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Deciding if a coronary calcium screening is right for you

Main Line Health February 23, 2018 Heart Health

Beginning at a young age, we’re taught that annual screenings are a part of staying well. From pediatric well visits, dental cleanings and sports physicals to mammograms and colonoscopies, preventative screenings and annual visits are one of the best ways to detect health risks and treat them before they become more serious.

One screening, in particular, can help determine your risk for heart disease, a condition that claims the lives of one in every four Americans.

A coronary artery calcium (CAC) scan is a precautionary screening that is used to detect atherosclerosis, a buildup of fatty deposits that can clog and harden your arteries, restrict blood flow and increase your risk for heart disease.

But the risks of atherosclerosis don’t stop there—left untreated, it can lead to stroke, peripheral artery disease, kidney disease and aneurysm, too.

Is a CAC right for me?

So, should you ask your doctor about a CAC scan? Is it right for you?

While it’s a conversation everyone should have with their health care provider, Lankenau Heart Institute cardiologist Andrea Becker, MD, offers a good rule of thumb.

“A coronary calcium scan is a pure screening test for the healthy person. Someone who might feel terrific but have risk factors for heart disease like smoking, hypertension or a family history would make a good candidate for this screening.”

Like other health screenings—including Pap smears, mammograms and colonoscopies—the recommended age for CAC scans can range depending on personal or family health history. However, men and women over age 45 are generally considered candidates.

If you have already been diagnosed with heart disease, a CAC scan isn’t necessary, as it likely would not change your course of treatment. If you’re under age 45 and do not have any risk factors for heart disease—like hypertension, obesity, smoking, family history, high cholesterol or diabetes—a CAC scan isn’t the right fit for you. It might help put your mind at ease, but testing comes at a cost and the results likely would not affect you.

Understanding your results

The result of your CAC scan is given in the form of an Agatston score, a number that represents the amount of plaque build-up in your arteries. This score can range anywhere from zero to more than 300. A lower score represents less plaque build-up, and indicates you’re at a low risk for heart attack over the next 10 years.

“If the results are zero, you can say that you have 95 percent certainty that you don’t have a heart blockage. Anything above that means that you do have some plaque build-up, and the higher number you have, the more plaque you have,” explains Dr. Becker.

There are a variety of treatment options available to treat plaque build-up, including statins, angioplasty with stenting and—if necessary—cardiac surgery. Depending on your Agatston score and your personal health history, other diagnostic testing may be necessary to determine if you need additional treatment.

While zero to 10 is an optimal score, Dr. Becker cautions patients against panicking if their score is higher than expected.

“A high number doesn’t necessarily mean you need to be under the care of a cardiologist or that you have a critical narrowing. It just means you should follow up with your primary care doctor.”

Are there any risks?

A CAC scan might sound like the perfect screening test for you. But before you head into the doctor’s office, there are a few things to know.

First, CAC scans are conducted used X-ray technology and, as a result, you’ll be exposed to a small dose of radiation. While radiation from a single CT scan is not dangerous, you should discuss your concerns with your doctor. If you’re pregnant, you may wish to wait until after you have delivered.

If radiation is a concern for you, there’s good news: CAC scans are not required annually. These screenings are conducted once every seven years, so your radiation exposure will be minimal.
Another factor to consider is cost. Because this test is relatively new and not a part of standard heart disease screening guidelines, CAC scans are not currently covered by insurance.

While the ultimate decision to get a CAC scan lies with you, Dr. Becker urges men and women to consider its benefits.

“A coronary calcium test delivers personalized results about your heart disease and heart attack risk, which is something that no other screening can offer. It’s an important tool in the fight against heart disease.”

To schedule a coronary artery calcium scoring appointment at Main Line Health, call 484.580.1800.