So you've had a heart scan…. now what?

You have had your heart scan by either referring yourself for a scan or you were referred by your another health care provider.  I have found that many medical providers do not know how to read these scans.

There are common medications that he repeated often such as:
1.      Calcified plaque does not rupture so do not worry about it (calcified plaque can rupture especially if it is mixed plaque and the point of the scan to track progression of disease and make sure your treatments are working)

2.      It’s not a complete test because it does not show soft plaque (true and a carotid intima media thickness test checks for soft plaque and if your calcium score keeps going up more than 50 percent a year you got soft plaque)

3.      It’s a useless test (just not true, find a different doctor)

4.      An angiogram would be better (an angiogram is completely different and really just indicates degree of stenosis not disease activity and is highly invasive)

5.      You cannot reverse plaque so why bother checking for it (plaque can be reversed and can be slowed down significantly.  Since heart attack is the #1 cause of death checking to see if you have coronary artery disease is extremely important from a preventive medical standpoint, see #3)

The point of getting a heart scan is to get a baseline level of atherosclerotic disease burden.  The reason it is called calcium score is because the CT machine can only see calcium.  The more calcium there is the more disease burden there is.  If, over time the calcium level keeps going up beyond 15 percent per year the disease is out of control.

If you have had a stent in one of your coronary vessels you can still do a heart scan.  The point of doing it is to be able to track progression of the disease.  Again, 15 percent a year or less is the goal. The scan report will indicate where and at which arteries there is increased calcification.  It does not indicate blockages.

Often patients are very anxious about their score and want to get it checked again as soon as possible.  I recommend waiting at least a year if not 2 or 3 because the plaque modification process takes a long time.  If you begin an aggressive plaque reversal program you may not see results until year 2 or 3.  In the interim a good way to check disease activity is to do a carotid intima media thickness test which does not use any radiation but does detect the earliest stages of plaque very accurately measures its progression or regression.

A high score is not the end of the world.  Often patients will have a history of activities that increase their plaque significantly but presently have very low disease activity.  This is classic in ex-smokers.  Again, its about progression of disease.  Its true that calcified plaque can become very stable.  He will not be stable however if progression is 30 percent per year.  The reason why is because that progression indicates do vulnerable plaque.  This is the type that can rupture and cause a heart attack.  In fact this type of plaque is what causes the majority of heart attacks.

To learn more about imaging and preventive cardiology including heart scan see my latest article which can be found here.

To find out more about heart attack prevention or how to interpret your heart scan please consider an appointment or read the article above. Front desk 303.884.7557