Health & Wellness |Ask your healthcare provider if a CT calcium screen is right for you

by Tim Ditman
OSF Healthcare

Ash Al-Dadah, MD

URBANA - Here’s something new to bring up the next time you visit your health care provider: Should I undergo a CT calcium score screen to take stock of my heart health? It’s not for everybody, but it could mean the difference between a long, healthy life and finding yourself on an operating table.

“The number one killer in the United States is heart disease,” says Ash Al-Dadah, MD, an interventional cardiologist at OSF HealthCare. “We have to do a better job.

“This calcium scoring is a screening where we may say ‘Hey, you need to exercise more’ or ‘Hey, we just found out you have high blood pressure. Let’s control that.’ or ‘Hey, you’re a smoker. Maybe you need to quit that,’” he adds. “We go after the risk factors that precipitate and lead to heart disease. It’s a wake-up call. Getting ahead of things so you’re not coming in with a heart attack and damage to the heart muscle. At that point, it’s too late.”

The screening

Dr. Al-Dadah says the 15-minute or so, non-invasive procedure is similar to other CT [computed tomography] scans. “A fancy X-ray,” he calls it. You lie down, and a doughnut-looking device surrounds you and takes pictures of your heart.

“The arteries in our heart are supposed to be flesh and appear gray [on the imaging]. As we roll the body through the scan, we want to see all gray,” Dr. Al-Dadah explains. “But if there’s hardening and plaque formation in the arteries, it will light up as white. That’s because plaque as it ages forms calcification. There are calcium deposits.”

You could be told you’re at low, medium or high risk. Or, providers may look at the results based on your age compared to the typical amount of plaque found in a person of that age.

Put simply: “It’s one way to measure risk for heart disease,” Dr. Al-Dadah says. “The most common heart disease is blocked arteries, leading to a risk for heart attacks and other issues.”Cardiologists and radiologists have a scoring system based on how much plaque is found.

Next steps

Dr. Al-Dadah says if your screen comes back with red flags, you’ll want to see a cardiologist to discuss next steps. That could mean more tests, especially if you have daily symptoms like chest pain or shortness of breath:

• A stress test, where you walk and run on a treadmill while providers see how your heart functions.
• A coronary angiogram, which provides more comprehensive images of your arteries.
• Or, a provider could recommend you get another CT calcium screen in a few years.

Plaque in heart

Other treatment options for milder cases: “Even if your cholesterol level is normal, I could still put you on a medication class called statins. Statins reduce plaque thickness. They stabilize the plaque and reduce the risk for heart attack,” Dr. Al-Dadah outlines.

“I could put you on aspirin. Aspirin will dramatically reduce the risk for a heart attack if you have significant plaque,” he adds.

One other outcome of note: Though rare, Dr. Al-Dadah says your CT calcium screen could come back OK, but you could still have a heart issue soon after. No screening is a silver bullet to keep you 100% healthy, in other words. That’s why it’s important to follow your provider’s recommendations and practice healthy habits, like eating a balanced diet, exercising and ditching the cigarettes.

For me?

Who is this screening intended for? Dr. Al-Dadah says it’s often done on people aged 40 to 65 or people with a family history of heart disease. But, anyone can and should ask their provider about it.

“If you’re 75 and have diabetes,” for example, Dr. Al-Dadah says. “You’re going to have a lot of calcification in the arteries. But it does not signify blockages. It’s just hardening of the arteries that comes with age. But if you’re younger and have that calcification, that’s a marker for risk of heart disease and heart attack.”

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