What is Calcium Scoring?

Healthcare providers use a calcium score test to assess whether you need treatment to help prevent stroke or heart attack. With this test, your doctor may be able to gather additional information on your heart’s structure, how well it pumps blood, scarring from a previous heart attack, your risk of heart attack and other abnormalities. Coronary calcium score test takes only a few minutes with little to no preparation on your part. You can immediately go back to your usual activities after the test.

What Is a Calcium Score Test?

Calcium score is a computed tomography (CT) scan that can check plaque buildup in the arteries. Plaque is composed of cholesterol, calcium, fat and other substances in the blood. As it collects on the walls of your arteries, arteries will narrow, slowing down or clogging blood flow to the heart. Despite the word “calcium” in the CT calcium score test, calcium in plaque is not related to calcium in your diet and is different from the calcium found in bones.

The test involves taking images of your heart to show plaque buildup and blockages in your arteries. The pictures can help your doctor discover how your heart pumps blood and if any issues need to be addressed.

What Is the Normal Calcium Score?

A normal cardiac calcium score is zero, which means there should be no calcium deposits in the heart arteries. A high calcium score means a significant calcium presence, which can translate to a higher risk of a heart attack in the future due to narrowing in the coronary arteries. Here’s how the scoring works to inform you of heart-related concerns before there’s a problem:

Calcium ScoreInterpretation
  • No identifiable atherosclerotic plaque.
  • Low risk for cardiovascular disease.
  • Less than a 5% chance of coronary artery disease.
  • Minimal plaque burden.
  • Significant coronary artery disease is unlikely.
  • Mild plaque burden.
  • Likely mild or minimal coronary stenosis.
  • Moderate plaque burden.
  • Moderate non-obstructive coronary artery disease is highly likely.
Over 400
  • Extensive plaque burden.
  • High likelihood of at least one significant coronary stenosis (>50% diameter).

With heart calcium test, doctors can provide customized heart disease prevention strategies for each patient, including lifestyle modification recommendations and medication. It can help patients avoid unnecessary treatment interventions.

Does a Calcium Score Test Show Blocked Arteries?

A positive calcium score can suggest a higher risk of coronary artery disease (CAD), but it does not directly show whether arteries are blocked. As such, additional tests are often needed to get detailed images of the coronary arteries, assess the severity of blockage and plan appropriate treatments.

Is a Calcium Score Test Worth It?

Calcium scoring results are accurate. Heart specialists may use your calcium score to predict the possibility of a future heart attack and decide on the most appropriate treatment. The CT scanner used in calcium scoring takes photos of the heart in thin sections. When combined, calcium deposits in the pictures become more evident. False-positive or false-negative results are unlikely in calcium scoring.

Calcium scoring is not for everyone. If you have minimal risk of heart attacks and do not have any symptoms of heart disease, your doctor may not recommend a calcium scoring CT in your routine health screening. If you have already had a coronary stent, heart attack or coronary bypass surgery, CT scan cardiac calcium scoring will not provide additional information.

What Is the Treatment for a High Calcium Score?

Your doctor may recommend adjustments in your lifestyle, medications and diet based on your calcium scoring test results. Our doctors may recommend that men over 40 years old and women over 45 years old with the following heart disease risk factors undergo calcium scoring test:

  • Diabetes
  • Family history of heart disease
  • High cholesterol level
  • Hypertension or high blood pressure
  • Obesity
  • Smoker

Calcium Scoring CT Scan Preparation

Share information about your medications, medical conditions, recent illnesses and medications you are currently taking with your doctor. Tell your doctor if you have any allergies, so you can be prescribed medicines to reduce the risk of an allergic reaction. You must take any prescribed medications 12 hours before your exam. Before the exam:

  • Remove jewelry, hairpins, eyeglasses and other metal objects from your body, as they may affect the results of CT scan images.
  • Wear loose, comfortable clothing. You may be asked to wear a gown.
  • Stay relaxed so that your CT scan will produce more accurate results.

During the Calcium Scoring Test

Typically, the machine used for CT heart scans for heart calcium test is large and doughnut shaped. It has a short tunnel in the middle. You will lie on a narrow bed that slides in and out of the machine’s tunnel. Around you will be a rotating ring (gantry) that holds X-ray detectors and an X-ray tube. A technologist operates the CT scanner through a computer workstation in a separate room. The technologist can communicate with you through a microphone and speaker.

The entire CT scanning test may take up to 10 minutes. Straps and pillows may be used to help you maintain the correct position throughout the exam. You will be connected to an electrocardiograph (ECG) machine through electrodes or small, sticky discs to record your heart's activity. Next, the bed will move through the CT scanner, making several passes depending on the type of CT scan ordered by your doctor. You will be asked to hold your breath for 10 to 20 seconds as the technologist records images. When the exam is done, the technologist will verify that the photos are high quality enough for the radiologist to interpret accurately.

For an electron beam computed tomography (EBCT) scan, you will lie on a bed under an arch-shaped scanning machine. EBCT can take photos quicker than conventional CT scanners, avoiding blurred images caused by the heart beating. Unclear pictures can be an issue with traditional CT scanners. During an EBCT scan, you must stay still and hold your breath at times. Although the actual scanning time is only a few seconds, the entire procedure may take 15 minutes.

After calcium test, you may continue your normal daily activities.

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