Coronary Artery Calcium (CAC) Screening

Coronary Artery Calcium (CAC) screening is a non-invasive imaging test that helps assess the risk of coronary artery disease (CAD). This test detects the presence and extent of calcified plaque in the coronary arteries, which are the blood vessels that supply the heart with oxygen-rich blood.

What is Coronary Artery Calcium (CAC) Screening?

CAC screening uses a specialized X-ray technology called a computed tomography (CT) scan to visualize calcium deposits in the coronary arteries. Calcium is a marker of atherosclerosis, a condition characterized by the buildup of fatty deposits (plaque) within the arterial walls. Over time, these plaques can harden and narrow the arteries, leading to reduced blood flow and potentially causing heart attacks or other cardiovascular events.

The Screening Process

  1. Preparation: Before the test, patients are usually advised to avoid caffeine and smoking for a few hours. They may also need to wear comfortable clothing and remove any metal objects that could interfere with the scan.

  2. CT Scan: During the procedure, the patient lies on a table that slides into a CT scanner. Electrodes are attached to the chest to monitor the heart's activity. The CT scanner rotates around the chest, capturing detailed images of the heart and coronary arteries.

  3. Image Analysis: The images obtained from the CT scan are analyzed by a radiologist or a cardiologist. The amount of calcium detected is quantified using the Agatston score, which helps determine the extent of calcification and the associated risk of coronary artery disease.

Pros of CAC Screening

  1. Early Detection: CAC screening can identify coronary artery disease before symptoms appear, allowing for early intervention and management.

  2. Risk Stratification: The Agatston score provides valuable information about an individual's risk of cardiovascular events, helping to guide treatment decisions. This score factors into your Cardiometabolic Risk Assessment results.

  3. Non-Invasive: The procedure is quick, painless, and does not require any contrast dye or invasive techniques.

  4. Motivational Tool: Seeing the results can motivate patients to make lifestyle changes or adhere to prescribed medications.

Cons of CAC Screening

  1. Radiation Exposure: Although the radiation dose from a CAC scan is relatively low, it is still a consideration, especially for repeated screenings.

  2. False Positives/Negatives: Some individuals with significant heart disease may have little or no calcium (false negatives), and some with high calcium scores may not develop symptoms (false positives).

  3. Cost and Availability: The test may not be covered by all insurance plans and might not be readily available in all healthcare settings.

  4. Psychological Impact: Receiving a high calcium score can cause anxiety or stress in some individuals.

Conclusion

Coronary Artery Calcium screening is a valuable tool in the early detection and management of coronary artery disease. By understanding its benefits and limitations, individuals and healthcare providers can make informed decisions about its use. As with any medical procedure, it is essential to discuss with a healthcare professional to determine if CAC screening is appropriate for you.

If you already have had a CAC screening, your Cardiometabolic Risk Assessment from Precision Health Reports considers your score to provide you with the most accurate measurement of your risk for heart attack or stroke. If you have not completed a CAC screening and your risk profile suggests that it would be beneficial, the “Additional Topics to Discuss with your Provider” section on page 7 of your report will recommend you consider this valuable test.

For further reading and references, consider exploring resources from reputable health organizations such as the American Heart Association and the National Institutes of Health.

References:

  1. American Heart Association: Coronary Artery Calcium (CAC) Test

  2. National Institutes of Health: Coronary artery calcium score: current status

  3. Mayo Clinic: How a coronary calcium scan assesses heart attack risk