The Difference Between Coronary Calcium Scoring and Coronary CT Angiogram
Two important cardiac imaging exams could help identify coronary artery disease. You may have heard of them but have wondered what the difference is between CT Coronary Calcium Scoring and Coronary CT Angiogram.
According to the American Heart Association, heart disease is the leading cause of death for men and women in the U.S. – accounting for one in four deaths each year. That is why radiologists like Dr. Robin Parker, and our team at Consulting Radiologists, Ltd., are committed to helping you understand your heart health through advanced imaging technology.
Coronary Calcium Scoring
Coronary calcium scoring (CAC), often referred to as a heart scan, is a test that can detect coronary artery calcifications, which is correlated with future risk of heart disease. Think of it as an early warning system for your heart health.
The coronary arteries supply blood to the heart. Coronary calcium scoring evaluates calcium deposits — hardened plaque in the coronary arteries — a marker for coronary artery disease.
Why It Matters
Traditional testing methods are unable to identify these calcium deposits until there is a minimum of 50 percent narrowing of the arteries. Unfortunately, a narrowing of only 30 to 50 percent is common in people who have already had heart attacks, thus making Coronary Calcium Scoring an essential tool for early detection and prevention.
Who Should Consider a Coronary Calcium Scoring Test?
Coronary Artery Calcium (CAC) testing can be beneficial for making treatment decisions, such as whether to start low-dose aspirin, statin therapy, or other medications. The American Heart Association identifies several groups for whom this test may be particularly useful:
- People reluctant to begin statin therapy and who want to understand their risks and potential benefits more precisely.
- People concerned about resuming statin therapy after stopping treatment because of side effects.
- Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
- Individuals aged 40 to 55 with an estimated 10-year risk of developing heart disease between 5% and 7.5%, along with additional risk factors that may elevate their chances of heart disease.
If you think you might benefit from Coronary Calcium Scoring, your best option is to consult with your healthcare provider to determine if it is appropriate for your situation. Your provider can evaluate your individual risk factors and medical history to help you make an informed decision.
What to Expect
The procedure is remarkably straightforward and doesn’t involve needles or contrast dyes. It is quick and painless, and you can continue taking your medications as usual, but you should avoid caffeine and smoking for 24 hours prior to the exam.
Understanding Your Results
A negative calcium score suggests minimal plaque buildup and a lower risk of coronary artery disease developing over the next few years. A positive test score, however, indicates the presence of coronary artery disease, even without symptoms. Your score helps predict your likelihood of experiencing a heart attack in the coming years.
Coronary CT Angiogram
A Coronary CT Angiogram (CCTA) offers a comprehensive assessment of your heart’s condition when more detailed visualization is required. The advanced imaging of a CCTA uses contrast and a higher degree of radiation to generate more detailed images of your coronary arteries, thereby assisting in the identification of any blockages or narrowing that may be the cause of the symptoms.
Differences from Coronary Calcium Scoring
Although Coronary Calcium Scoring plays a crucial role in evaluating the presence or absence of calcium, it does not, however, visualize coronary artery patency directly. By using contrast for increased detail to reveal the difference between the coronary artery and surrounding tissues, the Coronary CT Angiogram reveals blockages beyond the presence or absence of calcium buildup, making it especially beneficial for patients who are considered high risk for heart disease or are experiencing symptoms such as chest pain or shortness of breath.
Unlike Coronary Calcium Scoring, which is accessible without a referral, a physician referral is necessary for the Coronary CT Angiogram.
When is a Coronary CT Angiogram recommended?
A Coronary CT Angiogram (CCTA) is generally recommended for individuals who are experiencing symptoms such as chest pain or shortness of breath, and/or who have high-risk factors. These factors include, but are not limited to:
- High-risk calcium scoring results
- Hypertension (high blood pressure)
- High cholesterol
- Diabetes
- A significant family history of heart attacks
When your healthcare team needs more information than other tests can provide, the CCTA is recommended. In addition to showing details about plaque buildup and narrowing of your coronary arteries, as well as assessing your risk of heart attack, the American Heart Association notes that a CCTA can also reveal information about:
- Your heart’s structure
- How well your heart pumps blood
- Heart muscle scarring caused by a heart attack
- Fluid in the pericardial sac that surrounds the heart
- Any abnormalities in the large blood vessels leaving the heart
Take Control of Your Heart Health
Early detection of heart conditions in their earliest stages through appropriate cardiac imaging can significantly reduce the risk of heart attacks and improve long-term outcomes.
Don’t wait for symptoms to appear – contact your healthcare provider today to learn which cardiac imaging option is right for you. With Consulting Radiologists, Ltd. as a partner on your healthcare team, we can help you prioritize your heart health to lead a healthier, longer life.
“At Consulting Radiologists, Ltd., our team of radiologists is dedicated to empowering you with the information needed to make informed decisions about your cardiovascular health.” – Robin Parker, MD