Coronary Artery Calcium Scans: When are they useful ?
One test that I find particularly useful in the appropriate patient is the coronary calcium scan. This is a CT scan that takes only minutes.There is no contrast involved nor any intravenous lines. This scan literally detects the presence or absence of calcium within the 3 main coronary arteries. You end up with a total calcium score. The perfect score is zero. (probably the only time in your lifetime you would be content with a zero score)! The higher the score, the greater degree of calcium in the coronaries . Besides learning the calcium burden, an individual's results are compared to a large database of several thousand patients. So you actually learn where you fare with individuals matched by your age and gender.
How do I use this test? As an integrative cardiologist, I'm simply not interested in treating everyone who walks in my door with an elevated cholesterol level with statins. I prefer to stratify my patients according to their risk. A high calcium score would bend me in the direction of more aggressive risk factor. modification.This always begins with lifestyle changes. It always boils down to diet and exercise.For me, it's all about treating those patients who need it the most!
One caveat : A zero score doesn't mean you are totally off the hook! Keep in mind that this test only measures the calcium within plaque. Plaque actually starts off as an inflammatory reaction involving smooth muscle cells and cholesterol esters. This inflammatory complex subsequently takes up calcium which is what this test detects.