Frequently Asked Questions about Heart Scans

What is Coronary Artery Scanning?

Coronary Artery Scanning (CAS) uses CT Scan to allow for imaging of the coronary vessels without any injections, needles or removal of clothing. You lie down, pictures are taken over 30 seconds, and you’re done. The calcium in the atherosclerosis is visualized and measured by a board-certified cardiologist at CT Scanner. Studies have shown that this coronary calcium equates to coronary atherosclerosis, which is the leading cause of myocardial infarction (heart attack).

Who Should Have This Test?

The Heart Scan is an appropriate tool for otherwise healthy individuals who may be at risk for heart disease – primarily men over 35 or women over 45 who have risk factors such as:

• High Cholesterol
• Family History of Early Coronary Disease
• Diabetes
• High Blood Pressure
• Smoking History
• Sedentary Lifestyle
• Overweight/Obese

This test should be ordered in conjunction with your physician, who is then expected to follow-up on this test and treat you accordingly.

Isn't Treadmill Testing the Way to Detect Early Atherosclerosis?

The traditional method to detect blockages is by an exercise treadmill test or similar, which looks for advanced blockages and can only reliably detect disease at advanced stages. Tests like the stress electrocardiogram (also known as treadmill tests) or thallium stress tests or echocardiograms can only detect blockages of 50% or more.

Coronary Artery Scanning has the unique ability to detect and quantify minute amounts of calcified plaque in the major coronary arteries, which are the cause of most attacks. Minor blockages can rupture suddenly, causing complete blockage. These minor blockages would have been missed by the traditional tests. By looking at coronary anatomy and not function, we have the opportunity to detect and measure plaque accumulation from the point at which the very first speck of calcium is deposited in your arteries. Typically, this is many, many years before high grade blockages can occur.

What is the Significance of Coronary Artery Calcium?

Calcification is caused from the buildup of fatty streaks in the inner lining of an artery that forms plaque. As the plaque builds and hardens, it can reduce and block the flow of blood through the artery. The plaque can rupture, become dislodged, or form a blood clot leading to a heart attack.

Research study findings show that coronary artery calcium is a significant marker of this atherosclerosis. More importantly, the early detection of coronary calcium allows for the early detection of coronary artery disease, which enables patients to make lifestyle changes in order to stop, stabilize and perhaps even reverse the atherosclerotic process. Diabetes, tobacco use, high blood pressure, obesity, high cholesterol, sedentary lifestyle and family history are important contributors to building atherosclerosis, which can lead to a heart attack.

What is a Calcium Score?

The calcium score is a total of the amount of the calcified plaque in the coronary arteries. A “normal” score is zero (no calcium in the coronaries). After a Coronary Artery Scan, the Cardiologist measures the amount of calcification using a highly accurate computerized scoring technique. The total score is then compared against research findings of 20,000 patients in many age groups. The physician reviews and interprets all scores, images and test results to categorize the person with low, intermediate or high risk of heart disease, and makes recommendations on follow-up medical care to the patient’s physician.

• A positive test means: Coronary calcification indicates at least some coronary disease. The amount of calcium is related to the amount of disease, and would guide your doctor in recommending appropriate treatment, including diet, medication or further testing.
• A negative test means: You probably don't have any coronary disease and your risk of heart attack is very low. You may need to work on any modifiable risk factors, and return for another Coronary Artery Scan in 2 to 5 years, but for now you can relax!

What Does the Procedure Involve?

The procedure is simple, safe, painless and only takes a few minutes. Patients will complete a risk factor questionnaire upon arrival. Our CT technologist will apply a few EKG leads to your ankle and wrists, and will ask you to lie on a table and hold your breath a couple times. The radiation exposure is minimal and no intravenous injections or needles are required. In most cases (unless there are certain types of buttons or bra metal involved), patients will be able to keep their shirt or blouse on while the 30 or so pictures are taken.

Is Atherosclerosis Treatable?

Yes, the atherosclerotic process can be slowed, stabilized and actually reversed to some degree through aggressive lifestyle modifications and/or through medication therapies under the guidance of your physician. Our aim is to identify those individuals with coronary atherosclerosis early, before a heart attack, so that they may become active participants in halting the progression of this disease process. By identifying atherosclerosis early, we hope to prevent the onset of symptoms and/or a sudden coronary event.

How Accurate is the Coronary Artery Scan?

The sensitivity of this test is at least 95%, depending upon the research study. In other words, if you have a blockage in your arteries, this test has at least a 95% chance of being positive. Exercise treadmill testing, as a comparison, is about 70% sensitive. Also, if there is no calcium in your study (zero score) then there is a >95% chance there is no significant blockage.

Is the Coronary Artery Scan an Adequate Substitute for an Angiogram?

A coronary artery scan is not a substitute for an angiogram. A coronary artery scan is used for the early detection of coronary artery disease, while an angiogram is used to measure the amount of narrowing in the coronary arteries. Due to the invasiveness, the angiogram is not used as a screening test for atherosclerosis.

Do I Need a Physician Referral?

Depending on your insurance, physician referrals may or may not be necessary for reimbursement. However, we encourage all of our patients to work with their personal physicians. Please call for more details. If physician-referrals are not necessary, we accept self-referred men between the ages of 35-70 and women between the ages of 45-75 years of age, who have one additional risk factor for heart disease such as family history of heart disease, high cholesterol, high blood pressure, diabetes, obesity, smoking, high stress and physical inactivity.

I Have Had Bypass Surgery - is the Test Useful for Me?

The coronary artery scan is not an indicator of luminal narrowing, but rather an indicator of the atherosclerotic process itself. For those patients with established disease, more advanced tests are necessary to accurately assess the extent of the blockage. The coronary artery scan would only confirm the presence of atherosclerosis. However, there are non-invasive tests using the CT Scan to assess if the bypass blockages are still open, and how tight (if any) the blockages are. Talk to your physician about this non-invasive measurement of your bypass grafts.

I Have Chest Pain - is the Test Useful for Me?

Heart Scan is recommended for patients with risk factors for coronary artery disease. Risk factors include family history of heart disease, high cholesterol, high blood pressure, diabetes, obesity, smoking, high stress and physical inactivity. Patients with symptoms like chest pain should consult with their personal physicians immediately. Symptoms for coronary artery disease are serious and should not be treated lightly.

Is the Test/Equipment Approved by the FDA?

Yes, the scanner has been cleared by the FDA and coronary artery scanning is one of the scanner's intended uses.