Heart Disease and the Heart CT Scan

EBCT, also called calcium-score screening heart scan, is a test used to detect calcium deposits found in atherosclerotic plaque in the coronary arteries of heart disease patients. State-of-the-art computerized tomography (CT) methods, such as this one, are the most effective way to detect coronary calcification from atherosclerosis, before symptoms develop. More coronary calcium means more coronary atherosclerosis, suggesting a greater likelihood of significant narrowing somewhere in the coronary system and a higher risk of future cardiovascular problems.

Your doctor uses the calcium-score screening heart scan to evaluate risk for future coronary artery disease.

Because there are certain forms of coronary disease, such as "soft plaque" atherosclerosis, that escape detection during this CT scan, it is important to remember that this test is not absolute in predicting your risk for a life-threatening event, such as a heart attack.

Your doctor may also order a coronary CT angiogram (CTA) to look directly at the arteries of the heart. With the CTA, pictures of your coronary arteries are made. This is regularly performed in addition to a heart CT scan now.

You may continue to take any medications but should avoid caffeine and smoking for four hours before the test. CT scanners use X-rays. For your safety, the amount of radiation exposure is kept to a minimum. But, because X-rays can harm a developing fetus, this procedure is not recommended if you are pregnant. Tell your technologist and your doctor if you are:

• Pregnant.
• Undergoing radiation therapy.

During the CT scan of your heart:

• You will change into a hospital gown. The nurse will record your height, weight, and blood pressure. He or she may draw your blood for a lipid analysis.
• You will lie on a special scanning table.
• The technologist will clean three small areas of your chest and place small, sticky electrode patches on these areas. Men may expect to have their chest partially shaved to help the electrodes stick. The electrodes are attached to an electrocardiograph (ECG) monitor, which charts your heart's electrical activity during the test.
• You may also be given an injection of a contrast material to help the CT scanner directly visualize your coronary arteries.
• During the scan, you will feel the table move inside a donut-shaped scanner. The high-speed CT scan captures multiple images, synchronized with your heartbeat.
• A sophisticated computer program, guided by the cardiovascular radiologist, analyzes the images for presence of calcification within the coronary arteries. Absence of calcium is considered a "negative" exam. But, it does not exclude the presence of "soft" noncalcified plaque. If calcium is present, the computer will create a calcium "score" that estimates the extent of coronary artery disease.
• The calcium-score screening heart scan takes only a few minutes.

You may continue all normal activities and eat as usual after the heart CT scan.

The results of the scan will be reviewed. The following information will be obtained:

• The number and density of calcified coronary plaques in the coronary arteries.
• Calcium score.

Your heart CT scan results will be examined and reviewed by a team of cardiovascular specialists, including a cardiovascular radiologist and a preventive cardiologist. The team will evaluate the calcium score and/or your CT angiogram, along with other risk factor measurements (risk factor evaluation, blood pressure, lipid analysis), to determine your risk for future coronary artery disease and will make recommendations regarding your lifestyle, medications, or additional cardiac testing.

You and your primary care doctor will receive the full report outlining your risk assessment and follow-up recommendations. Ask your doctor if you have any questions about the calcium-score screening heart scan.

Because this CT scan is a screening examination, it is not currently covered under most insurance companies and Medicare. Therefore, you will likely be responsible for all involved costs at the time of the exam. The examination cost is about $350.00 and includes all lab, technical, medical and professional interpretation charges.

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