February is Heart Month, so for the next few posts, I'll be sharing information from some of the heart specialists on staff at Des Peres Hospital. This week, I caught up with board certified cardiologist, Dr. Michael Twyman about cardiac calcium scores.
You know the score from your favorite team’s last game, may or may not want to remember the score of your most recent golf game, and are trying to lower your cholesterol score. But do you know your cardiac calcium score?
"Based on a scale of 0 to over 400, your cardiac calcium score can help predict if you are at a higher risk of a heart attack or other problems before you have any symptoms," said Dr. Twyman.
Dr. Twyman explained that cardiac calcium scans use noninvasive techniques to obtain information about the location and extent of calcium buildup in the arteries that supply blood to the heart.
"Healthy coronary arteries do not have plaque, a buildup of fat and other substances including calcium," Dr. Twyman said. "A higher cardiac calcium score means more plaque in the arteries of your heart, putting you at greater risk for coronary artery disease (CAD)."
Cardiac calcium scans most often are recommended for men over the age of 45, women over the age of 55 or who are postmenopausal, and those who have risk factors for CAD but show no symptoms. In addition to age, risk factors for CAD include unusually high cholesterol, family history of heart disease, diabetes, high blood pressure, smoking, obesity and physical inactivity. You probably would not have this test if you have had a heart attack, coronary bypass surgery, angioplasty with or without stent placement, or if you are or might be pregnant.
A cardiac calcium scan requires no needles, cutting or sedation. During the approximately 30-minute procedure, patients lie on a table connected to a computed tomography (CT) scanner. The table slides into the round opening of the CT scanner which moves around the patient, taking about 200 pictures of the heart in thin sections.
Calcium deposits show up as bright white spots on the scan. A cardiac calcium score is then determined based on the presence of calcium detected during the procedure. A score of 0 means there is no plaque present; one to 10 means a small amount of plaque; 11 to 100, plaque is present; 101 to 400, there is a moderate amount of plaque; over 400, there is an extensive amount of plaque.
Unlike standard cardiac tests, a cardiac calcium scan can detect the presence of CAD even when arteries leading to the heart are less than 50 percent narrowed. More than half of all heart attacks occur when coronary arteries are blocked by less 50 percent. However, not all calcium deposits mean there is a blockage in coronary arteries and not all block arteries contain calcium. In addition, cardiac calcium scans cannot detect soft plaque, the earliest form of CAD.
"If your cardiac calcium score shows that you are at higher risk for developing coronary artery disease, you can take some steps to improve your health," said Dr. Twyman. "Talk to your doctor about your health concerns, stop smoking, reduce your cholesterol, eat a healthier diet and get more exercise. Just like your golf game, the lower your cardiac calcium score, the better."