What is a Coronary Artery Calcium Score?

A coronary artery calcium scan reports your coronary artery calcium score. It is useful as a screening tool for those who are not known to have arterial disease. It should not be used to assess symptoms or monitor arterial disease in response to therapy. 

If you already know of the presence of arterial disease in your body (if you’ve had a stroke, heart attack, stent, or bypass surgery) or carotid artery ultrasound, determining this score is unnecessary. It may also lead to risky, costly/lucrative stents or surgery with no benefit in the absence of symptoms like angina or heart failure.

What does the score mean?

A score of zero is generally reassuring that the risk of heart attack is low in studied populations. You want this score to be as low as possible. However, if you have other risk or evidence of arterial disease, you could have plaque that is not calcified, known as soft/homogeneous/vulnerable/or unstable plaque. This occurs in about 10% of those with zero calcium scores.

Non-calcified plaque is the most vulnerable to rupture (the event that leads to heart attack). Therefore, a score of zero does not guarantee that you will not have a heart attack. Plaque can still form after a reassuring test in response to a change in conditions that promote inflammation, such as a dental infection.

Coronary calcium scores rise as plaque heals and inflammation subsides. In our experience, scores rarely fall, which makes this scan less than ideal for measuring progress.

Instead, we recommend measuring the thickness (sickness or inflammation) of your carotid arterial wall, which can be done with completely safe ultrasound. This is a much more meaningful measure of disease response to treatment.

Coronary artery calcium scans can lead to a slippery slope that can be dangerous to your health and your pocketbook. They can lead to unnecessary procedures, such as stents, that do not prevent heart attack or stroke in individuals with no symptoms. 

If there is no plaque seen on carotid ultrasound, an elevated Coronary Artery Calcium Score should provoke a search for root causes and efforts to eliminate them.  

There is abundant evidence, however, that the proper response to a positive screening/asymptomatic coronary artery calcium score should be to identify the root causes of arterial disease and eliminate them. This is what we do at the CureCenter.

If you have no history of heart attack, stroke, TIA, stent, bypass or other evidence of arterial disease, we suggest first getting a carotid ultrasound to screen for plaque as the first step. You can do this by scheduling your 15-minute CureScreen.

If you’re unsure what to do next, request a no cost/no obligation Discovery Call today.