining your calcium score, the best approach is to talk to your health care professional about your risks. They can conduct a risk assessment that tells you what the likelihood of experiencing a heart attack over the next ten years based on your medical history, family history, lipid levels, glucose level, body weight, and other factors. All you have to do is answer a few questions. Once you know your risk, they can help you determine whether a coronary calcium scan would be beneficial for you.
The Bottom Line
Whether you get a coronary calcium scan depends on your age and your risk of developing cardiovascular disease based on family history and lifestyle habits. These are all issues to discuss with your physician. However, lifestyle makes a difference regardless! So keep eating and living healthy!
- com. “What Is a Coronary Calcium Scan?”
- Mayo Clinic. “Heart scan (coronary calcium scan)”
- Harvard Health Publishing. “Should you consider a coronary artery calcium scan?”