Coronary artery calcium scoring
A coronary artery calcium score can be used following a Heart Health Check to estimate your risk of heart attack.
A coronary artery calcium score uses a CT scan. It measures the amount of calcified plaque (calcium) inside the walls of your heart’s arteries
Why is the test done?
Your doctor may refer you for coronary artery calcium scoring following a Heart Health Check. Not everyone needs to have this additional CT scan.
A Heart Health Check is used to estimate your risk of heart attack or stroke based on any risk factors you may have. These can include raised blood pressure or high cholesterol. These factors are used to calculate a risk score, to estimate your risk of having a heart attack or stroke in the next five years. People can be classified as high, moderate, or low risk. Your doctor will make recommendations about changes to your health behaviours, such as stopping smoking. They may also prescribe medicine to reduce the risk of a heart attack or stroke.
Based on your Heart Health Check result, your doctor may discuss coronary artery calcium scoring. For some people, this additional CT scan can help you better understand your risk of having a heart attack in the future.
How is the test done?
During the test, you lie down flat on a table which will move through a circular scanning machine. The staff performing the scan will tell you to hold your breath at times. The machine monitors your heart rhythm by placing sticky dots and ECG leads on your chest. You won’t need to stay in hospital or take any precautions after the test, and you’ll be able to drive.
What does the test show?
A collection of calcium in the walls of your heart’s arteries can mean that there’s a build-up of plaque. This could increase your risk of a heart attack. Your doctor will discuss the results with you and what they mean for your health.
It’s important to remember that a high coronary artery calcium score does not mean you will have a heart attack– it just means your risk may be higher than someone with a lower calcium score.
Preparing for the test
Your doctor may tell you to avoid smoking or drinking caffeinated drinks before having the test. Otherwise, there’s nothing you need to do to prepare. If you have questions, it is best to check with your doctor or the centre where you are having your test for specific information about what to do.
How much does a Heart Health Check and coronary artery calcium scoring cost?
Since April 2019, Heart Health Checks have been covered by Medicare and are free at practices that bulk bill for this service. However, coronary artery calcium scoring is not covered by Medicare and you will need to pay for this additional test. Your doctor is best placed to help work out if calcium scoring will be useful for you. They can help provide information on where it is available near you and how much it will cost.
Plain language summary
Below is a plain language summary of the Heart Foundation’s position statement on the use of coronary artery calcium scoring. The summary has been developed to help people understand:
- What is coronary artery calcium scoring
- The Heart Foundation’s position statement on coronary artery calcium scoring
- What the recommendations mean for people
Plain language summary
Heart attack and stroke are some of Australia’s biggest killers. The Heart Foundation works to prevent people from developing heart disease through awareness campaigns, resources and support programs.
Our guidance for health professionals includes the use of risk scores to help estimate a person’s risk of having a heart attack or stroke. As part of a Heart Health Check, your doctor can estimate your risk of heart attack or stroke based on any risk factors you may have. These can include raised blood pressure or high cholesterol. These factors are used to calculate a risk score, to estimate your risk of having a heart attack or stroke in the next five years. People can be classified as high, moderate, or low risk. Your doctor will make recommendations about changes to your health behaviours, such as stopping smoking. They may also prescribe medication to reduce the risk of a heart attack or stroke.
The Heart Foundation reviewed the evidence to assess whether coronary artery calcium scoring can help better understand a person’s risk of having a heart attack.
What is coronary artery calcium scoring?
A coronary artery calcium score is a measure of how much calcified plaque (calcium) is in the walls of your heart’s arteries (blood vessels). A build-up of plaque can cause these arteries to become narrow, reducing the amount of blood, oxygen and nutrients that reach your heart. In some cases, this plaque can break away and form a clot that blocks the arteries, causing a heart attack.
A coronary artery calcium score is measured using a non-invasive computed tomography (CT) scan of the heart. The CT scan shows how much calcium is in the walls of the heart’s blood vessels. The amount of calcium is reported on a number scale. A score of zero indicates there is no calcified plaque. Medical dye or contrast is not used in CT scans for measuring a coronary artery calcium score. In someone without previous symptoms or a diagnosis, coronary artery calcium scoring can indicate a person’s risk of heart attack.
What is the Heart Foundation’s position on coronary artery calcium scoring?
Our position is that there can be a role for coronary artery calcium scoring in determining a person’s risk of heart attack. Our recommendations for the use of coronary artery calcium scoring are conditional. This means the recommendations are based on the best available evidence, but more research is needed to fully understand the role of coronary artery calcium scoring. The Heart Foundation acknowledges that Australian research on calcium scoring is limited. This affects the certainty of the evidence and our recommendations. We encourage people to speak to their doctor about their risk of heart attack and stroke. It is important to decide together whether a coronary artery calcium score is appropriate.
What do our recommendations mean for people?
The decision to have a coronary artery calcium score will depend on many factors. Your doctor will discuss these with you, including:
- Your risk factors
- Cost
- Your personal preferences and values
How useful coronary artery calcium scoring is will vary from person to person. Your doctor is best placed to help work out if calcium scoring will be useful for you. Our recommendations guide health professionals on:
When a coronary artery calcium score could be considered, and;
How a coronary artery calcium score could be used to work out your risk of heart attack.
For more information about coronary artery calcium scoring, speak to your doctor, nurse or health worker.
References
1. Commonwealth of Australia: Department of Health and Aged Care. Australian Guideline for assessing and managing cardiovascular disease risk. https://www.cvdcheck.org.au/
2. Jennings GL, Audehm R, Bishop W, et al. National Heart Foundation of Australia: position statement on coronary artery calcium scoring for the primary prevention of cardiovascular disease in Australia. Med J Aust. May 2021;214(9):434-439. doi:10.5694/mja2.51039
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Last updated08 January 2021