Coronary Artery Calcium (CAC) Test


June 11, 2023


CAC Test

Editor’s Note: For a family caregiver, the health of the person they care for is a primary factor in the amount and type of help that they need. You may also be at risk for developing health problems due to family history, stress, and other factors. Often, health conditions are not as obvious as others. One test, the Coronary Artery Calcium (CAC) Test, which is still somewhat new and usually not paid for by health insurance, can identify plaque build-up in the coronary arteries. The earlier this can be identified, the higher the success of treatment for a lowered risk of heart attack and stroke.

Knowing nothing about this test, a friend’s new doctor recommended it. Two of the three people she told about the test had a high CAC score. Based on the results of his CAC, an otherwise healthy 66-year-old man required the placement of a stent into his left anterior descending artery (LAD). Without this test, her husband was at high risk for stroke and heart attack.  

A massive heart attack caused by severe blockage in the LAD is known as “the widow-maker”  which occurs when the LAD is totally or almost completely blocked. The critical blockage in the artery usually forms a blood clot and stops all the blood flow to the left side of the heart, causing the heart to stop beating normally.

The other friend, also with a high score on the CAC, is still being tested to determine the best intervention. Treatment options span the range from medication and lifestyle changes to the surgical intervention of a bypass.

Before taking a CAC or other medical test, talk with your physician about what might be best for you.

What is a CAC Test?

A Coronary Artery Calcium, CAC test, also called a heart scan, is a CT scan of your heart done with a multi-detector CT (MDCT) that takes detailed images of the arteries that supply blood to the heart muscle. The images show calcium deposits you may have in your coronary arteries. Higher amounts of calcium are associated with more severe disease in the heart arteries.

coronary arteries

See an illustration of coronary arteries

Why do people have the CAC test done?

A CAC test can measure the amount of calcium in your heart arteries (“calcium score”). Your calcium score gives your healthcare team an idea of how much plaque is in your heart arteries and may help predict your risk of a future heart attack. Your CAC score can help you determine your risk of cardiovascular disease. It’s particularly helpful if you’re at “intermediate” risk.

CAC testing is useful for making treatment decisions, such as whether to start low-dose aspirin, statin therapy, or other medications. These are some groups where it may be useful:

  • People reluctant to begin statin therapy and who want to understand their risk and potential benefit more precisely.
  • People concerned about restarting statin therapy after stopping treatment because of side effects.
  • Men ages 55 to 80 or women 60 to 80 with few risk factors who question whether they would benefit from statin therapy.
  • People ages 40 to 55 with an estimated 10-year risk for developing heart disease between 5% and 7.5%, and risk factors that increase their chances of heart disease.

Calcium scoring isn’t recommended for routine screening of people who don’t have symptoms of heart disease and have a low risk of heart attacks unless they have a strong family history of premature coronary heart disease. If you’ve already had a heart attackcoronary bypass surgery (PDF) or a coronary stent calcium scoring won’t provide additional information.

What are the risks of the CAC scan?

The scan exposes you to the same amount of radiation exposure as a mammogram. Repeated exposure can have negative health effects, such as increased cancer risk. Talk with your health care team about safety and risks for any test you’re undergoing.

How do I prepare for the scan?

Since no dye is used for this scan, no special preparation is needed.

What happens during the test?

Technicians perform the CAC scan in hospitals or special outpatient clinics.

  • Electrodes will be attached to the chest to monitor ECG (measures the electrical activity of the heartbeat). The ECG also helps the computer connected to the MDCT scanner create clear pictures of the heart.
  • The table slowly moves inside the machine. The scanner arches around the patient, but doesn’t touch the patient.
  • The technician will watch closely through a window. He can talk to the patient through a two-way intercom.
  • The technician will ask the patient to hold their breath for short periods.
  • CT scanning takes about 10-15 minutes.

Are CAC scans covered by insurance?

The test isn’t always covered by insurance and can range in cost from $100 to $400.

What happens after the CAC scan?

After the healthcare team gets the test results, make an appointment to discuss the results and the next steps for you or the person you care for.

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