What You Should Know About Heart Scans

According to the CDC, heart disease is the leading cause of death in the U.S. for both men and women, with more than 600,000 Americans dying from the condition each year.

Heart disease is not actually a disease, it’s a term used to refer to many different types of heart conditions, including coronary artery disease, the leading cause of heart attacks. Heart disease develops due to a buildup of calcified plaque in your arteries that can cause them to narrow over time, ultimately reducing the flow of oxygen-rich blood to your heart.

Fortunately, there’s a way to detect plaque buildup in your arteries before it becomes a major problem. A simple heart scan can give you a clear picture of your heart’s current health years before symptoms, and heart disease, develop.

What is a heart scan and why might you need one?

Heart scans, also called coronary calcium scans, are a non-invasive method of detailing the presence, location and extent of calcified plaque buildup in the arteries. Using safe amounts of radiation (comparable to two chest x-rays), heart scans can reveal risk factors for heart disease or a heart attack by providing a picture of your heart and its adjacent blood vessels.

“A heart scan is considered a screening test, meaning that it is designed to detect disease at a very early stage, before symptoms develop, and before any complications from the disease,” says Dr. Jon Blaschke, a cardiologist at the INTEGRIS Heart Hospital. “Heart scans actually let us see atherosclerosis, which is the disease that ultimately results in heart attacks and strokes, and can be very helpful in estimating risk of future vascular events for patients."

The plaque found in arteries is a combination of fats, cholesterol, calcium and other substances found in blood. Plaque deposits will gradually develop over time, with buildup starting years before you may notice any symptoms. High levels of plaque can restrict blood flow to your heart. Plaque may also burst and trigger a blood clot, increasing your risk of heart attack. If calcium is found in your heart scan, it’s an early indication that your arteries are already stiffening and narrowing due to the presence of plaque.

“This is a test that I employ in my practice daily to help reduce risk of events for patients and to develop individual treatment regimens,” says Dr. Blaschke.  “It is a simple, inexpensive and quick test."

Heart scans are usually painless and can be done without a referral. They usually taking less than 10 minutes, and do not require you to change your clothes. Doctors may order a heart scan if they want a better understanding of your potential risk for heart disease, and they may also recommend a heart scan to test for the following conditions.

• Congenital heart defects
• Defects or injury to the heart’s four primary valves
• Blood clots in the chambers of the heart
• Tumors in or on the heart

Who should receive heart scans?

Heart scans are considered most useful for those with a known “moderate” risk of heart disease or for those whose risk is uncertain. Your risk for heart disease can be calculated based on your age, sex, blood pressure, cholesterol levels and tobacco use.

“Current guidelines indicate that patients at intermediate risk for vascular events should consider heart scan testing as a tool for better understanding their true risk of vascular events in the future,” says Dr. Blaschke. “In some cases, even fairly healthy patients (those at “low” risk for events) may wish to consider this testing modality, but only after discussing with his or her physician.”

It is recommended that those over the age of 40 with one or more of the following risk factors should receive a heart scan.

• Diabetes
• Smoking
• High cholesterol
• High blood pressure
• Family history of heart disease
• Poor diet

However, heart scans are not for everyone. "Patients who already have symptoms indicating heart disease should not have a heart scan," says Dr. Blaschke. "Alternate tests are much more likely to be helpful, and delaying appropriate, timely care by first obtaining a heart scan can actually put a patient at greater risk."

In addition, although these tests require low amounts of radiation, exposure is not recommended when there is no foreseeable benefit to getting the scan. In these cases, the risk of radiation exposure outweighs the benefits provided by the scan. 

Hearts scans are also not recommended for the following populations.

• Men under the age of 40 and women under the age of 50 with no known risk factors, as calcium buildup is harder to detect at a younger age
• Young people with no family history of heart attacks at an early age and no other known risks
• People who already have known “high” risk of heart disease, as the scan may not provide any new information needed to develop a treatment plan
• People who have received an abnormal heart scan result in the past

Heart scan results

The amount of calcium detected in your blood provides an estimated measurement of how much plaque has accumulated in your arteries. This measurement is then used to calculate a number known as an Agatston score. This score represents a combination of the total area of calcium deposits in your arteries and the density of the calcium.

An Agatston score of zero indicates no calcium present in the heart and a low likelihood of future heart attacks. A score between 100 and 300 indicates moderate plaque position and a relatively high risk of experiencing a heart attack or developing heart disease in the next three to five years. A score greater than 300 indicates a very high risk of heart attack and disease.

“We know that the higher the calcium score, the greater the likelihood of vascular events in the next five years,” says Dr. Blaschke. “The problem is that about two-thirds of vascular events in the U.S. occur in people who have not had prior diagnosed coronary disease or stroke, and who qualify as low to intermediate risk by our current available models. As such, a calcium score gives us a real window into our patients’ futures.”

When combined with other health information, your doctor may use your score to create a treatment plan for reducing your risk, including any necessary medications or lifestyle changes. Some studies have demonstrated that a heart scan may be a motivational factor for people at moderate risk to make lifestyle changes and follow treatment plans including exercise, sensible diet, controlling blood pressure and managing weight. 

For patients with an elevated calcium score, an aggressive medical regimen to control blood pressure, prevent plaque progression and to lower inflammation in the arteries is typically recommended. Patients with a very high calcium score will often be recommended for a more aggressive regimen, and may even require stress testing or other cardiac studies.

INTEGRIS HeartScan

INTEGRIS is proud to offer heart scans using the 320 Aquilion One Computer Technology (CT) Scanner. Following an INTEGRIS HeartScan, your physician will be able to study a three-dimensional picture of your heart along with blood flow and function, allowing them to reduce the time needed to diagnose heart disease from days to mere minutes.

A $50 HeartScan from the INTEGRIS advanced imaging system can give you a precise measure of the calcium deposit in your arteries. Call 405-946-2273 today to schedule a HeartScan.