Calcium Score Test: An Early Warning for Heart Disease

Heart disease often develops silently, without obvious symptoms, until it leads to something serious like a heart attack. One tool doctors now rely on to detect these risks early is the calcium score test, also known as a coronary artery calcium (CAC) scan.

What the Test Does

The calcium score test is a quick, safe, and non-invasive scan using a CT machine. It looks for calcium buildup in the arteries that supply blood to the heart. Calcium shows up when fatty deposits, cholesterol, and other substances harden inside the artery walls, a condition known as atherosclerosis. This narrowing or stiffening of the arteries can reduce blood flow and raise the risk of chest pain, heart attack, or stroke.

Understanding the calcium score

The CAC score is measured using the Agatston scale, and the results fall into different categories that help predict heart disease risk:

0 (No identifiable risk): No calcium is found, and this means the risk of having significant coronary artery disease (CAD) is very low (<5%).

1–10 (Minimal risk): A tiny amount of calcium is present. The risk of CAD remains low (<10%), but early signs of plaque are beginning to appear.

11–100 (Mild risk): Mild calcium buildup suggests some early CAD, with a mild level of risk.

101–400 (Moderate risk): Clear calcium deposits confirm the presence of atherosclerosis. There’s a moderate risk of having CAD, and possibly some narrowing of the arteries.

Over 400 (High risk): A large amount of calcium is present. This signals a very high likelihood (over 90% risk) of one or more significant blockages in the arteries, and the chance of a heart attack or other problems is high.

In simple terms, the higher the score, the greater the risk of heart disease. A score of zero is reassuring, while higher scores mean closer medical attention and preventive steps are needed.

 

Why calcium score Matters

The primary advantage of the calcium score test is that it can identify hidden risks before symptoms develop. Many people with early heart disease may feel fine, but the test serves as a “check engine light” for the heart, giving patients and doctors a chance to act early.

Knowing the calcium score can help guide next steps, such as:

·      Starting or adjusting cholesterol-lowering drugs (like statins).

·      Adding preventive medications such as aspirin (in some cases).

·      Making lifestyle changes, improving diet, exercising regularly, managing stress, and quitting smoking.

Interestingly, studies show that patients who learn they have a high score are often more motivated to adhere to their medications and healthy habits.

Who should get the scan for the CAC score?

Experts don’t recommend this scan for everyone. It’s most useful for people at moderate risk of heart disease, especially if they:

·       Have high blood pressure, diabetes, or high cholesterol.

·       Have a family history of early heart disease.

·       Are unsure about starting statins and want a clearer picture of their risk.

For people at very low risk, routine use of the test isn’t necessary. But for the right group, it can be a powerful tool that helps prevent heart attacks and strokes.

Things to keep in mind

·      The test only detects hardened (calcified) plaque, not “soft” plaque, which can still cause problems.

·      It should be part of a broader heart health assessment, not a standalone test.

·      In some cases, calcium can also be assessed from other CT scans performed for different reasons, such as lung cancer screening.

*The coronary artery calcium scan is a quick and painless test that helps doctors identify early signs of heart disease. For the right patients, it provides a clear picture of heart health and a roadmap for preventing future complications.