Heart X-ray - Calcium Scoring

Calcium scoring, also known as cardiac calcium scoring or coronary artery calcium scoring, is a test performed using computed tomography scan (CT scan or CAT scan) to check for any presence of calcification in the coronary arterial walls. This test is able to detect at an early stage the percentile risk of having or to determine the severity of coronary heart diseases.

The machine takes a series of images at an interval of 20 seconds using X-ray at sub-second rates, in between split second pauses of the heart. It is very important to be still when the images are taken for a precise diagnosis. Patients are also asked to hold their breath for 20-30 seconds. Calcium scoring images are taken at cross sections of the chest. Electrocardiogram (ECG) leads are placed on a patient's chest for the CT scanner to precisely measure every beating of the heart.

Calcium scoring today is performed with more up-to-date machines that use electron beam computed tomography (EBCT) or electrocardiographically gated spiral computed tomography also known as multi-slice CT. These machines are able to shoot images for 10 seconds making them ideal for elderly people who are not able to hold their breaths that long.

The practicability of calcium scoring may not be that high since other tests are able to diagnose heart diseases. Moreover, the soft plaque surrounding the coronary arteries is not seen in the calcium scoring, but could also cause a heart attack.

Who should get calcium scoring
People who have the likelihood, or have strong family background of coronary heart disease, can opt to get the test: men over 45 or women who have passed the menopausal stage, high cholesterol levels, high blood pressure, smokers, obese individuals, and those who lack regular physical activity.

Your calcium score
A calcium score that is 0 to10 indicates there are no presence of calcified plaque in the walls of the coronary artery and is also suggestive of lower than 5% risk of developing heart disease. A calcium score between 11 and100 is consistent with mild plaque burden but, although the possibility of having obstructive heart disease is below 20%, atherosclerosis is clearly present. A score of 101 to 400 is associative of moderate atherosclerosis, at the least, and a high risk of moderate non-obstruction coronary atherosclerosis disease. Any score above 400 means there is an advanced presence of atherosclerosis plaque and patients are advised to aggressive risk strategies to prevent any future attacks.