Cardiac Computed Tomography (CT)

Treatment Options

Cardiac Computed Tomography (CT)

Calcium buildup is a marker of coronary artery disease. Cardiac CT for coronary artery calcium scoring involves the use of computed tomography (e.g., CT or CAT scan) to take multiple pictures of the heart and send them to a computer. The pictures can be examined on a computer monitor or printed. CT for coronary artery calcium scoring looks for a buildup of calcium on the walls of the arteries of the heart (coronary arteries). The amount of calcium detected in the coronary arteries is measured and a coronary artery calcium score is determined.

Coronary artery disease occurs when these arteries become clogged with fatty deposits (plaque). Soft plaque (earliest form of calcium buildup in the arteries) cannot be found with calcium scoring. If you have soft plaque, the test may look normal resulting in a false negative. It is also possible the test may show a high chance of blockage in the arteries when it is not true. A false positive could lead to additional tests that are not necessary and a risk of side effects from the testing. Calcium deposits in the coronary arteries do not always mean that there is a blockage; blocked arteries do not always contain calcium.

The goal of CT coronary artery calcium scoring is to check for early heart disease before symptoms occur and determine how severe it is. The hope is that the coronary calcium score may help decide what measures may be taken to prevent chest pain, heart attacks or sudden death.

Things to Consider

It is still undetermined how calcium scores relate to the likelihood of experiencing chest pain, having a heart attack, or sudden death.
Soft plaque (earliest form of calcium buildup in the arteries) cannot be found with calcium scoring.
The test may show a high chance of blockage in the arteries when it is not true.
Calcium deposits in the coronary arteries do not always mean that there is a blockage.
Blocked arteries do not always contain calcium.
A false positive could lead to additional tests that are not necessary and a risk of side effects from the testing.
A high heart rate (90 beats or higher) may interfere with the test.

Results

Will I live longer if I have this procedure?

No, there is no scientific evidence to show that CT coronary artery calcium scoring will lengthen your life.

Will CT cardiac calcium scoring improve my quality of life?

No, it is still undetermined how CT calcium scores relate to the likelihood of experiencing chest pain, having a heart attack, or sudden death.

Safety

How safe is this for me?

How safe is this procedure?

CT calcium scoring radiation exposure is similar to that of ten chest x-rays. It is noninvasive and does not require an injection of contrast. Women should always tell their doctor if there is any chance that they may be pregnant.

Minor reported complications:

CT calcium scoring is a fairly simple test. You may feel some discomfort because the table is hard or become chilled from the room being cold.

Major reported complications:

None reported.

Comparison

Alternative testing for coronary artery disease includes:

CT coronary artery calcium measurement has not been compared to alternative risk assessment approaches. The procedure may assist in the detection of calcium deposits, however there is no evidence that this knowledge in any way alters the health outcomes expected from conventional treatments that are readily available.

Cost

The costs for CT coronary artery calcium scoring may vary depending upon the physician, the facility, the geographic location, as well as any special needs or complications that you may experience.

The cost may or may not be covered by your health benefits plan.

Sources

The following are off-site links :

American Heart Association. (2010). Computed imaging / tomography. Retrieved March 2, 2010 from http://www.americanheart.org/presenter.jhtml?identifier=4554.

American Heart Association. (2007). ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain. Retrieved March 2, 2010 from http://www.americanheart.org/downloadable/heart/1168626471943CECD%20on%20EBCT%20rev3.pdf.

Cardiosource. American College of Cardiology. (2006, October). New developments and future directions for CT. Retrieved March 2, 2010 from http://www.cardiosource.com/rapidnewssummaries/summary.asp?SumID=184. http://www.cardiosource.com/rapidnewssummaries/index.asp?EID=24&DoW=Fri&SumID=184.

RadiologyInfo.org. (2009, June). Cardiac CT for calcium scoring. Retrieved March 2, 2010 from http://www.radiologyinfo.org/en/pdf/ct_calscoring.pdf.