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Coronary calcium scans use a special X-ray test called computed tomography (CT) to check for the buildup of calcium in plaque on the walls of the arteries of the heart (coronary arteries). This test is used to check for heart disease in an early stage and to determine how severe it is. Coronary calcium scans are also called cardiac calcium scoring.
The coronary arteries supply blood to the heart. Normally, the coronary arteries do not contain calcium. Calcium in the coronary arteries may be a sign of coronary artery disease (CAD).
A CT scan takes pictures of the heart in thin sections. The pictures are recorded in a computer and can be saved for more study or printed out as photographs.
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Your doctor may want you to have a coronary calcium scan if it can help you and your doctor make decisions about how to lower your risk for heart disease, heart attack, and stroke.
This test might be most helpful for people who do not have heart disease but who are at medium risk for heart disease. Your doctor can help you know your risk of heart disease, heart attack, and stroke. Your doctor will look at things that put you at risk, including blood pressure, cholesterol, diabetes, and your age, sex, and race.
A coronary calcium scan is not advised for routine screening for coronary artery disease.footnote 1This test may not tell your doctor any more about your risk for heart disease than your risk factors do.
This screening test is not for you if:
This test may not be right for you if you are a man younger than 40 or a woman younger than 50. This is because younger people typically do not have much calcium buildup in their arteries yet.
You do not need to do anything before you have this test. But you may be asked to not smoke or not eat or drink anything that has caffeine for a few hours before your test.
Tell your doctor if you might be pregnant or are pregnant. This test is not done on pregnant women.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form( What is a PDF document? ).
A coronary calcium scan is usually done by a radiology technologist. The pictures are usually interpreted by a radiologist. Other doctors, such as a family medicine doctor, internist, cardiologist, or surgeon, may also review this test.
You will need to remove any jewelry that might be in the way of the X-ray picture. You may need to take off some of your clothes. If so, you will be given a gown to use during the test. For some CT scans, you may be able to wear your clothes. If so, wear loose clothes that do not have zippers or snaps.
Small pads or patches called electrodes will be put on your chest. Wires connect these to an EKG machine that records the electrical activity of your heart on paper. The EKG records when your heart is in the resting stage, which is the best time for the CT scans to be taken.
If your heart rate is 90 beats per minute or higher, you may be given medicine to slow your heart rate.
During the test, you will lie on a table connected to the CT scanner. The scanner is a large doughnut-shaped machine.
The table slides into the round opening of the machine, and the scanner moves around your body. The table will move a little every few seconds to take new pictures. You may hear clicking or buzzing sounds as the table and scanner move.
You may be asked to hold your breath for 20 to 30 seconds while pictures of your heart are taken. It is very important to hold completely still while the pictures are taken.
During the test, you are usually alone in the scanner room. But the technologist will watch you through a window. You will be able to talk with the technologist through a two-way intercom.
A coronary calcium scan takes about 30 minutes.
You won't have any pain from the X-rays during the coronary calcium scan. But the table you lie on may feel hard and the room may be cool. You may find it hard to lie in one position for a long time.
The chance of a coronary calcium scan causing a problem is small.
After you have the test, talk with your doctor about your results.
Your test result is a number that is your calcium score. The score can range from 0 to more than 400. The higher your score, the greater your chance of having a heart attack. The score might be helpful if you are unsure whether to take a statin to lower your risk of a heart attack.footnote 2
Reasons you may not be able to have the test or why the results may not be helpful include:
U.S. Preventive Services Task Force, et al. (2018). Risk assessment for cardiovascular disease with nontraditional risk factors: U.S. Preventive Services Task Force recommendation statement. JAMA, 320(3): 272–280. DOI: 10.1001/jama.2018.8359. Accessed October 24, 2018.
Grundy SM, et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology, published online November 8, 2018: S0735. DOI: 10.1016/j.jacc.2018.11.003. Accessed January 28, 2019.
Other Works Consulted
Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
Daubert MA, et al. (2011). Computed tomography of the heart. In V Fuster et al., eds., Hurst's The Heart, 13th ed., vol. 1, pp. 599–630. New York: McGraw-Hill.
Goff DC Jr, et al. (2013). 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online November 12, 2013. DOI: 10.1161/01.cir.0000437741.48606.98. Accessed November 22, 2013.
Greenland P, et al. (2007). ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. Circulation, 115(3): 402–426.
Kim KP, et al. (2009). Coronary artery calcification screening: Estimated radiation dose and cancer risk. Archives of Internal Medicine, 169(13): 1188–1194.
Taylor AJ, et al. (2010). ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010—Appropriate use criteria for cardiac computed tomography: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. Journal of the American College of Cardiology, 56(22): 1864–1894.
U.S. Preventive Services Task Force (2009). Using nontraditional risk factors in coronary heart disease risk assessment. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscoronaryhd.htm.
Current as of: April 9, 2019
Author: Healthwise StaffMedical Review: E. Gregory Thompson MD - Internal MedicineMartin J. Gabica MD - Family MedicineAdam Husney MD - Family MedicineStephen Fort MD, MRCP, FRCPC - Interventional Cardiology
Current as of:
April 9, 2019
Medical Review:E. Gregory Thompson MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Adam Husney MD - Family Medicine & Stephen Fort MD, MRCP, FRCPC - Interventional Cardiology
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