What’s a Heart Scan and Should You Get One?

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Maybe you’ve heard the ads from hospitals in your area urging folks to come in for a heart scan. You’re thinking about getting one, but you’re not sure if it’s worth it. The cost isn’t outrageous, but it’s not cheap either.

While it’s true that heart scan results can indicate if you’re at a higher risk for certain types of heart disease, the test has its limitations and it isn’t useful for everyone.

A heart scan, also called a coronary calcium scan, takes pictures of your heart’s arteries to find out whether or not you have calcium deposits (calcifications) in your artery walls. The non-invasive test takes only 10 to 15 minutes. Heart scans are done using one of two types of specialized X-ray equipment: electron-beam computed tomography (EBCT or EBT) or multi-detector computed tomography (MDCT).

Coronary calcifications can indicate heart disease

Calcium, along with fat and cholesterol, comprise a substance called plaque. Plaque is the stuff that can accumulate in your arteries and block blood flow, causing you to have a heart attack or stroke. The medical term for plaque buildup is atherosclerosis.

A heart scan will tell you and your doctor how much calcium is in the plaque that lines the inside of your arteries. These coronary calcifications are indicators of atherosclerosis and other heart diseases. Many heart specialists believe that your calcium score is a better indicator that you’ll suffer from a cardiovascular illness than other risk factors.

The results of your heart scan will come in the form of a calcium score called an Agatston Score. You may receive a separate score for each major artery, as well as an overall score. Generally, the higher your score the greater the atherosclerosis in your arteries. The more atherosclerosis you have, the more likely it is that you’ve got heart disease.

Keep in mind that your heart scan results come with a few caveats.

  • A heart scan won’t reveal if your arteries are blocked. To find out if your arteries are narrowed due to plaque buildup, your doctor will have to perform another test called a coronary angiogram.

  • A small Agatston Score doesn’t mean you won’t go on to develop heart disease. You and your doctor still need to consider your personal health habits and medical history, including diet and exercise patterns and family history.

  • The scan only detects the presence of older, hard plaque. It doesn’t pick up on newer, softer plaque, even though softer plaque can block your arteries too. So, while you might have few hard calcifications, you could still have some degree of arterial blockage.

Heart disease risk determines heart scan need

When it comes to classifying a person’s risk for a heart attack or other heart-related illness, doctors divide their patients into three categories: low, intermediate, and high. If you’re in the intermediate risk group, doctors believe you’re the best candidate for a heart scan. If you’re in either the low or high group, a heart scan probably isn’t for you. Here’s why.

  • Low risk: If you’re younger than 55, don’t smoke, and don’t have high blood pressure or cholesterol, you’re considered at low risk for heart trouble. Since you and your doctor are already successfully monitoring the major factors that contribute to heart disease, you’d be wasting your money on a heart scan.

  • Intermediate risk: You fall into the intermediate category if you have at least two of these risk factors: you’re between 55 and 65 years old, you smoke, have borderline high blood pressure, or elevated cholesterol. If you’re in this category you would benefit the most from a heart scan. People who have an intermediate risk account for more than 50 percent of cardiac events, including severe chest pain and heart attack.

  • High risk: Being a smoker older than 65 who’s been diagnosed with high blood pressure and cholesterol puts you in the high risk group. If you’re older and have these kinds of health problems, or if you’ve already been treated for cardiovascular problems, you and your doctor already know you’re in heart-disease danger. A heart scan isn’t going to tell you anything new.

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