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Home Knowledge Center Wellness Library Coronary Calcium Scan: Should I Have This Test?

Coronary Calcium Scan: Should I Have This Test?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Coronary Calcium Scan: Should I Have This Test?

Get the facts

Your options

  • Have a coronary artery calcium scan.
  • Don't have a coronary artery calcium scan.

This information is only for people who are curious about their risk for heart disease but don't have angina symptoms, such as chest pain or pressure.

Key points to remember

  • A coronary calcium scan checks for calcium buildup in the coronary arteries. Calcium in these arteries may be a sign of heart disease. A high score on a calcium scan can mean that you have a higher chance of having a heart attack than someone with a low score.
  • The results of a coronary calcium scan may prompt you to make some lifestyle changes, such as exercising, eating better, losing weight, and quitting smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.
  • People who are at medium risk for heart disease will get the most benefit from this test. Your doctor can help you find out your risk. Knowing your risk for a heart attack is a key part of your decision to get a scan.
  • A calcium scan is not helpful to patients who have a low or high risk of heart disease.
  • A calcium scan can give your doctor more information about your risk for heart disease. If you have a high score, you and your doctor may decide to start or change treatment to lower your risk.
  • You could get a high score from the test even if your arteries do not have signs of heart disease. This could lead to other tests or treatments that you don't need.
  • Not all arteries that have early signs of heart disease have calcium. So you could get a low calcium score and still be at risk.
  • Not all health plans will pay for this test. The cost can range from about $100 to $400.
FAQs

What is a coronary calcium scan?

A coronary calcium scan is a test for people who have no symptoms of heart disease but may be at risk for getting it. The test uses computed tomography (CT) to check for calcium buildup in plaque on the walls of the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen. Calcium in these arteries is a sign of heart disease.

During the test, a CT scan takes pictures of your heart in thin sections. The result is a score based on the amount of calcium seen on the scan. The higher your calcium score, the higher your risk for a heart attack. The test takes about 30 minutes.

Most health insurance plans don't pay for coronary calcium scanning. The cost can range from about $100 to $400.

CT angiography is a test that uses computed tomography to see if an artery is narrowed or blocked. It's different from a coronary calcium scan and may be best after you already have symptoms of heart disease and other test results are not clear.

Talk with your doctor if you want to know more about CT angiography. This Decision Point is about coronary calcium scanning.

Who should get a coronary calcium scan?

Your doctor may want you to have a coronary calcium scan if it can help you and your doctor make decisions about how to lower your risk for heart disease and heart attack.

This test might be most helpful for people who do not have heart disease but who are at medium risk for heart disease. Your doctor can help you know your risk of heart disease and heart attack. Your doctor will look at things that put you at risk, including blood pressure, cholesterol, diabetes, and your age, sex, and race.

In most cases, the results from your physical exam and other tests will give your doctor enough information about your risk for heart disease.

A coronary calcium scan is not advised for routine screening for coronary artery disease.footnote 1 This test might not tell your doctor any more about your risk for heart disease than your risk factors do. Risk factors are things that can increase your risk for heart disease, such as diabetes, high blood pressure, high cholesterol, and smoking.

This screening test is not for you if:

  • You don't have any risk factors for heart disease, so you have a low risk of a heart attack.
  • You are at high risk for heart disease or you were diagnosed with heart disease. (You should already be under a doctor's care.)

This test may not be right for you if you are a man younger than 40 or a woman younger than 50. This is because younger people typically do not have much calcium buildup in their arteries yet.

What do the results mean?

Your test result is a number that is your calcium score. The score can range from 0 to more than 400. The higher your score, the greater your chance of having a heart attack. The score might be helpful if you are unsure whether to take a statin to lower your risk of a heart attack. Your doctor will look at your calcium score as well as your age, your health, and your other test results such as your cholesterol level.footnote 2

After you have the test, talk with your doctor about your results.

What are the benefits of a coronary calcium scan?

Many people only learn that they have heart disease when they have a heart attack. A coronary calcium scan is one way to find out if you have early heart disease before it gets worse. After you know your risk, you and your doctor can make decisions about how to lower it. You can make lifestyle changes such as having a heart-healthy eating plan, staying at a healthy weight, getting more exercise, and quitting smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.

A coronary calcium scan can give your doctor more information about your risk for heart disease, especially if you already have risk factors. Then you can make decisions about how to lower your risk. For example, you and your doctor can use your score plus your other risk factors to decide whether cholesterol medicine is right for you.

What are the risks?

  • You could get a high score from the test even if your arteries do not have signs of heart disease. This could lead to extra tests that you don't need. Or it could cause you to worry when there's no reason. But these kinds of results are most likely to happen in people who are at low risk for heart disease. So if you already know that you're at low risk, you shouldn't get this test.
  • Not all arteries that have early signs of heart disease have calcium. A low test score may make you feel safe even though you're still at risk.
  • There is a slight chance of developing cancer from having cardiac calcium scoring. The chance is higher in people who have many radiation tests. If you are concerned about this risk, talk to your doctor about the amount of radiation this test may give you and confirm that the test is needed.

Why might your doctor recommend this test?

  • You are at medium risk for heart disease, based on your risk factors.
  • Your doctor thinks that the results of this test could change your treatment and lower your risk for heart disease.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have a coronary calcium scan Have a coronary calcium scan
  • You will lie on a table connected to the CT scanner. The table slides into the opening in the machine, and the scanner moves around your body. The test takes about 30 minutes.
  • A coronary calcium scan can give your doctor more information about your risk for heart disease, especially if you have several risk factors.
  • The results of the test may prompt you to make lifestyle changes or take medicines that can help your heart.
  • The test can give a high score even if your arteries do not have signs of heart disease. This might lead to tests or treatment you don't need.
  • Not all arteries that have signs of heart disease have calcium. So you could get a low test score and still be at risk.
  • Most health insurers don't pay for this test.
Don't have a coronary calcium scan Don't have a coronary calcium scan
  • Instead of having a CT scan, your doctor gets information about your heart disease risk from a physical exam and other tests.
  • You make healthy lifestyle changes or take medicines that can help your heart without taking a test.
  • You don't pay for a test you may not need. Most insurers do not pay for this test.
  • You avoid possible unnecessary treatment or worry.
  • If you are at medium risk for heart disease and don't get a coronary calcium scan, you may not have all the information you need to reduce your risk.

Personal stories about coronary calcium scanning

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My mom had a heart attack in her early 60s, followed by bypass surgery. She didn't have a clue that she had heart disease. I don't want that to happen to me. I already know I have a couple of health issues that raise my risk for heart disease. So I'm going to ask my doctor about getting a coronary calcium scan to check my risk.

Rose, age 48

My wife has been bugging me to get this test. So I asked my doctor about it. He said my risk for getting heart disease is pretty low even though I have high blood pressure. I'm taking medicine for that and for high cholesterol. I'm also trying to eat better and exercise. I just don't think the test is going to tell me more about my risk than I already know.

Jeffrey, age 56

My doctor says I am at risk for heart disease. She wants me to have a coronary calcium scan so that we can get a better idea of my risk of a heart attack. Then, we can decide whether I should start taking medicine so I can lower my risk. I like the idea of having all the information before I make decisions. So I'm going to have the test.

Tony, age 53

I get a physical exam from my doctor every year, and she says I'm in pretty good shape. But ever since I passed 50, I've been worried about heart disease. I saw an ad for this test in the newspaper and asked my doctor about it. It turns out that in healthy people like me, the test results aren't very reliable. I'm going to just keep getting an annual checkup.

Maria, age 54

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have a coronary calcium scan

Reasons not to have a coronary calcium scan

I need more information about my risk so I can commit to making lifestyle changes or taking medicines.

I already know that I should make some lifestyle changes to keep my heart healthy.

More important
Equally important
More important

It's worth it to me to pay for this test myself.

My insurance won't pay for this test, and I can't afford it.

More important
Equally important
More important

I want to take any tests that could help me find out my risk for heart disease.

I don't want to take tests I don't need.

More important
Equally important
More important

I want to take this test because I need more information about my risk for having a heart attack.

I already know my risk for having a heart attack, so I don't need this test.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having a coronary calcium scan

NOT having a coronary calcium scan

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Can anyone who is worried about heart disease benefit from a coronary calcium scan?
2, Does a high score on a coronary calcium scan always mean you have heart disease?
3, Could you still be at risk for heart disease even if you get a low calcium score on the test?
4, Is having a coronary calcium scan the only way to tell if you need to make lifestyle changes to help your heart, such as exercising, eating better, and not smoking?

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
2, Check what you need to do before you make this decision.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts

Key concepts that you understood

Key concepts that may need review

Getting ready to act

Patient choices

What matters to you

Print Summary

Credits and References

Credits
Author Healthwise Staff
Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
References
Citations
  1. U.S. Preventive Services Task Force (2009). Using nontraditional risk factors in coronary heart disease risk assessment. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscoronaryhd.htm.
  2. Grundy SM, et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology, published online November 8, 2018: S0735. DOI: 10.1016/j.jacc.2018.11.003. Accessed January 28, 2019.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Coronary Calcium Scan: Should I Have This Test?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have a coronary artery calcium scan.
  • Don't have a coronary artery calcium scan.

This information is only for people who are curious about their risk for heart disease but don't have angina symptoms, such as chest pain or pressure.

Key points to remember

  • A coronary calcium scan checks for calcium buildup in the coronary arteries. Calcium in these arteries may be a sign of heart disease. A high score on a calcium scan can mean that you have a higher chance of having a heart attack than someone with a low score.
  • The results of a coronary calcium scan may prompt you to make some lifestyle changes, such as exercising, eating better, losing weight, and quitting smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.
  • People who are at medium risk for heart disease will get the most benefit from this test. Your doctor can help you find out your risk. Knowing your risk for a heart attack is a key part of your decision to get a scan.
  • A calcium scan is not helpful to patients who have a low or high risk of heart disease.
  • A calcium scan can give your doctor more information about your risk for heart disease. If you have a high score, you and your doctor may decide to start or change treatment to lower your risk.
  • You could get a high score from the test even if your arteries do not have signs of heart disease. This could lead to other tests or treatments that you don't need.
  • Not all arteries that have early signs of heart disease have calcium. So you could get a low calcium score and still be at risk.
  • Not all health plans will pay for this test. The cost can range from about $100 to $400.
FAQs

What is a coronary calcium scan?

A coronary calcium scan is a test for people who have no symptoms of heart disease but may be at risk for getting it. The test uses computed tomography (CT) to check for calcium buildup in plaque on the walls of the coronary arteries. The coronary arteries wrap around the heart and supply it with blood and oxygen. Calcium in these arteries is a sign of heart disease.

During the test, a CT scan takes pictures of your heart in thin sections. The result is a score based on the amount of calcium seen on the scan. The higher your calcium score, the higher your risk for a heart attack. The test takes about 30 minutes.

Most health insurance plans don't pay for coronary calcium scanning. The cost can range from about $100 to $400.

CT angiography is a test that uses computed tomography to see if an artery is narrowed or blocked. It's different from a coronary calcium scan and may be best after you already have symptoms of heart disease and other test results are not clear.

Talk with your doctor if you want to know more about CT angiography. This Decision Point is about coronary calcium scanning.

Who should get a coronary calcium scan?

Your doctor may want you to have a coronary calcium scan if it can help you and your doctor make decisions about how to lower your risk for heart disease and heart attack.

This test might be most helpful for people who do not have heart disease but who are at medium risk for heart disease. Your doctor can help you know your risk of heart disease and heart attack. Your doctor will look at things that put you at risk, including blood pressure, cholesterol, diabetes, and your age, sex, and race.

In most cases, the results from your physical exam and other tests will give your doctor enough information about your risk for heart disease.

A coronary calcium scan is not advised for routine screening for coronary artery disease.1 This test might not tell your doctor any more about your risk for heart disease than your risk factors do. Risk factors are things that can increase your risk for heart disease, such as diabetes, high blood pressure, high cholesterol, and smoking.

This screening test is not for you if:

  • You don't have any risk factors for heart disease, so you have a low risk of a heart attack.
  • You are at high risk for heart disease or you were diagnosed with heart disease. (You should already be under a doctor's care.)

This test may not be right for you if you are a man younger than 40 or a woman younger than 50. This is because younger people typically do not have much calcium buildup in their arteries yet.

What do the results mean?

Your test result is a number that is your calcium score. The score can range from 0 to more than 400. The higher your score, the greater your chance of having a heart attack. The score might be helpful if you are unsure whether to take a statin to lower your risk of a heart attack. Your doctor will look at your calcium score as well as your age, your health, and your other test results such as your cholesterol level.2

After you have the test, talk with your doctor about your results.

What are the benefits of a coronary calcium scan?

Many people only learn that they have heart disease when they have a heart attack. A coronary calcium scan is one way to find out if you have early heart disease before it gets worse. After you know your risk, you and your doctor can make decisions about how to lower it. You can make lifestyle changes such as having a heart-healthy eating plan, staying at a healthy weight, getting more exercise, and quitting smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.

A coronary calcium scan can give your doctor more information about your risk for heart disease, especially if you already have risk factors. Then you can make decisions about how to lower your risk. For example, you and your doctor can use your score plus your other risk factors to decide whether cholesterol medicine is right for you.

What are the risks?

  • You could get a high score from the test even if your arteries do not have signs of heart disease. This could lead to extra tests that you don't need. Or it could cause you to worry when there's no reason. But these kinds of results are most likely to happen in people who are at low risk for heart disease. So if you already know that you're at low risk, you shouldn't get this test.
  • Not all arteries that have early signs of heart disease have calcium. A low test score may make you feel safe even though you're still at risk.
  • There is a slight chance of developing cancer from having cardiac calcium scoring. The chance is higher in people who have many radiation tests. If you are concerned about this risk, talk to your doctor about the amount of radiation this test may give you and confirm that the test is needed.

Why might your doctor recommend this test?

  • You are at medium risk for heart disease, based on your risk factors.
  • Your doctor thinks that the results of this test could change your treatment and lower your risk for heart disease.

2. Compare your options

Have a coronary calcium scan Don't have a coronary calcium scan
What is usually involved?
  • You will lie on a table connected to the CT scanner. The table slides into the opening in the machine, and the scanner moves around your body. The test takes about 30 minutes.
  • Instead of having a CT scan, your doctor gets information about your heart disease risk from a physical exam and other tests.
  • You make healthy lifestyle changes or take medicines that can help your heart without taking a test.
What are the benefits?
  • A coronary calcium scan can give your doctor more information about your risk for heart disease, especially if you have several risk factors.
  • The results of the test may prompt you to make lifestyle changes or take medicines that can help your heart.
  • You don't pay for a test you may not need. Most insurers do not pay for this test.
  • You avoid possible unnecessary treatment or worry.
What are the risks and side effects?
  • The test can give a high score even if your arteries do not have signs of heart disease. This might lead to tests or treatment you don't need.
  • Not all arteries that have signs of heart disease have calcium. So you could get a low test score and still be at risk.
  • Most health insurers don't pay for this test.
  • If you are at medium risk for heart disease and don't get a coronary calcium scan, you may not have all the information you need to reduce your risk.

Personal stories

Personal stories about coronary calcium scanning

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My mom had a heart attack in her early 60s, followed by bypass surgery. She didn't have a clue that she had heart disease. I don't want that to happen to me. I already know I have a couple of health issues that raise my risk for heart disease. So I'm going to ask my doctor about getting a coronary calcium scan to check my risk."

— Rose, age 48

"My wife has been bugging me to get this test. So I asked my doctor about it. He said my risk for getting heart disease is pretty low even though I have high blood pressure. I'm taking medicine for that and for high cholesterol. I'm also trying to eat better and exercise. I just don't think the test is going to tell me more about my risk than I already know."

— Jeffrey, age 56

"My doctor says I am at risk for heart disease. She wants me to have a coronary calcium scan so that we can get a better idea of my risk of a heart attack. Then, we can decide whether I should start taking medicine so I can lower my risk. I like the idea of having all the information before I make decisions. So I'm going to have the test."

— Tony, age 53

"I get a physical exam from my doctor every year, and she says I'm in pretty good shape. But ever since I passed 50, I've been worried about heart disease. I saw an ad for this test in the newspaper and asked my doctor about it. It turns out that in healthy people like me, the test results aren't very reliable. I'm going to just keep getting an annual checkup."

— Maria, age 54

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have a coronary calcium scan

Reasons not to have a coronary calcium scan

I need more information about my risk so I can commit to making lifestyle changes or taking medicines.

I already know that I should make some lifestyle changes to keep my heart healthy.

More important
Equally important
More important

It's worth it to me to pay for this test myself.

My insurance won't pay for this test, and I can't afford it.

More important
Equally important
More important

I want to take any tests that could help me find out my risk for heart disease.

I don't want to take tests I don't need.

More important
Equally important
More important

I want to take this test because I need more information about my risk for having a heart attack.

I already know my risk for having a heart attack, so I don't need this test.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having a coronary calcium scan

NOT having a coronary calcium scan

Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. Can anyone who is worried about heart disease benefit from a coronary calcium scan?

  • Yes
  • No
  • I'm not sure
You're right. People who are at medium risk for heart disease will get the most benefit from this test. If you are at low risk, the test results may not be reliable. If you are at high risk, you should already be under a doctor's care.

2. Does a high score on a coronary calcium scan always mean you have heart disease?

  • Yes
  • No
  • I'm not sure
That's right. You could get a high score on the test even if your arteries do not have signs of heart disease. That could lead to other tests or treatments you don't need.

3. Could you still be at risk for heart disease even if you get a low calcium score on the test?

  • Yes
  • No
  • I'm not sure
That's right. Not all arteries that have early signs of heart disease have calcium. So you could get a low score on the test and still be at risk.

4. Is having a coronary calcium scan the only way to tell if you need to make lifestyle changes to help your heart, such as exercising, eating better, and not smoking?

  • Yes
  • No
  • I'm not sure
You are right. Even without taking the test, you can make healthy lifestyle changes that can help your heart.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.
Credits
By Healthwise Staff
Clinical Review Board Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
References
Citations
  1. U.S. Preventive Services Task Force (2009). Using nontraditional risk factors in coronary heart disease risk assessment. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscoronaryhd.htm.
  2. Grundy SM, et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology, published online November 8, 2018: S0735. DOI: 10.1016/j.jacc.2018.11.003. Accessed January 28, 2019.
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