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Cardiac Imaging Services
Loma Linda University Professional Plaza
Coronary Calcium Scoring

What's Your Coronary Calcium Score?
A screening modality for detecting heart disease.

Facts about heart disease:

Source: American Heart Association

  • 58 million Americans have one or more forms of cardiovascular disease.
  • Heart disease is the number one killer of men and women in the United States, more than all other diseases combined, including cancer
  • 1.5 million Americans have heart attacks each year, 1/3 of which are fatal
  • At least 250,000 people a year die of a heart attack within one hour of the onset of symptoms and before they reach a hospital.
  • Most people who suffer heart attacks have only average or slightly elevated cholesterol levels. In people with cholesterol levels as low as 180, heart attack is still the leading cause of death.
  • San Bernardino County has the highest ischemic heart disease rate in the state of California
  • 12 million people alive today have a history of heart attack, chest pain or both.

What are some risk factors for heart disease?

  • Age (men 40 or older, women 50 or older)
  • Family history of heart disease
  • High cholesterol levels
  • History of smoking
  • High blood pressure
  • High stress levels
  • Sedentary lifestyle and obesity
  • Diabetes

What causes heart disease?

CT Scan

The primary cause of heart disease is the build-up of plaque (atherosclerosis) in the arteries of the heart. This build-up, which consists of a combination of fatty material, fibrous material and calcified plaque, can cause the arteries to narrow. Plaque can also break away from the artery walls and cause a blockage. In both instances the heart muscle does not receive enough blood flow and oxygen - thus a heart attack can occur.

Image: CT scan reveals moderate calcification (plaque build-up) in the left coronary artery.

What is coronary calcium scoring?

Coronary calcium scoring is a pain-free, non-invasive and inexpensive procedure requiring less than 10 minutes. Using CT imaging with sub-second scanning capability, the equipment takes 70-90 images of your heart and coronary arteries without any injections, needles or removal of your clothing. The amount of calcified plaque detected in your coronary arteries is used to establish your coronary calcium score.

What does the procedure involve?

3-D heart imageThe scan itself takes about 10 minutes but you should plan on being there for 45-60 minutes, accounting for registration time, patient evaluation and instructions. First, you complete a brief risk factor questionnaire. Next, you lie down on the imaging table while a CT technologist places a few EKG leads on you. You are then asked to hold your breath while the images are taken. That's it. You can return to your regular routine. A board certified radiologist, using high tech software, calculates your cardiac score based on the images taken. He or she provides an evaluation of the results within 48 hours.

Image: Reconstructed 3-dimensional image of the heart obtained from CT scanning with intravenous contrast. This cannot be done with coronary calcium screening as no intravenous contrast is administered.

Is coronary calcification scoring safe?

The radiation exposure during cardiac scoring is very minimal (comparable to the radiation received during a chest x-ray). No intravenous injections or needles are required. Not only is it safe, it is also simple. In most cases (unless there are certain types of buttons or bra metal involved), patients may keep their shirt or blouse on during the procedure.

What does my cardiac score tell me?

Subtle early warning signs of heart disease can be detected. Cardiac scoring is the latest diagnostic tool to detect calcified plaque in the coronary arteries. The score, based on age, gender and other risk factors, is a strong indicator of your risk for coronary artery disease. With this information, your doctor can recommend the appropriate treatment, including diet and lifestyle changes, medication and/or further testing.

Is coronary artery disease treatable?

Yes, the plaque build-up process can be slowed, stabilized and reversed, in some cases, through aggressive lifestyle modification and/or through medication therapies under the guidance of your physician.

Conventional Methods for Detecting Coronary Artery Disease

Test
Advantages
Disadvantages
Stress Test
  • Ideal for patients who are symptomatic
  • Used to determine extent of ischemia
  • Does not produce an image of coronary arteries
  • Significant blockage must be present to detect ischemia (i.e. does not detect preclinical disease)
Angiography
  • "Gold standard"
  • Shows narrowing of lumen
  • Shows number of diseased vessels
  • Generally used only with demonstrable ischemia
  • Invasive
  • Expensive
  • No information regarding type of plaque (soft or hard)
Intravascular Ultrasound
  • Direct visualization of vessel wall and lumen size; useful for angioplasty and stent placement
  • Can detect calcification
  • Generally used only with demonstrable ischemia
  • Invasive
  • Expensive
Helical/EBCT Cardiac Score
  • Noninvasive
  • Detects and quantifies coronary calcification
  • May be used in asymptomatic patients
  • May be used to estimate total atherosclerotic plaque burden and risk of future events
  • Does not identify stenotic lesions Conflicting evidence regarding correlation of CAC score to risk of events
  • No universally defined treatment plans for those with positive test results


What will my report include?

Loma Linda University Medical Center provides a comprehensive report, which includes the findings from your CT and the normal amounts of calcium found in men and women of differing ages. Also included in the report is the risk level that your score places you at and the current recommendations for treatment.

How will I receive my results?

A formal report will be mailed to you and your designated physician in two to three days. If you do not have a physician, we can arrange for a referral to a Loma Linda University physician.

How do I pay for the test?

Payment is due in full at the time of your appointment. Most insurance carriers do not cover this test. If you wish to submit a claim to your insurance carrier, we will provide you with the necessary documentation.

Do I need a written physician's order?

No. You can choose to have the study on your own. If your physician has requested this test, please bring the written order with you at the time of your appointment.

How do I make an appointment?

Our scheduling desk is open from 8:00 a.m. to 5:00 p.m. Monday through Friday. If you would like to schedule an appointment for an outpatient scan, please call (909) 558-4407 or (909) 558-6113.

Where do I go for the examination?

The examination will take place at Loma Linda University Medical Center Professional Plaza, Room 103B, 25455 Barton Road, Loma Linda, California.

Why choose cardiac scoring at Loma Linda University Professional Plaza?

Loma Linda University Medical Center was recently named a TOP 50 cardiac hospital in the nation, and is the first hospital in the area to offer cardiac MRI and 64 slice CT imaging services. As a hospital-based program you can be assured of receiving the quality of care that has been a tradition for more than 100 years.

Where Can I Learn More About Cardiac Scoring?

For the most current, comprehensive discussion of this screening test and its implications, there are several web sites related to cardiac imaging that discuss this topic. Listed below are a few medical journal articles that have recently evaluated this test:

Coronary Calcium Screening Seen Useful Beginning Age 40 and 50. J Am Coll Cardiol. 2005;46:807-814

Coronary Artery Calcium Measurement: Agreement of Multirow Detector and Electron Beam CT. Becker CR et al, Am J. Roentgenol., May 1, 2001; 176(5): 1295-1298.

Evaluation of Subsecond Helical CT for Quantification of Coronary Artery Calcium and Comparison with Electron Beam CT. Carr JJ et al. Am.J. Roentgenol 2000; 174;915-921

Coronary Artery Calcification as an Indicator of Preclinical Coronary Artery Disease. William Stanford MD Radiographics 1999;19:1409-1419

Where Can I Learn More About Controlling my Cholesterol?

The National Heart, Lung, and Blood Institute (NHLBI) launched the National Cholesterol Education Program (NCEP) in November 1985. The goal of the NCEP is to contribute to reducing illness and death from coronary heart disease (CHD) in the United States by reducing the percent of Americans with high blood cholesterol.

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