Coronary heart disease (CHD) is the number one cause of death for men and women in the United States. Still, many people don’t know what it is or its causes.
So just what is coronary heart disease? The disease takes hold when a substance called plaque – fatty material consisting largely of cholesterol-carrying and inflammatory cells – builds up in the arteries that supply oxygen-rich blood to your heart.
If there’s a sudden change in plaque, it can result in a plaque rupture. This in turn causes an adjacent blood clot to form that obstructs blood flow. Without adequate blood supply, the downstream heart muscle dies and a heart attack or stroke can occur.
Unfortunately, by the time most patients begin to show physical symptoms of CHD, it may be too late to reverse the process. In other cases, patients may not realize they are at an elevated risk.
What is coronary artery scoring?
Fortunately, there’s a simple, non-invasive test that can help evaluate your risk early on.
Coronary calcium scoring, or cardiac scoring, is an imaging test that uses a computed tomography (CT) scan to detect specks of calcium in the coronary arteries. These calcium specks, or “calcifications,” can indicate an increased risk of heart disease.
“Calcium, when seen in the heart arteries, means that plaque is present,” says Daniel Soffer, MD, of the Preventive Cardiovascular Program at Penn Medicine. “The higher the calcium score, the greater the amount of plaque and the higher the risk of heart attack.”
How Coronary Artery Calcium Scanning Helps Prevent Heart Disease
Cardiac scoring can be particularly useful for patients without any obvious risk factors or symptoms of coronary heart disease. “The primary reason health care providers consider a coronary artery calcium scan for their patients is to identify individuals who otherwise would not be known to be high risk,” says Dr. Soffer.
The emphasis on accurate risk prediction is important: There are many effective therapies that can reduce a person’s risk once it’s identified. Based on the results of the test, for example, patients may be able to make lifestyle changes to lower the risk to their heart, take medication such as statins, or discuss other options with their physician.
“The current national guidelines for heart disease prevention are very ‘one size fits all’ and sometimes make healthy people feel like they are being overtreated, while others are worried that undertreatment may leave them vulnerable to heart attacks,” notes Daniel Soffer, MD from Penn’s Preventive Cardiovascular Program. Dr. Soffer uses the test in his patients because it allows him to “customize treatment more precisely in apparently healthy middleaged people.”
Are you a candidate for coronary artery calcium scanning?
Dr. Soffer says he considers the test for men age 40 or older and women age 50 or older who do not have current symptoms of heart disease or a history of atherosclerotic cardiovascular disease (blocked arteries), but who do have other risk factors, including: