Coronary Calcium Scanning: Who needs it and who doesn’t?

By admin
September 18, 2013

If you could have a painless, non-invasive test to check for the build-up of plaque in your coronary arteries, would you do it, even if it were not covered by most insurance policies? Well, there is. A heart scan, or coronary calcium scan, uses computed tomography (CT) technology to check for the accumulation of calcium in plaque on the walls of the arteries of the heart, and it can be used to identify the presence of heart disease.

Plaque in the artery walls is made up of cholesterol, fat and calcium. CT scans can detect the calcium in the plaque because the calcium shows up intensely on the CT x-ray file. The amount of calcium can then be used to calculate the calcium score which, when combined with other health information, helps determine the patient’s risk of coronary artery disease or a heart attack. The calcium score can range from 0 to more than 400. Any score over 100 means that the patient is more likely to have heart disease. The higher the score, the greater the risk.

Who may benefit from a coronary calcium scan?

Well-Being spoke to Dr. Keith D. Thorne, Cardiologist, at the Jackson Heart Clinic, about the appropriate use of coronary calcium scanning and how it can aid in the treatment of early-stage heart disease.

“We don’t really have just one test that tells us everything about the state of a person’s heart health,” notes Dr. Thorne. “We can do blood tests for cholesterol, check blood pressure, do stress tests, etc., and each test gives us a different piece of the puzzle. However, with the development of CT technology, which gives us a look inside the soft tissue of the body, we now have the ability to see inside the blood vessels to determine if there are signs of potential blockage.”

According to Dr. Thorne, the coronary calcium scan is useful in young patients and those at a moderate degree of risk who have not experienced symptoms, but who have some risk factors or family history of heart disease.

“Knowing that there is evidence of plaque starting to build up in the coronary arteries is valuable to us because it can help us determine the best course of action to manage the patient’s risk factors,” Thorne continues. “For younger patients who have borderline levels of bad cholesterol, it can help us determine if we should start medication or if changes in diet, exercise and lifestyle factors, such as not smoking will be enough for a while.”

“A beneficial ‘side effect’ of having a higher than normal calcium score is that often a patient will take their risk factors seriously. They tend to be more motivated to take their medications as directed and to make important lifestyle changes, such as quitting smoking, getting regular exercise and eating a heart healthy diet,” Thorne adds.

Who is NOT a candidate for a coronary calcium scan?

A coronary calcium scan is not beneficial for patients who fall at either end of the risk spectrum – those with a very low risk of heart disease and those with a very high risk.

Low Risk – If you are young, have normal cholesterol and blood pressure levels, and don’t smoke, a calcium scan probably won’t provide any information you and your doctor don’t already have.

High Risk – If you have high cholesterol levels and high blood pressure, smoke, and are older than 65, a calcium scan is not beneficial because you and your doctor are already aware of your risks and should be taking steps to prevent a heart attack. For patients who have already had a heart attack or have had an angioplasty or coronary bypass surgery, a calcium scan will not provide any more information on how your condition should be treated.

Another Consideration – A calcium scan is not recommended for women who know they are pregnant or might be pregnant.

Should coronary calcium scans be repeated annually?

A coronary calcium scan is not advised for routine annual screening for coronary artery disease. Once the cardiologist has determined there is evidence there is a build up of plaque in the coronary arteries, and the patient’s disease is being managed, further scans are not beneficial and amount to unnecessary exposure to radiation and out-of-pocket cost for the patient.

Consult your doctor.

As with all medical procedures, a person should seek the advice of their primary care physician or cardiologist before having a calcium scan. Your doctor will review your medical history and discuss your risk factors for heart disease to determine whether a coronary calcium scan can provide additional information that can aid in the development of a management or treatment plan that is appropriate for your risk of coronary artery disease or a heart attack.

Keith D. Thorne, M.D., Cardiologist, at Jackson Heart Clinic completed his undergraduate degree at Mississippi State University. He then earned his medical degree at the University of Mississippi Medical Center, where he also completed a residency in internal medicine and a fellowship in cardiology. Dr. Thorne is board certified in internal medicine and cardiovascular diseases.

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