Heart Blockage Test Calcium score
What is Heart KYC (Know your Calcium)?
Heart KYC (Know your Calcium) score is a test that measures the amount of coronary artery calcium (CAC). Coronary artery calcium is the calcium (Ca) that is deposited within the abnormal plaques caused by damage to the lining of the arteries. In simple words it means heart blockage test calcium score.
The coronary artery calcium score plays an important role in diagnosing cardiovascular disease. Calcium score test is considered as best predictor of a future heart attack. This test is also known as coronary calcium scan, calcium scan test and Cardiac CT for calcium scoring.
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Why Calcium score test is performed?
Calcium is essential for all living organisms. Most of the calcium within the human body is found in teeth and bones. A small amount, around one percent of total body calcium is dissolved in the blood. Undissolved calcium is metallic and very hard. Such calcium deposits are normally found in various parts of body. Calcification of arteries and internal organs can be regarded as a normal part of aging.
The calcium that the test is looking for is tied in with plaque. It’s a different kind found in of calcium found in your arteries. It’s made partly of fat and calcium, and it’s not good for your heart.
Plaque is waxy at first, and it builds up slowly. But over time, it can harden. You may hear doctors call this “calcified” plaque. It’s a problem for two reasons.
First, hard plaque in your arteries is like a clog in a pipe. It slows your blood flow. That means some parts of your body don’t get enough of the oxygen they need. If plaque collects in your heart’s arteries, you may feel chest pain and discomfort, called angina.
Second, that plaque can break open, which can lead to a blood clot. That could cause a heart attack.
The coronary calcium scan tells you how much calcified plaque is in your heart’s arteries. You and your doctor can take the results and decide if you need to make any changes to your medicine or lifestyle.
Coronary artery disease (CAD):
Cardiovascular disease is the leading cause of death worldwide, coronary artery disease (CAD) accounting for half of all such death.
Due to a variety of reasons, when there is damage to the lining of the arteries, there is deposition of abnormal soft or hard material (plaque) within or in the wall of the artery. This eventually leads to heart blockage, either acute, which can cause immediate death or a bad “heart attack” or chronic, leading to chest pain (angina).
The Ca score test helps by measuring the amount of Calcium in the coronary arteries, the Ca score tests can assess the risk of CAD/heart disease.
When the test picks up calcified (hard) plaques (the tip of the iceberg), it implies that there are also non-calcified soft plaques in the coronary arteries, which are the ones that are more likely to rupture and cause sudden catastrophic events.
A positive Ca score test implies that there is CAD that needs attention. If does not mean that if your calcium score is high, you will have a heart attack, but the probability is high if compared with someone having low calcium score.
How is Calcium score test performed?
This test is performed by taking a special computed tomography (CT) scan of the heart. The scan shows the amount of hardening of the artery wall. With this scan it is possible to estimate the risk of a heart attack in the next 5–10 years. High calcium score indicates high risk of a heart attack.
The test is done in a CT scanner in less than a minute. The entire procedure from filling the form to getting the result usually takes less than 10 minutes. Any specific preparation/fasting is not required for this test. There is no dye injection and also it doesn’t have any radiation risk.
As high heart rate may reduce imaging quality, patients are often asked to refrain from smoking and drinking coffee before the scan.
Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant.
Ca score test is the single best risk predictor for coronary artery disease currently if compared to other tests like blood cholesterol levels, ECG, echo and stress tests.
Day of your test:
After you reach the scanning centre, you will be asked to provide your personal details along with medical history and any medicines you take. The radiologist who will carry out the scan will guide you during the procedure.
You will be required to put on a hospital gown. Before starting the test four electrode patches will be put onto your skin on the front of your chest so an electrocardiogram (ECG) machine can be attached. An ECG machine measures the activity of your heart to show if it is working normally.
You will then be taken to the scanner and asked to lie on a scanning table. The scanner has a round opening and the table moves through the opening during the scan. The ECG machine will be attached to the patches and you can watch the ECG trace of your heart on the monitor. The CT machine links to the ECG so that the recorded electric pulses from your heart tells the CT exactly when to take the scans. You will be asked to hold your breath, the table will move and the images of the heart will be taken.
The radiologist checks for the scanned images and confirm that scan is a success, and then you can leave.
There are no after effects. You can continue to carry on your normal dailyactivites immediately after the scan. In some rare cases, skin irritation from the patches used to connect the ECG electrical wires can occur.
Risks v/s Benefits:
As in all X-ray scans, small amount of radiation is used. These scans should not be carried out if you are pregnant or trying to conceive. If you have concern about the radiation risk factors, even though it is very small, do not hesitate to discuss this with your doctor.
The benefit is that you get a better understanding of the relative risk for you of having a heart attack in the future, and with this information your doctor decides which strategies you should use to reduce your risk if the scan results show high risk.
Your doctor may decide that a second calcium score scan after a few years might be helpful to compare the results with the previous scan.
Coronary calcium scores are most informative for women aged between 35 and 70 years and men aged between 40 and 60 years in terms of providing information about cardiovascular risk, or the risk of a heart attack.
Ca score Result:
Ca score of 0 means that the chance of CAD is almost nil. The higher the Ca score, the more is the chance of a cardiac problem in the next 5-10 years. Depending on the amount of Ca score, measures have to be taken to reduce risk and to stabilize the plaques in the coronary arteries with a combination of sensible eating, exercise and medications.
| Score | Risk Level | Treatment Recommendation |
| 0 | Very low | Statin not recommended |
| 1-99 | Mildly increased risk | Moderate intensity statin if <75% |
| Moderate to high-intensity statin if >75% | ||
| 100-299 | Moderately increased risk | Moderate to high intensity statin + ASA* 81 mg |
| >300 | Moderate to severely increased risk | High-intensity statin + ASA 81 mg |
*ASA – acetylsalicylic acid – aspirin
**This is a general recommendation that should be discussed with your physician in detail before starting medication
Lifestyle modification with diet and exercise is a must to complement the medication
Your doctor will use the calcium score to decide whether you are at low, normal or high risk and guide you to reduce your risk. He would advise for changes in diet, exercise, controlling blood pressure and diabetes, stopping smoking and reducing cholesterol in the blood.
The test should be repeated once in 3 years, if positive and once in 5 years if the score is 0.