CT Coronary Artery Calcium Scoring is a non-invasive examination that evaluates the location and extent of calcified (hard) plaque in the heart arteries. The scoring evaluates arteriosclerosis or “hardening” of the heart arteries. CT images of the heart are analyzed using sophisticated computer software to determine the size and density of calcified plaque in the heart arteries. The information obtained is then converted into a “score.” The level of the score is a general indication of the degree to which the hard plaque has narrowed the heart arteries.  Higher scores indicate higher amounts of plaque and therefore an increased risk of heart attack.

 

No Calcification in Coronary Arteries	Calcification in Coronary Artery

 

Soft plaques, which also put patients at risk of having a heart attack, are not seen on this type of CT. 

 

Scoring

 

A negative cardiac CT scan that shows no calcification within the coronary arteries suggests that atherosclerotic plaque is minimal and that the chance of coronary artery disease developing over the next two to five years is very low.

 

A positive test means that coronary artery disease is present, regardless of whether or not the patient is experiencing any symptoms. The amount of calcification—expressed as a score—may help to predict the likelihood of a myocardial infarction (heart attack)in the coming years.

 

Coronary artery calcium scoring is as follows

 

Score	Presence of plaque
0	No plaque is present. You have less than a 5% chance of having heart disease. Your risk of a heart attack is very low.
1 – 10	A small amount of plaque is present. You have less than a 10% chance of having heart disease. Your risk of a heart attack is low. However, you may want to quit smoking, eat better, and exercise more.
11 – 100	Plaque is present. You have mild heart disease. Your chance of having a heart attack is moderate. Talk with your doctor about quitting smoking, eating better, beginning an exercise program, and any other treatment you may need.
101 – 400	A moderate amount of plaque is present. You have heart disease, and plaque may be blocking an artery. Your chance of having a heart attack is moderate to high. Your health professional may want to do more tests and may start treatment for heart disease. Or, he or she may start you on aggressive treatment for any risk factors such as high blood pressure and high cholesterol.
Over 400	A large amount of plaque is present. You have more than a 90% chance that plaque is blocking one of your arteries. Your chance of having a heart attack is high. Your health professional will want to do more tests and will start treatment.

Reasons for coronary calcium scoring

 

CT Coronary Artery Calcium Scoring may be ordered before a CCTA to determine the amount of hard plaque present in the coronary arteries. Heavily calcified vessels are more difficult to assess by CCTA and this test gives the physician an overview of the heart arteries, which then assists in the subsequent CCTA evaluation.  The test is also sometimes used to detect coronary artery disease at an early stage when a patient has risk factors for the disease but no symptoms.  Some of these risk factors include high blood pressure, high blood cholesterol levels, cigarette smoking, a family history of heart disease and stroke, excessively overweight and an inactive life style.

 

Preparation

 

No special preparation is necessary.  Wear loose comfortable clothing without metal snaps or zippers to your appointment.  If necessary you will be asked to change into scrubs or a patient gown.  Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and may need to be removed prior to your examination. You may also be asked to remove hearing aids and removable dental work. Lockers are available for your personal items however, it is recommended that you leave your valuables at home.

 

During the Examination

 

You will lie on a comfortable table that moves you through a large opening in a donut-shaped machine.  You will be kept informed when you need to lie very still and when it is okay to move.  The technologist will be able to see and hear you during the entire examination.  The examination may take from ten to twenty minutes.

 

Following the Examination

 

After the examination, you may resume your normal activities. 

 

Once the CT study is completed, the images are stored on a computer. These images will be studied by board certified radiologists who are specially trained to analyze radiology examinations.  A report with your calcium score will be sent to your physician.  Your physician will discuss the results of the examination with you.