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A Simple Scan to Know Your Risk


Talk with your primary care provider about whether a coronary calcium scan is needed based on your age and risk factors. 

A coronary calcium score screening heart test (coronary calcium scan) uses a special X-ray (a CT scan) to show calcium build-up in the arteries. That build-up, in turn, could indicate the presence of cholesterol-rich plaque that can cause blockages.

The results of the test are scored to indicate your risk for a future heart attack.  The higher the score, the higher your risk.

Once a woman goes into menopause, her risk of heart disease goes up significantly and calcium scores in the heart arteries can also increase.  If you have risk factors for heart disease and you are at intermediate risk for a cardiovascular event (and some women considered at low risk) you may want to get this test to better understand your risk.

To better understand your risk for heart disease and whether a coronary calcium score screening is right for you, talk with your primary care provider. If you have one or more of the following risk factors, your provider may order a scan.

  • Family history of heart disease
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Diagnosis of rheumatoid arthritis or lupus
  • Gestational diabetes or preeclampsia during pregnancy
  • Current or former smoker
  • History of anxiety or depression

Before the scan, a technician attaches electrodes to the chest. The electrodes are connected to a machine that takes continuous X-ray photos in between heart beats. The actual scan itself takes about 30 seconds.

Your doctor will go over the results of your scan and, if needed, will refer you to a cardiologist for further evaluation.

  • Score of zero (no calcium detected): The likelihood of developing cardiovascular disease is low; your doctor may recommend a repeat scan in 3-5 years.
  • Any score above zero may qualify you for a statin (a class of drugs used to lower cholesterol levels), depending on your risk factors.
  • Score above 100: Your doctor may suggest taking a low dose aspirin and a statin every day.
  • Score above 300: Tour doctor may strongly recommend taking a low dose aspirin and a statin every day.

Once you begin taking a statin, a repeat calcium score is not recommended.

“Even with healthy lifestyle changes, your coronary calcium score will not go down once you begin taking a statin,” says MetroHealth cardiologist Ashish Aneja, MD. “There’s no need to be disheartened, though, since a healthy lifestyle always pays dividends in the long term.”

“Getting a very low calcium scan score – especially if you have one or more risk factors – doesn’t mean you should stop doing things to help lower that risk, says Dr. Aneja. The score goes up with age, as does the risk of a future cardiovascular event, so a low score is somewhat reassuring.”

“The great thing about this test is that it shows what has been going on with your vessels. It doesn’t matter what your cholesterol level or other risk factor status is, if you’re making plaque, it will show up on your scan eventually,” says Dr. Aneja. “The scan is good at ruling out cardiovascular disease.”

If you don’t have a primary care provider, call 216-My-Metro  (216-696-3876) or visit metrohealth.org/appointments. Remember to mention your concerns about heart health and have your risk assessed.

Contributors:

Ashish Aneja, MD
Cardiology