• What is your calcium score?

  • This is not an article about whether you're getting enough calcium in your diet. Rather, this is about having too much calcium in a vital system that could predict your future risk for cardiovascular disease.

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  • This is not an article about whether you're getting enough calcium in your diet. Rather, this is about having too much calcium in a vital system that could predict your future risk for cardiovascular disease.
    Normally, the arteries of the heart (coronary arteries) do not contain calcium. The presence of calcium in the coronary arteries is an indication of an increased risk for coronary artery disease. Many of us are familiar with traditional risk factors for heart disease, such as:
    • Smoking
    • Family history
    • High blood pressure
    • High cholesterol
    • Diabetes
    Heart attacks are caused due to the rupture of "plaques" which develop in the walls of arteries supplying blood to your heart. Calcium gets deposited in theses plaques within the walls of the arteries. Therefore, presence of calcium is considered to be an indirect marker of an increased risk of having a heart attack.
    Coronary calcium scans use a special X-ray test called computed tomography (CT Scan) to check for calcium buildup in the coronary arteries. This test is used to provide an early forecast of the potential for heart disease and to determine how severe it is. Coronary calcium scans are also called cardiac calcium scoring or cardioscan.
    What does the scoring mean? In one study, investigators found that the risk of heart attack increases proportionally to the calcium score. With a score of:
    0 - Low risk (Risk is indeed very low)
    1-100 - Average risk (Risk is twice the low risk category)
    100 - 400 - Moderate risk (Risk is four times the low risk category)
    400 - 1,000 - High risk (Risk is 10 times the low risk category)
    1,000 and above - Very high risk.
    A CT coronary calcium scan is usually done by a radiology technologist and takes about 30 minutes. A series of pictures, or images, of the heart in thin sections are then recorded in a computer and can be saved or printed out as photographs. The results are typically reviewed by a radiologist and other physicians. Radiation exposure with this scan can be equivalent to 15-20 chest X-rays.
    Should everyone have this test?
    This screening test is not for you if you have no risk factors for heart disease. In fact, the American Heart Association and the American College of Cardiology don't recommend routine heart scans for those who are asymptomatic (don't have symptoms) of heart disease and who don't smoke or have traditional cardiac risk factors, such as elevated cholesterol or high blood pressure or a family history.
    Nor is it recommended if you already have or at very high risk for heart disease, in which case you should already be on risk reduction measures under a doctor’s care.
    Page 2 of 2 - Calcium scoring is most helpful for people who have asymptomatic, but who are also at medium risk for heart disease. Your doctor can use a number of available calculators to estimate this risk of heart attack over the next 10 years. Medium risk means that you have a 10 to 20 percent chance of having a heart attack in the next 10 years, based on your risk factors. This means that 10 to 20 out of 100 people with this level of risk will likely have a heart attack in the next 10 years.
    Until recently, calcium scoring procedures have been somewhat expensive and not all insurance companies cover them. At St. Mary's Medical Center, we consider this to be among the best ways we can help our patients in the fight against heart disease and will be offering calcium scoring testing for just $50. You'll need to consult with your doctor to see if you are a good candidate for this testing.
    Bear in mind that there's no crystal ball for predicting who will a have a heart attack, but calcium scoring is currently among the best ways of foreseeing the likelihood of it happening to you--along with other variables taken into consideration. If you smoke, for instance, a low calcium score does not mean you are not at risk. On the contrary, some with a moderately high calcium score could avoid or prevent a heart attack by simply taking charge of controllable risk factors. Even those with high scores can reduce their chances of cardiovascular issues within months, through an aggressive prevention program coordinated by their doctors.
    Dr. Bapat is a Cardiologist and Specialist in Cardiovascular Imaging at St. Mary's Medical Center Heart Institute. He can be reached at 816-220-1117.

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