Coronary Artery Calcium Score: The Best Way to Know if You Have Early Atherosclerotic Heart Disease

Only CT Cardiac Calcium Scoring can take pictures of the inside of your heart detailed enough to quantify the amount of calcified plaque.

An illustration of a heart inside a chest

Many heart attacks and cardiovascular “events” occur suddenly and without warning.

© Sebastian Kaulitzki |

The best time to detect coronary artery disease, or atherosclerotic heart disease, the number one cause of death in the Western world, is in an early stage long before there are any of the well-known symptoms. And the one and only way to do this is by finding out your coronary calcium score with CT Cardiac Calcium Scoring. This test to determine your calcium score also goes by the name Coronary Artery Calcium Scoring, or Coronary Artery Calcification Score Scan, is non-invasive, pain-free and surprisingly inexpensive. Most people have no idea that for a total cost of about $99, they can find out their calcium score in many radiology clinics around the U.S., and it can often be ordered directly by patients without a doctor’s referral.

Traditional tests like cholesterol, and even treadmill stress tests, don’t tell you if you have early calcified plaque in the coronary arteries, which are the vessels that supply oxygen to the heart wall. This is important because many heart attacks and cardiovascular “events” occur suddenly and without warning in people with early atherosclerotic heart disease whose cholesterol is normal and who don’t have other obvious risk factors like diabetes or high blood pressure. Only CT Cardiac Calcium Scoring can take pictures of the inside of your heart detailed enough to quantify the amount of calcified plaque, which is tallied as your calcium score.

How CT Scans Detect Atherosclerotic Heart Disease

Calcium is a marker of coronary artery disease, also called coronary heart disease, atherosclerosis, or atherosclerotic heart disease. CT Cardiac Calcium Scoring identifies the location and extent of coronary artery disease by looking for calcium inside the coronary arteries and then computing your calcium score. The test involves a quick “CT” or “CAT” scan, which is an abbreviation for “computerized tomography”. The CT scanner is a doughnut-shaped machine that takes pictures of cross-sections (“slices”) of your body. The specific type of CT procedure most often used is called electron beam tomography, or EBT. EBT scans use the latest advances in high-speed imaging, coupled with sophisticated computerized 3-D imaging techniques, to capture well-focused, detailed pictures of the inside of your heart and calculate your calcium score in order to identify the presence and severity of atherosclerotic heart disease.

What is “Calcium Score”?

The amount of calcium in the arteries, and thus the total calcium score, directly correlates with the amount of total plaque. The lining of a normal, healthy artery has no calcium.  In arteries, calcium exists exclusively in those that are diseased with atherosclerosis. Simply put, the presence of calcium around the heart and in the arteries that supply the heart muscle (the coronary arteries) indicates you have at least some degree of atherosclerotic heart disease. Therefore, an ideal normal calcium score is zero. Look at the chart below for the average calcium score by age.



Calcium Score is a Better Predictor of Your Risk of Heart Attack

Traditionally, the ability to screen for atherosclerotic heart disease and, hopefully, prevent its terrible consequence—heart attack—has depended on the assessment of risk factors such as weight, age, cholesterol, blood pressure, diabetes, smoking, and family history. However, many adults who experience cardiac events are not classified as high risk based on these traditional risk factors. For instance, approximately 1/3 of patients who have a heart attack have a total cholesterol score under 200, which is considered normal. One recent study confirmed that using age as a risk factor is also not very useful. Researchers from the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease found that the calcium score predicts your likelihood of dying from atherosclerotic heart disease regardless of your age.[1] They published their results in the European Heart Journal, highlighting the fact that ‘arterial age’, rather than biological age, is the true cardiovascular risk factor. Overall, the latest research seems to suggest that the coronary calcium score is better able to predict cardiac events than any of these traditional risk factors.[2]

For people without symptoms of atherosclerotic heart disease, such as chest pain, the coronary calcium score is also a better predictor of risk than the traditional stress (treadmill) tests. Stress/treadmill testing is designed to find areas of narrowing in coronary arteries where flow is reduced. Since 2/3 of heart attacks are caused by plaque that does not obstruct flow until it ruptures and becomes inflamed, treadmill testing may be normal in patients with hidden atherosclerotic heart disease who don’t have signs or symptoms of a narrowed artery.[3] Therefore, while treadmill testing may be useful for patients with known heart disease or symptoms suggestive of heart disease, the fact is that it frequently fails to identify people who don’t have narrowed arteries but none the less are at risk for subsequent cardiac event.[4]

The total calcium score indicates the extent of atherosclerotic heart disease and is the most powerful predictor of cardiac events, such as a heart attacks or “sudden cardiac death.” Sudden cardiac death is the medical term for “unexpected death due to cardiac causes occurring in a short time period (generally within 1 h of symptom onset). Most cases of sudden cardiac death are related to heart arrhythmias and approximately half of all heart-related deaths can be classified as sudden cardiac deaths. In other words, the higher your calcium score, the more likely you are to have a heart attack or die of sudden cardiac death. In one study, the average calcium score in people that had a cardiovascular event was about 399, compared to an average calcium score of 76 in those without such an event. Another study revealed a calcification score of 100 or more to be highly predictive in separating prior event patients  from those without prior cardiac events. It is best, of course, to have a zero calcium score, indicatiing no coronary artery calcification at all and no atherosclerotic heart disease. While it is still possible to have a cardiac event with a score of zero, the chances are very, very small.

High Heart Calcium Score Treatment

Natural high calcium score treatment is one of the best ways to prevent atherosclerotic heart disease. If it is likely that you are already at increased risk for cardiovascular disease because of your high cholesterol or weight, one of the best ways to motivate yourself to make necessary changes is to find out your calcium score. In less than ten minutes and for about $99, you can take a calcium test for heart disease find out if your coronary calcium score is high. If it is, you have the most definitive proof available that you have atherosclerotic heart disease and need to take action to prevent or reverse your heart disease now. You can find effective, evidence-based, safe and natural therapies for lowering your calcium score and preventing heart disease by  following our advice for cholesterol, high blood pressure, and weight issues.

Originally published in 2015, this post has been updated.

[1] Eur Heart J. 2012 Dec;33(23):2955-62.

[2] Circ Cardiovasc Imaging. 2012 Jul;5(4):467-73.

[3] Circulation.1995; 92: 657-671.

[4] Br J Cardiol 2011;18:120–3.

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UHN Staff

University Health News is produced by the award-winning editors and authors of Belvoir Media Group’s Health & Wellness Division. Headquartered in Norwalk, Conn., with editorial offices in Florida, Cleveland, Pittsburgh, … Read More

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