What Is a Coronary Artery Calcium Scoring?

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A coronary artery calcium scoring, or coronary calcium score test, is a CT scan of the heart. It measures the amount of “calcium” in the arteries (the vessels that carry blood away from the heart) to evaluate the risk of a heart attack or stroke. The calcium mentioned here is not calcium on the teeth. Instead, it’s the special kind of calcium that is tied with plaque (calcified plaque). Since calcified plaque affects blood flow, the amount of calcium is a sign of the condition of the heart. In general, the more the calcium there is, the higher the risk of a heart attack or stroke in the next 5-10 years.
Calcium Score Presence of CAD
0 No evidence of CAD
1-10 Minimal evidence of CAD
11-100 Mild evidence of CAD
101-400 Moderate evidence of CAD
Over 400 Extensive evidence of CAD
When the score goes above 400, it means a severe risk of heart attack in 5-10 years. A CAC score 400 doesn't directly mean 40% of the artery is blocked. The score is  based on the weighted density score given to the highest attenuation value (HU) multiplied by the area of the calcification speck. For example: if a calcified speck has a maximum attenuation value of 400 HU, the weighted density score is given as 4, and it occupies 8 sq mm area, then its calcium score will be 32. The score of every calcified speck is summed up to give the total calcium score. Although a high CAC score points to a higher risk of CAD, a zero value doesn't mean 100 percent safe. Because in some plaque deposition, there's no calcification, which means the blockage isn't captured by the CAT. This isn't common, but cases exist. Risk factors for extensive calcification of coronary artery include:
  • old age
  • diabetes
  • high cholesterol
  • high blood pressure
  • smoking
  • chronic kidney disease
  • hypercalcemia
  • hyperphosphatemia
  • parathyroid dysfunction
  • dialysis
  Keywords: coronary artery calcium scoring; coronary calcium score.
what is the treatment if you have a large amount of calcium
Coronary artery calcification (CAC) typically causes no symptoms initially, as the condition develops over many years. When blood flow reaches a critically low level, symptoms such as shortness of breath with exertion and chest pain often occur.
People with CAC are at increased risk for a heart attack, heart failure and stroke. Treatment for CAC mirrors that for other forms of coronary artery disease. Lifestyle modifications, and medical and interventional treatments can relieve symptoms and prolong life.
Lifestyle Modifications
Lifestyle modifications are important components of the treatment for coronary artery disease.
Smoking Cessation
Stopping smoking and avoiding exposure to secondhand smoke is one of the most important steps you can take to reduce the risks that accompany CAC. According to a November 2013 article published in the European Heart Journal, stopping smoking reduces your risk of dying from heart disease or stroke by 36 percent in the first 2 years after you quit.
Heart-Healthy Diet
A diet planned with a dietitian or another qualified healthcare professional can help reduce blood cholesterol and lower blood pressure, key aspects of coronary heart disease treatment. The American Heart Association and American College of Cardiology recommend a diet that limits salt, saturated fats, trans fats and cholesterol while incorporating a rich array of fruits, vegetables and whole-grain foods.
Physical Activity and Weight Management
Regular physical activity and exercise can be useful for coronary artery disease treatment, although it's important to consult a healthcare professional before beginning an exercise program. Weight loss can be beneficial if you are overweight or obese. Even a modest amount of weight loss can help lower your risk of coronary artery disease complications.
Medical management refers to the use of medications to treat coronary artery disease. Aspirin is one of the most common medicines prescribed.
Other drugs, such as statins, are prescribed to lower total and bad cholesterol (LDL) levels in the body. If you have high blood pressure, various medications are used to lower the blood pressure. If symptoms are interfering with your daily activities, your doctor might prescribe nitrates to temporarily dilate the coronary arteries. Other medications such as beta blockers and calcium channel blockers can be used to decrease the amount of work the heart needs to do.
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