Understanding Coronary Calcium Scans: A Vital Heart Health Assessment

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality globally, prompting an urgent need for effective early detection methods. One such method is the Coronary Artery Calcium (CAC) scan, a non-invasive imaging technique that provides crucial information regarding the presence of calcified plaque in the coronary arteries. This five-minute test can identify underlying heart disease long before patients experience significant symptoms, offering a proactive approach to cardiac health management.

According to Dr. Dinesh Narang, a senior interventional cardiologist at Lilavati Hospital, "CAC scanning is one of the few tools we have that can spot a heart attack risk that’s otherwise invisible." The scan leverages computed tomography (CT) to assess calcium deposits, which serve as early indicators of atherosclerosis—a condition characterized by the build-up of plaque that can lead to cardiac events.

The CAC scan generates a calcium score that categorizes heart health into several risk levels. A score of 0 indicates no detectable plaque, suggesting a low risk for heart disease. Conversely, scores of 1-100 signal mild plaque build-up, while scores between 101-400 indicate moderate plaque, warranting lifestyle modifications or medical intervention. A score exceeding 401 denotes extensive plaque, indicating a critical risk that demands immediate medical attention.

Dr. Aakruti Mehta, a preventive cardiologist, emphasizes the importance of the CAC score as a predictive tool: "A CAC score of zero is the most powerful negative predictor we have in cardiology. It’s like getting a clean bill of health for your arteries." Conversely, a higher score can provoke essential discussions about treatment options and lifestyle changes.

The CAC scan is particularly beneficial for individuals who fall into intermediate risk categories. Dr. Narang suggests that men over 40 and women over 50 with risk factors such as hypertension, diabetes, or a history of smoking should consider this test. It can also serve as a decisive factor for individuals uncertain about initiating a long-term medication regimen based on borderline cholesterol levels or family history of heart disease.

While the CAC scan is not universally recommended—for example, younger individuals without risk factors typically do not need it—it plays a vital role in preventive cardiology for those at risk. Furthermore, it offers distinct advantages over traditional heart health assessments. Unlike cholesterol tests, which measure risk factors without confirming disease presence, or stress tests that evaluate blood flow during exertion, the CAC scan directly visualizes arterial plaque. As Dr. Mehta notes, "Most heart attacks are caused by soft plaques that rupture, not always the big blockages we usually look for in most cardiac tests. That’s why someone can pass a stress test today and still have a heart attack next week."

Despite its advantages, the CAC scan has limitations. The exposure to radiation, while present, is comparable to that of a mammogram or a couple of cross-country flights. Additionally, while the scan effectively detects calcified plaque, it does not identify soft plaque, which can also contribute to cardiovascular events. Dr. Dheeraj Kapoor, a radiologist in Bengaluru, acknowledges the minimal radiation risk and asserts the immense value of the information derived from the scan: "The test can absolutely change how someone approaches their heart health."

Insurance coverage for the CAC scan can vary, with typical costs ranging from Rs 5,000 to Rs 15,000 in various clinics. Given the escalating prevalence of heart disease, the CAC scan represents a significant advancement in preventive healthcare, allowing patients and physicians to take informed actions before the onset of acute cardiac events. As Dr. Narang articulates, "The CAC scan helps people take action before something happens. That’s powerful." With heart disease remaining a critical health concern worldwide, this test offers a clearer picture of an individual’s heart health and the opportunity for timely intervention. Therefore, individuals concerned about their heart health are encouraged to consult with their healthcare providers about the potential benefits of the CAC scan, which may very well save lives.