How a CT heart scan works? What does the Agatston score mean?
A calcium-score heart scan, or coronary calcium scan, is a screening test used to detect and measure calcium deposits in coronary arteries that nourish the heart. The goal is to assess the risk of future heart attacks.
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Coronary circulation is of utmost importance as it is required for normal function of the heart, which supplies blood to the entire body. A blocked coronary artery may cause life-threatening myocardial infarction, or heart attack. The most common cause of blockage is the buildup of plaques on the wall of blood vessels, in a condition known as coronary artery disease. Because calcium is one of the components of plaques, the amount of calcium present in coronary arteries is a measure of plaque deposits.
The purpose of calcium scoring is to determine if plaques are present and if so, to what extent, in people with no symptoms. Physicians may recommend the test for high-risk patients, such as those with diabetes, high cholesterol, high blood pressure, family history of heart attacks, those who smoke, or are overweight or physically inactive. For people who have already been diagnosed with coronary artery disease, the test has limited usefulness.
Calcium-score scans use a specialized X-ray technology, called computed tomography, commonly known as CT or CAT scan, to produce multiple images of the heart. A computer program is then used to calculate the total amount of calcium deposits.
During the test, the patient lies flat on a table, which moves inside a circular scanner. The patient’s electrocardiogram, ECG, is recorded at the same time to ensure that images are taken when heart muscles are relaxed.
The entire procedure takes about 10 to 15 minutes.
The result is given as a number called a calcium score, or Agatston score. A score of zero, or negative result, means no calcium is present in the heart. It suggests a low chance of having a heart attack in the future. When calcium is present, the higher the score, the higher the risk of heart diseases.
The results may help provide guidelines for treatment plans, as well as lifestyle changes.
CT scanning is a reliable non-invasive test, but there are risks and limitations. The test involves radiation, and is not generally recommended for pregnant women. The exposure from the procedure is between 1 to 2 mSv, about the same as the average amount of radiation a person is naturally exposed to in a year. Calcium scoring test cannot detect "soft plaques" that do not contain calcium. The results should be considered in combination with other risk factors while evaluating future risk for heart disease.