Coronary artery disease is the number one cause of death in the developed world. Needless to say, newer testing focusing on both diagnostic and preventative measures to improve coronary health and screening have become quite widespread. The use of the CT scan (ultrafast CT) to detect coronary artery calcification is one of the most popular of these evolving tests.

Most people, as they age, have one or more cardiac risk factors. These include high cholesterol, high triglycerides, low HDL cholesterol fraction, hypertension, smoking history, diabetes or obesity. A family history of heart disease, women post-menopause, a sedentary lifestyle and high stress levels may also predispose to cardiac disease.

Coronary artery calcium, picked up on a CT scan as an obstruction of a coronary artery, is actually in the form of calcium phosphate, a material resembling actual bone. As the arteries accumulate atherosclerotic plaque, calcium is deposited and actively remodeled just like bone. The amount of calcium is directly related to the amount of atherosclerotic plaque within the vessel, and gives a good approximation of future risk of closure when detected with a CT scan.

Scans are not foolproof, however, and as a result are not the standard of care to screen the general population. A positive scan does, in most cases, confirm the presence of coronary atherosclerotic plaque. The greater the degree of calcification, the greater the chance of obstructive disease. A negative scan does not absolutely rule out the presence of atherosclerotic plaque. One thing the test cannot determine is a significant cause of heart attack and cardiac arrhythmia with what is called unstable plaque- when a non-obstructive piece of plaque breaks off and obstructs a smaller vessel when carried through the blood stream.

Coronary arteriography is still the gold standard to diagnose the presence of coronary artery disease, but CT scanning is becoming an important adjunct in some people for cardiac care and diagnosis.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.