Heart disease remains the leading cause of death in the United States and Black, Hispanic, Native American , Asian communities continue to have a disproportionate share of that burden. Checking blood pressure and cholesterol are popular ways to measure heart health, but there is another tool that can help us understand it early on before symptoms appear. It is called a coronary artery calcium (CAC) scan, or a calcium score test.
A CAC scan is a specialized CT scan that looks for calcium buildup (also known as plaque) in the arteries which supplies blood to your heart. Plaque does not form overnight. Instead, it builds slowly and often without warning signs. CAC scans can be so impactful due to it revealing early coronary artery disease (CAD) before it is too late.
Understanding a CAC scan
The test itself takes between 10-15 minutes. The patient lies on a table, and medical electrodes are placed on the chest to track the heartbeat. The CT machine then captures images of the heart. If the patient is anxious or nervous, they may be prescribed medicine to slow their heart rate down. This is a noninvasive test, so there is no contrast dye, needles, or recovery time.
The result of the test includes a calcium score. This is a number ranging from zero to over 1,000.
- A score of zero means no detectable plaque and a very low short‑term risk of heart attack.
- Scores between 1 and 100 suggest mild plaque.
- 100 to 400 indicates moderate plaque and higher risk for CAD
- Above 400 signals significant plaque and a strong likelihood of CAD.
A normal calcium test scan would have a negative result. This means your score was a 0, and the scan did not find any calcification in your heart’s arteries.
A provider uses this score alongside other risk factors (like cholesterol, blood pressure, diabetes, inactive lifestyle, smoking history, and family history) to determine a patient’s true risk and if they might benefit from preventive steps such as taking statins, adopting diet changes, or more frequent monitoring.
Who Should Consider a CAC Scan?
Most experts recommend CAC scans for adults ages 40 to 75 who have an uncertain or intermediate risk of heart disease. It is especially useful if you have a strong family history of early heart disease.
It is not recommended for people who:
- Do not have a risk of heart disease
- Already have heart disease
- Want to check if their medication for heart disease is working
- Have had a heart attack
- Have had a heart stent
- Have had coronary artery bypass graft surgery
If you have had a heart stent or coronary artery bypass graft surgery, it is not recommended because other tests or procedures that are done for that will show the heart arteries.
It is not recommended that women who are pregnant, or think they may be pregnant, take a CAC test because it can harm the fetus.
What is the Cost?
Most insurance plans, including Medicare, do not cover CAC scans. This is because it is considered a prescreening or preventative care, which means that means people typically pay out of pocket. The price ranges from $100 to $400, but the national average is closer to $100 to $150.
For many families, even $100 can be a barrier, and that barrier falls hardest on the communities already at a higher risk for heart disease. Some imaging centers offer flat-rate pricing for self-pay patients and during American Heart Month in February, many hospitals provide discounted scans. Even with this assistance, the lack of insurance coverage remains a structural issue that limits access to this type of preventive care. Click here to learn more about CAC cost.
Knowledge is power, and when it comes to heart disease, early knowledge can save lives. CAC scanning can provide one more way to protect our hearts, families, and futures.
Sources
American Heart Month in February | NIH
Calcium Score Test | My Cleveland Clinic
Coronary calcium scan | Mayo Clinic
Coronary Artery Calcium Scan Cost and Savings Tips | GoodRx