This information is only for people who are curious about their risk for heart disease but don't have angina symptoms, such as chest pain or pressure.
A coronary calcium scan is a test for people who have no symptoms of heart disease but may be at risk for getting it. The test uses computed tomography (CT) to check for calcium buildup in plaque on the walls of the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen. Calcium in these arteries is a sign of heart disease.
During the test, a CT scan takes pictures of your heart in thin sections. The result is a score based on the amount of calcium seen on the scan. The higher your calcium score, the higher your risk for a heart attack. The test takes about 30 minutes.
Most health insurance plans don't pay for coronary calcium scanning. The cost can range from about $100 to $400.
CT angiography is a test that uses computed tomography to see if an artery is narrowed or blocked. It's different from a coronary calcium scan and may be best after you already have symptoms of heart disease and other test results are not clear.
Talk with your doctor if you want to know more about CT angiography. This Decision Point is about coronary calcium scanning.
This test might be most helpful for people who have no symptoms but who are at medium risk for heart disease. Medium risk means that you have a 10% to 20% chance of having a heart attack in the next 10 years, based on your risk factors. This means that 10 to 20 out of 100 people with this level of risk will have a heart attack in the next 10 years. The test might be helpful for some people who have a low to medium risk, which means you have a 6% to 10% risk.1
Knowing your risk for a heart attack is a key part of your decision to get a scan. Talk with your doctor about your risk for heart disease.
In most cases, the results from your physical exam and other tests will give your doctor enough information about your risk for heart disease.
A coronary calcium scan is not advised for routine screening for coronary artery disease.2 This test might not tell your doctor any more about your risk for heart disease than your risk factors do. Risk factors are things that can increase your risk for heart disease, such as diabetes, high blood pressure, high cholesterol, and smoking.
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.
After the scan, you will get a test result that is a number. This is your calcium score. The score can range from 0 to more than 400. Any score over 100 means that you are likely to have heart disease. The higher your score, the greater your chance of having a heart attack.
People who score between 100 and 400 or higher, and who are at medium risk for heart disease, are more likely to have a heart attack in the next 3 to 5 years than people who score 0.3
After you have the test, talk with your doctor about your results.
Many people only learn that they have heart disease when they have a heart attack. A coronary calcium scan is one way to find out if you have early heart disease before it gets worse. After you know your risk, you can make lifestyle changes such as eating a heart-healthy diet, getting more exercise, and quitting smoking. You might also take medicine such as cholesterol or blood pressure medicine. But if you're worried about heart disease, you can make these changes even if you don't have the test.
A coronary calcium scan can give your doctor more information about your risk for heart disease, especially if you already have risk factors. If your score is high, for example, your doctor may prescribe medicines to lower these risks. A high score may also lead to other tests and treatment that could help you avoid a heart attack.
|Have a coronary calcium scan||Don't have a coronary calcium scan|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"My mom had a heart attack in her early 60s, followed by bypass surgery. She didn't have a clue that she had heart disease. I don't want that to happen to me. I already know I have a couple of health issues that raise my risk for heart disease. So I'm going to ask my doctor about getting a coronary calcium scan to check my risk."
— Rose, age 48
"My wife has been bugging me to get this test. So I asked my doctor about it. He said my risk for getting heart disease is pretty low even though I have high blood pressure. I'm taking medicine for that and for high cholesterol. I'm also trying to eat better and exercise. I just don't think the test is going to tell me more about my risk than I already know."
— Jeffrey, age 56
"My doctor says I am at risk for heart disease. She wants me to have a coronary calcium scan so that we can get a better idea of my risk of a heart attack. Then, we can decide whether I should start taking medicine so I can lower my risk. I like the idea of having all the information before I make decisions. So I'm going to have the test."
— Tony, age 53
"I get a physical exam from my doctor every year, and she says I'm in pretty good shape. But ever since I passed 50, I've been worried about heart disease. I saw an ad for this test in the newspaper and asked my doctor about it. It turns out that in healthy people like me, the test results aren't very reliable. I'm going to just keep getting an annual checkup."
— Maria, age 54
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have a coronary calcium scan
Reasons not to have a coronary calcium scan
I need more information about my risk so I can commit to making lifestyle changes or taking medicines.
I already know that I should make some lifestyle changes to keep my heart healthy.
It's worth it to me to pay for this test myself.
My insurance won't pay for this test, and I can't afford it.
I want to take any tests that could help me find out my risk for heart disease.
I don't want to take tests I don't need.
I want to take this test because I need more information about my risk for having a heart attack.
I already know my risk for having a heart attack, so I don't need this test.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having a coronary calcium scan
NOT having a coronary calcium scan
1. Can anyone who is worried about heart disease benefit from a coronary calcium scan?
2. Does a high score on a coronary calcium scan always mean you have heart disease?
3. Could you still be at risk for heart disease even if you get a low calcium score on the test?
4. Is having a coronary calcium scan the only way to tell if you need to make lifestyle changes to help your heart, such as exercising, eating better, and not smoking?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology|
Greenland P, et al. (2010). 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 56(25): e50–e103.
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.
Budoff M, et al. (2006). Assessment of coronary artery disease by cardiac computed tomography: A scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation, 114(16): 1761–1791.