When to Consider Noninvasive Imaging to Assess Artery Blockage

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Noninvasive imaging identifies plaques (blockages) in arteries. These tests are often not covered by insurance, but many cardiovascular clinics offer these (particularly Coronary Artery Calcium Score) as part of their heart-health program and usually range from $75-$150.

For noninvasive imaging to be a good next-step, your assessment should meet all Baseline Characteristics below and at least one (1) Additional Characteristic:

Baseline Characteristics (All Criteria Must Be Present)

  1. No clinical ASCVD (Atherosclerotic Cardiovascular Disease): angina, claudication, TIA, heart attack, stroke, stent, bypass, angioplasty, angina, acute coronary syndrome

  2. No subclinical ASCVD: artery blockage (“plaque”) found in carotid (neck), coronary (heart), or peripheral (leg) arteries

  3. Elevated Pooled Cohort Equation values on the Cardiovascular Risk Details Page

    a. Calculated 10-Year Cardiovascular Risk: Borderline or Intermediate

and/or

b. Calculated Lifetime Cardiovascular Risk: Not Optimal

Additional Characteristics (Any One of the Following Criteria)

  1. Family History of Premature ASCVD (Parents, Siblings)

  2. Elevated Lp(a) 125 nmol/L or higher

  3. High Atherogenic Particle Number: LDL-P 1600 nmol/L or higher OR ApoB 110 mg/dL or Higher

Different Choices for Noninvasive Imaging

Carotid IMT “CIMT” (B Mode Ultrasound); (AKA “neck artery scan”)

  1. Best for ages 30 years or older 

  2. Detects plaques at all stages of development (e.g., early to advance plaques versus only advanced calcified plaques seen with coronary artery calcium score)

  3. Not as commonly available as a coronary artery calcium (CAC) score and requires a trained operator vs. automated CT scan technology.

Coronary Artery Calcium (CAC) Score (sometimes called a heart CT scan)

  1. Men ages 45 years or older

  2. Women ages 55 years or older

  3. Identifies calcified plaques in coronary (heart) arteries

  4. Commonly found in most hospitals or health systems that have CT scan technology