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The Little-Known Test that Can Prevent a Heart Attack


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  • | 2:45 p.m. January 22, 2020
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When it comes to tests, credit and sports, high scores triumph. But when it comes to your heart, it’s low numbers for the win. In general, the lower your blood pressure, cholesterol and pulse rates, the better your heart health. 

The same holds true for the latest need-to-know number — your coronary artery calcium (CAC) score. Relatively new, the CAC score is the number you need to know but probably haven’t heard about. The CAC measures the amount of calcium deposited with plaque in the walls of the heart’s arteries. Once there, the calcium can harden, further restricting or even cutting off blood flow to the heart.

“Hardening of the arteries, or atherosclerosis, refers to the buildup of this rigid calcium. A CAC scan pinpoints where the calcium is and measures the amount it sees in the arteries,” says Dr. Mark Steiner. He’s an interventional cardiologist with the Orlando Health Heart Institute Cardiology Group, which has offices on the campus of Orlando Health – Health Central Hospital.

The resulting CAC score can be a crucial indicator of coronary artery disease before other symptoms occur. “If we can identify plaque and calcium deposits before someone has a heart attack, we can effectively begin aggressive treatment with statins, aspirin and diet,” says Dr. Steiner.

Keeping Score
The CAC score is calculated using a specialized CT scan. Scores range from 0 to more than 400. “You want the lowest score possible,” says Dr. Steiner. “Higher scores translate to more calcium, putting you at a greater risk of a cardiac event. Above 400, there is danger of significant blockage.”

A score of zero means no calcium is seen in the heart and the probability of having a heart attack in the next five years is low. Scores of 100 to 300 indicate moderate plaque deposits. Those already at risk for heart disease who score above 100 are more likely to have a heart attack.

Taking the Test 
This simple, cost-effective scan allows doctors to identify patients with coronary blockage earlier, especially those with no other visual symptoms. 

CAC scores are calculated by a quick, noninvasive test that doesn’t require dye injection, removing all your clothes or even seeing a cardiologist. “Your primary care physician can order this test for you,” says Dr. Steiner. “It takes about 30 seconds to perform, there is minimal radiation and the test provides a lot of good information quickly.”

If test results show calcium and plaque buildup, says Dr. Steiner, “we will work with the patient to stabilize the plaque and treat the risk factors.”

Who’s a Candidate?
If you are 40 years old or older and have any of these risk factors, ask your doctor about scheduling a CAC scan.

  • Family history of heart disease
  • High cholesterol levels 
  • High blood pressure 
  • Diabetes
  • Past or present smoker
  • Inactive lifestyle
  • Overweight 

If you already have suffered a heart attack, have coronary stents or are pregnant, you are not considered a candidate for a CAC screening.