Coronary Calcium Scoring
Coronary heart disease (atherosclerosis) is the nation’s leading killer, and is responsible for more deaths than all types of cancer combined. Every year, more than one million Americans will suffer a heart attack. More than 50% of the patients suffering their first heart attack this year will have no prior symptoms before their first coronary event or death. Coronary heart disease is caused by the accumulation of “plaque” within the arteries of the heart, and was previously called “hardening of the arteries”. Coronary calcium scoring (CCS) is a proven, non-invasive method that can directly identify plaque buildup in the coronary (heart) arteries. This test has been performed on tens of thousands of patients in the United States. More than 100 scientific articles proving the validity of this test have been published since 1998. In 2006, an international panel of leading cardiologists endorsed this technique, arguing that virtually everyone between the ages of 45–75 should be screened with the test. Such screening of the population could save 90,000 lives per year. Yet, despite the growing acceptance of calcium scoring’s value, many doctors remain uncertain when and how to use this test effectively. Some of the most commonly asked questions about this procedure include:
I have been scheduled for coronary artery calcium scoring. What do I need to know? What should I expect during my exam? Refrain from caffeine for 24 hours before your exam. This will help maintain a slow steady heart rate, improving the quality of your examination. Typically, no medications and no IVs are needed for this examination. You will lie on your back in the scanner. X-rays of your heart will be made during a single breath hold. The examination should be completed within 5–10 minutes. Your examination will then be quality controlled for accuracy by a board certified radiologist, and your score calculated by computer analysis. The result will be sent directly to your physician within hours of your exam completion.
Q: Does calcium scoring predict a patient’s risk of heart attack or death?
A: YES Calcium scoring predicts a patient’s risk of heart attack or death over five years with higher sensitivity than stress testing or any other known risk factors. In fact, an individual with a calcium score in the highest quartile for age (greater than 75th% rank) is more than 6 (six) times likely to have a heart attack than a patient with no coronary calcium. The risk of death in an individual with a calcium score greater than 1000 is more than 12 times higher than that of an individual with a calcium score less than 10.
Q: Does calcium scoring predict the presence of high-grade blockages in coronary arteries?
A: YES Asymptomatic patients with a calcium score of less than 100 will only rarely have an abnormal stress test (fewer than 5%). If the calcium score is 0, the probability that an asymptomatic person has a significant blockage is less than 1% (one percent). Conversely, patients with a calcium score of more than 400 can be expected to have a positive stress test in up to 40% of the cases.
Q: Who should be considered for this test?
A: Calcium scoring has been shown to be useful in patients with low, intermediate, and high risk for heart attack by other risk assessment methods (most commonly used = Framingham Criteria). Calcium scoring has also been shown to be accurate in men and women in all age groups. We believe that calcium scoring is particularly useful in patients who are at intermediate risk for coronary disease, and who are either being considered for or have begun lipid lowering drug therapy.
Q: Is this test covered by insurance?
A: We have found that some insurance carriers will pay for this study, but we require full payment for this exam at time of service. If your insurance carrier considers this a covered service, we will file a claim for you. Any overpayment will be refunded to the patient. After obtaining a referral from your physician you can call WakeRad Scheduling at 919-232-4700 to schedule your Cardiac Calcium Scoring appointment at any of these Wake Radiology offices: Cary, North Hills and Wake Forest.
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