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Computed Tomography (CT) - Cardiac Calcium Scoring

Last updated Nov. 4, 2018

Tim Samoff

The Cardiac Computed Tomography (CT) scan for Calcium Scoring is a radiology procedure that gives information about the presence and location of plaques (due to fat build-up).


Background Information: 

What are the other Names for the Procedure?

  • Cardiac CT for Calcium Scoring
  • Coronary Artery Calcium Scoring
  • X-ray Computed Tomography - Cardiac Calcium Scoring 

What is Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

  • CT (Computed Tomography) scanning, also referred to as a CAT scan, is a noninvasive test used to diagnose and treat medical conditions, by combining a special x-ray machine with computers, to produce images of the body insides
  • Coronary arteries supply oxygenated blood to the heart. These arteries may get blocked by the build-up of fat. When fat calcifies in the artery (a condition termed atherosclerosis), it leads to coronary artery disease (CAD). Due to blockage of coronary arteries, the blood flow to the heart gets obstructed resulting in a heart attack or chest pain, called angina
  • The presence of calcium in the coronary artery indicates coronary artery disease. The amount of calcium present is used to predict the prognosis of CAD; greater the calcium level, poorer is the prognosis
  • ‘Computed Tomography - Cardiac Calcium Scoring’ of coronary artery gives information about the presence and location of plaques (due to fat build-up). Calcium score is given from the CT scan results

What part of the Body does the Procedure involve?

The Cardiac CT for Calcium Scoring procedure involves the heart, arterial and venous vessels, serving the heart. The CT scan procedure involves the chest area.

Why is the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure Performed?

  • A CT - Cardiac Calcium Scoring procedure is used to determine, if there is any presence of coronary artery disease (CAD); even if a patient does not show any symptoms
  • This scan is recommended for patients with certain risk factors for CAD, such as cigarette smoking, physical inactivity, obesity, diabetes, high blood pressure, and high cholesterol 

What is the Equipment used? (Description of Equipment)

The equipment for a CT - Cardiac Calcium Scoring consists of:

  • A CT scanner that appears like a big box with a hole inside
  • The examination table on which the patient lies down; the table slides into the hole during the procedure
  • X-ray tube and electronic x-ray detectors that rotates around the patient
  • Images are taken from a computer

A transducer (part of the scanner) is used to send high frequency sound waves in the body and the computer creates the images, based on the echoes of that sound returning from the patient’s body.

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the CT scan procedure.

What is the Cost of performing the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

The cost of a CT- Cardiac Calcium Scoring procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding Cardiac CT for Calcium Scoring procedure and what needs to be done.
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician.
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently.

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=ct_calscoring (accessed on 08/30/2014)

Prior to Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure:

How does the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

  • A CT scan is very similar to taking an x-ray. In an x-ray, radiation passes through the body and an image is recorded on photographic film. The bones appear white, air appears black, and soft tissues appear as gray patches
  • In the CT scan, electronic x-ray detectors and x-ray beams rotate (around the patient) and measure the amount of radiation absorbed
  • The x-ray beam in a CT scan follows a spiral path, as the examination table is moving through the scanner
  • A two-dimensional, cross sectional image of the body is created by a computer program, by utilizing all the data generated by the scanner. The CT scan produces a very detailed multidimensional view of the body’s interior regions
  • The CT scan produces images of the chest, in a way as can be compared to looking at a loaf of bread, by cutting the loaf into thin slices
  • With an advanced detector technology, current CT scanners can obtain multiple slices in just one rotation. Such types of CT scanners are called “multislice CT” or “multidetector CT”
  • Advanced CT scanners can scan large sections of body in a very short time (like a few seconds). They can be adjusted to reduce the radiation dose too

How is the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure Performed?

  • For a Computed Tomography - Cardiac Calcium Scoring scan, the patient is asked to lay flat on their back, side, or stomach, during the examination
  • As any motion may affect the quality of examination, the patients are asked to stay still on the table; children may be given a sedation, to keep them still
  • An ECG machine is attached and electrodes are placed on the chest, to record the heart’s activity. The CT scan views the heart, when it is not contracting
  • The patient is moved rapidly through the scanner.

Where is the Procedure Performed?

The Cardiac CT for Calcium Scoring is generally performed as an outpatient procedure, at a hospital. 

Who Performs the Procedure?

A Cardiac CT for Calcium Scoring is usually performed by a radiology technologist, under the supervision of a radiologist.

How long will the Procedure take?

The Cardiac CT for Calcium Scoring procedure will take about 30-60 minutes.

Who interprets the Result?

A radiologist interprets the results of the Computed Tomography - Cardiac Calcium Scoring and informs the primary care physician, who then conveys the information to the patient.

  • If the scan is positive, it indicates the presence of coronary artery disease (CAD), whether or not the patient is having any symptoms
  • Calcium score indicating the amount of calcium present in coronary arteries, helps determine the likelihood of having a heart attack (myocardial infraction) in the future
  • Based on calcium score, the physician may recommend preventive medicine or only diet-modification and exercise, to prevent a heart attack (in future)
    • A calcium score of 0 indicates absence of coronary artery disease
    • A calcium score of 1-10 indicates minimal presence of coronary artery disease
    • A calcium score of 11-100 indicates mild presence of coronary artery disease
    • A calcium score of 101-400 indicates moderate presence of coronary artery disease
    • A calcium score over 400 indicates extensive presence of coronary artery disease
  • Patients may need follow-up examinations, to see if the treatment is working/responding positively

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a CT- Cardiac Calcium Scoring procedure:

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
  • Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
  • Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, which may be used in the procedure
  • Patients are asked to avoid caffeine consumption and smoking 4 hours before the exam. They may continue their medications before the scan
  • It is advisable to wear comfortable and loose clothes. Avoid wearing any jewelry, glasses, hairpins, dental work, or any other metal objects, as it may interfere with the quality of the scan
  • It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding

What is the Consent Process before the Procedure?

A physician will request your consent for a CT- Cardiac Calcium Scoring procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the CT- Cardiac Calcium Scoring procedure:

  • A CT scan is a painless, noninvasive procedure; it does not have any side effects
  • It can take images of the soft tissues, bones, and blood vessels, at the same time
  • A CT scan may be used, even if the patient has an implanted medical device
  • CT scanning is a very accurate modality, hence it eliminates the need of having other diagnostic procedures
  • It is also very useful in emergencies, helping to quickly identify any internal injuries and bleeding
  • Unlike MRI, it is less movement-sensitive (the patients are generally asked to remain very still, while the test is under progress, for both a CT scan and an MRI scan as well)
  • A CT scan produces real-time imaging. It can be used for guiding needle biopsies and needle aspirations
  • This procedure is very fast and accurate. Thus, it can be used to diagnose pain caused by infections and inflammations

Following are the risks of the CT- Cardiac Calcium Scoring procedure:

  • Over-exposure to radiation in a CT scan procedure may cause cancer. But, generally the chances of developing cancer is very remote
  • The CT scan procedure is not recommended for pregnant women
  • It is recommended for mothers to breastfeed their children (at least) 24 hours after the contrast material is injected, for CT scanning
  • There is a rare chance of developing an allergic reaction, due to the contrast material containing iodine used in the CT scan
  • CT scanning is recommended for children, only if it is absolutely necessary, as children are very sensitive to radiation

What are the Limitations of Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

Following are the limitations of the CT- Cardiac Calcium Scoring procedure:

  • In patients under the age of 50 years, plaques in coronary artery can be without calcium and they cannot be detected using this procedure
  • If the patient’s heart rate is higher than 90 beats per minute, a CT scan cannot be performed. A high heart rate interferes with the scanning
  • Cardiac Scan for Calcium Scoring is not covered by all health insurance plans
  • In some cases, obese or large patients may have a difficulty in bodily fitting into the CT scanner

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is the CT- Cardiac Calcium Scoring procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure:

What is to be expected during the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

The following may be expected during a CT- Cardiac Calcium Scoring procedure:

  • There is no pain involved in this procedure, unless a contrast material is injected into the body
  • There might be some noise of the device, as involved with any regular machine function
  • The individual may experience some anxiety, due to the noise of the machine, or from staying still for a long time; but, no scan associated pain may be felt

What kind of Anesthesia is given, during the Procedure?

No anesthesia is administered during the CT- Cardiac Calcium Scoring procedure.

How much Blood will you lose, during the Procedure?

There is no blood loss involved during a CT- Cardiac Calcium Scoring procedure.

What are the possible Risks and Complications during the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

  • Over-exposure to radiation in a Cardiac CT for Calcium Scoring procedure may cause cancer; however, such a risk is very low
  • The CT scan procedure is not recommended for pregnant women
  • Mothers are advised to breastfeed their children, only 24 hours after the contrast material for CT scanning is injected
  • There is a rare chance of developing an allergic reaction, due to the contrast material containing iodine used in the CT scan
  • CT scanning is recommended for children, only if it is absolutely necessary, as children are very radiation-sensitive

What Post-Operative Care is needed at the Healthcare Facility after the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

There is no post-operative care necessary after a Cardiac CT for Calcium Scoring procedure, at the healthcare facility.

After the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure:

What is to be expected after the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

Generally, no complications or side effects are observed, after the Cardiac CT for Calcium Scoring procedure.

When do you need to call your Physician?

If the patient is experiencing an allergic reaction from the contrast reaction; then, do contact the physician. 

What Post-Operative Care is needed at Home after the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

There is no post-operative care necessary after a CT- Cardiac Calcium Scoring, at home.

How long does it normally take to fully recover, from the Procedure?

The patient needs no recovery time after the CT- Cardiac Calcium Scoring procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue is extracted from the patient during a CT- Cardiac Calcium Scoring procedure. 

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Cardiac Computed Tomography (CT) scan for Calcium Scoring radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • A radiologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Computed Tomography - Cardiac Calcium Scoring procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 2, 2014
Last updated: Nov. 4, 2018