ZocdocAnswersWhy are coronary calcium scans necessary?

Question

Why are coronary calcium scans necessary?

I am an overweight 35 year old guy with an admittedly poor diet. My doctor would like me to undergo a calcium scan but am unconvinced it is ncessary.

Answer

A coronary calcium screen is a very specialized test that is designed to determine the extent of coronary artery disease without subjecting the body to a coronary artery catheterization with angiography (which is the most accurate test). Let me explain what this means. Most individuals (especially those in their 30s), need to have regular checkups in which screening tests are done high cholesterol, high blood pressure, and diabetes. If any of these are found, then they need to be treated. If someone comes in with many other risks for heart disease (overweight, smoking, strong family history of heart disease), then I would make sure that their "bad" cholesterol is even lower, and make sure that we are aggressive at weight loss and exercise. If someone comes in with symptoms of heart disease like chest pain, then I would get a stress test. If they failed the stress test, then I would send them to coronary artery catheterization (the gold standard test). The coronary artery calcium screen is a very specific test which has unproven usefulness. The only time I would order this test is if I had a patient that had no symptoms (i.e. no chest pain), a fairly normal cholesterol, but I was still worried was very high risk for coronary artery disease. The test would allow me to know whether I need to subject this person to life long cholesterol lowering drugs, despite having a fairly normal cholesterol. I hope this made a little sense (sorry, but this is a complicated question). As you can see, the decision to get a coronary artery calcium screen is complex. I would schedule an appointment with your doctor and ask very specifically what he or she is looking to gain from it. This is a reasonable question given the fact that it is not a routine test in cardiovascular heath care. Good luck.

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