I remember a patient, let’s call him John. He was in his early 50s, felt generally fine, but his dad had a heart attack young. John was, understandably, a bit worried. He’d heard about something called a Calcium Score Test and wanted to know if it was right for him. It’s a conversation I have quite often, actually. That little niggle of “what if?” when it comes to heart health is something many of us feel.
So, What Exactly is a Calcium Score Test?
Alright, let’s break this down. A Calcium Score Test is a special kind of CT scan (that’s computed tomography – a fancy X-ray, really) that gives us a look at your coronary arteries. These are the little pipes that feed your heart muscle with blood.
Now, why calcium? Well, if there’s a buildup of a waxy, fatty stuff called plaque in those arteries – a condition we call atherosclerosis or coronary artery disease – calcium often gets deposited there too. Think of it like hard water deposits in your home’s plumbing. So, this test is looking for those calcium specks. More calcium can mean more plaque, and more plaque can mean those arteries are getting narrower or even blocked. And that, unfortunately, can increase your risk of a heart attack.
Who Might Need a Calcium Score Test? (And Who Might Not?)
This is where things get a bit more personal, because it’s not for everyone.
When it can be helpful:
I often find a Calcium Score Test useful when we’re trying to get a clearer picture for folks who are sort of in a “borderline risk” zone for heart disease. We’re talking about people, say, between 40 and 70 years old, who don’t have obvious heart symptoms but do have some risk factors.
What kind of risk factors? Things like:
- A family history of heart disease (like John’s situation).
- If you smoke or used to smoke. Yep, even past smoking counts.
- A history of high cholesterol, diabetes, or high blood pressure.
- If you’re carrying extra weight (what we medically term overweight with a BMI over 25, or obesity with a BMI over 30).
- Living a mostly inactive lifestyle.
- Sometimes, other less common risk factors pop up too.
Even if you’re younger than 40, if high cholesterol runs strongly in your family (something called familial hypercholesterolemia), we might consider it.
It’s important to remember, though, this test isn’t a crystal ball. It can’t spot every type of coronary issue, like “soft plaque” atherosclerosis which doesn’t always have much calcium. So, it’s one tool in our toolbox, helping us decide if, for example, starting a medication like a statin to lower cholesterol is a good idea for you.
When it’s probably not needed:
There are times when a Calcium Score Test isn’t really the best route:
- If you’re pregnant – CT scans and growing babies don’t mix well.
- If you have no risk factors for heart disease.
- If you’re already at high risk or have a confirmed diagnosis of coronary artery disease. We already know what we need to know, in a sense.
- If you’re having symptoms that point to heart disease (like chest pain). We’d likely go for different tests then.
- If you’ve already had treatment for coronary artery disease, like a stent or bypass.
- If you’re looking to see if your current heart disease treatment is working. Again, other tests are better for that.
If you fall into these groups, don’t worry, we’ll talk about other ways to assess or monitor your heart.
How often should you get one?
If your first score is normal (zero, which is great!), some studies suggest repeating it every three to five years could be reasonable to see if your risk is still low. But, if you’ve had an abnormal result before, repeating the test usually doesn’t add much new information.
Getting Ready for Your Calcium Score Test: What to Expect
The good news? It’s a pretty straightforward and quick process. The CT scan itself only takes a few minutes. The whole appointment might be around 10 to 15 minutes. And it’s noninvasive, meaning nothing goes into your body.
Before the Test:
- Always tell us about any allergies, medications you’re on, and very importantly, if you are or might be pregnant.
- You’ll need to skip food, drinks, caffeine, and tobacco for about four hours beforehand.
- You might need to take off any metal – jewelry, glasses, that sort of thing.
- You’ll change into a hospital gown. Easy peasy.
- You’ll lie on your back on a table that slides into the CT scanner, which looks a bit like a big doughnut.
- A technician will gently clean (and maybe shave a tiny bit, if needed) three small spots on your chest. They’ll then stick on little electrode patches. These are connected to an EKG (electrocardiogram) monitor, which tracks your heart’s rhythm during the scan. This helps us time the pictures just right with your heartbeat.
During the Test:
- You’ll feel the table move smoothly into the scanner.
- You can usually talk to the person running the machine – they’re in another part of the room but can see and hear you.
- The CT scanner is super fast and takes lots of pictures, all timed with your heartbeat. You might be asked to hold your breath for just 10 to 20 seconds at a time.
- Then, a smart computer program looks at those images for any signs of calcification in your coronary arteries.
After the Test:
- That’s it! You can get dressed and go about your day, eat and drink as usual.
Let’s Talk About Risks (They’re Small, But Good to Know)
One of the nice things is that this test doesn’t use any contrast dye injections, so you don’t have to worry about side effects from that.
There is a very small risk related to radiation exposure, as with any CT scan. To put it in perspective, it’s about the same amount of radiation you’d naturally get from the environment over a year. The risk is slightly higher if you have many CT scans or if you’re younger than 40. And, as I mentioned, we don’t do this scan on pregnant women because of potential harm to the baby.
Understanding Your Calcium Score Test Results
Okay, so what do the numbers mean?
If the test is positive, it means the scan found some calcium in your coronary arteries. This tells us there’s evidence of coronary artery disease (CAD). You’ll get a score, a number, that gives us an idea of how much calcium is there.
This calcium score can range from zero all the way up to over 1,000.
- 0 (Zero): This is a normal or “negative” scan. It means no calcification was found. This is great news! It suggests a very low risk of having a heart attack in the next two to five years.
- 1 to 100: This suggests mild evidence of CAD.
- 101 to 400: This indicates a moderate amount of evidence of CAD.
- Above 400: This is considered strong proof of CAD.
Your doctor (that’s me, or your specialist!) will look at this score alongside all your other risk factors – your family history, lifestyle, other medical conditions – to get the full picture of your future heart attack risk.
When will you get the results?
Sometimes results are available the same day, other times it might take a couple of days. A radiologist (a doctor who specializes in reading scans) will review your scan and send a report to your main doctor.
Does a Calcium Score Test show blocked arteries?
Not quite directly. It doesn’t show blood flow or the exact percentage of blockage like some other tests can. What it does show is the calcification – those hard deposits – within the artery walls where plaque has built up. And those are the areas that can become blocked.
What Happens if My Calcium Score is High?
If your score comes back higher than we’d like, please don’t panic. It’s information, and information is power.
Based on your results and everything else we know about your health, we might suggest:
- A chat with a cardiologist (a heart specialist).
- Possibly starting a statin medication to help manage your cholesterol.
- Looking at ways to get more exercise.
- Making some positive changes to your diet.
- Sometimes, we might need a few more tests to get even more detail.
- And, of course, regular follow-up visits to keep an eye on things.
We’ll discuss all the options and make a plan together.
Key Things to Remember About the Calcium Score Test
- It’s a CT scan that looks for calcium in your heart’s arteries.
- Calcium can be a sign of plaque buildup (atherosclerosis), which increases heart attack risk.
- It’s most helpful for people with borderline risk and some risk factors, but no symptoms.
- A score of 0 is normal and means low risk. Higher scores indicate more calcium and higher risk.
- The test is quick, noninvasive, and involves a small amount of radiation.
- Your doctor uses the Calcium Score Test results along with other factors to assess your overall heart health.
You’re not alone in figuring this out. We’re here to guide you and make sense of what these tests mean for you.
