Understanding the Calcium Test for the Heart

Introduction

The coronary calcium test , also known as the coronary artery calcium (CAC) score , is a specialized CT scan that measures the amount of calcium buildup in the coronary arteries. This test helps assess the risk of coronary artery disease (CAD) and potential future heart problems.

Why is the Test Important?

Calcium deposits in the coronary arteries indicate atherosclerosis , a condition where plaque builds up inside the arteries, potentially leading to heart attacks or other cardiovascular issues.

Who Should Get a Calcium Score Test?

The test is most useful for people who: - Are middle-aged or older with risk factors for heart disease. - Have a family history of heart disease . - Are considering cholesterol-lowering medications but are unsure if they need them. - Have borderline cholesterol levels with other risk factors (e.g., smoking, diabetes, hypertension).

How Does the Test Work?

• A CT scan of the chest is performed to detect calcium deposits in the coronary arteries.
• The results give a calcium score :
  • 0 : No calcium. Low risk of heart disease.
  • 1–99 : Some calcium. Mild risk.
  • 100–299 : Moderate calcium buildup. Moderate to high risk.
  • 300+ : Large amounts of calcium. High risk of a heart attack.

What to Do Based on Your Score?

• Low score (0–99): Focus on maintaining a healthy lifestyle.
• Moderate score (100–299): Discuss aggressive prevention strategies with your doctor (e.g., cholesterol and blood pressure management).
• High score (300+): Requires strong intervention, including lifestyle changes and potential medications.

Benefits and Limitations

Pros:

✔ Helps predict heart disease risk. ✔ Can guide treatment decisions. ✔ Non-invasive and quick test.

Cons:

❌ May not be useful for very young or very old patients. ❌ Exposure to a small amount of radiation. ❌ Doesn’t measure soft (non-calcified) plaques, which can also cause heart attacks.

Conclusion

The coronary calcium test is a valuable tool for assessing heart risk but is not for everyone. If you have concerns about your heart health, consult your doctor about whether this test is right for you.

Source recommendations

1. American Heart Association Guidelines on Coronary Artery Calcium Scoring

1. https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/cac-test
2. https://www.jacc.org/doi/10.1016/j.jcmg.2022.06.018
3. https://www.heart.org/en/news/2018/11/13/coronary-calcium-test-could-help-clarify-heart-disease-risk-and-control-cholesterol
4. https://www.ahajournals.org/doi/10.1161/cir.0000000000000678
5. https://www.sciencedirect.com/science/article/pii/S1936878X22004107

2. European Society of Cardiology Guidelines on Cardiovascular Risk Assessment

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-Prevention-Guidelines
2. https://pubmed.ncbi.nlm.nih.gov/34458905/
3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines
4. https://academic.oup.com/eurheartj/article/42/34/3227/6358713
5. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-Guidelines-on-non-cardiac-surgery-cardiovascular-assessment-and-managem