Heart Score

Written by: Dr. Steve Windley, MD

TEST TAKING
Evaluating your risk for heart disease.

Heart disease continues its reign as our nation’s number one killer, hurting quality of life and
creating a huge financial burden. Like so many other chronic illnesses, prevention should
always be the goal. The calcium heart score, or heart scan, is now being offered as an option to
help assess a person’s risk. This test, a type of x-ray, may allow doctors and patients a
noninvasive view of heart disease issues.
      Prevention should be a top priority in health care. Often, diagnosis and treatment of many
diseases, including heart disease, comes after the illness is much more difficult to treat.
Prevention of heart disease becomes even more of a priority since one of the most frequent
symptoms of a heart attack is sudden death. Cholesterol treatment is now a prominent part of
the heart disease treatment program, but it is certainly not the only part. There are people who
suffer a heart attack with normal cholesterol levels. Many people are worried about talking to
their doctor about their risk since this can lead to big tests like a stress test or a heart
catheterization. There is a great need for a noninvasive assessment of heart disease risk. Many
centers are using CT scans to compute a score for the amount of calcium measured in the
arteries. This is commonly called a calcium heart score or heart scan. These tests are
suggested to be a relatively simple way to obtain another heart disease risk factor to help
outline how aggressive a treatment plan needs to be.
      At this point, several studies have been done to confirm that heart scans do provide useful
information to the doctor and patient [1,2,3]. The heart score can be used as a helpful guide to
help predict heart disease [2]. The heart score is essentially a CT scan of the heart and its blood
vessels. The calcium that has been deposited into the arteries is measured and a score is
determined based on the amount of calcium present.  Heart disease is the only known cause of
calcium deposits in the arteries [4]. A comparison percentile for males and females is made
using age to help determine the risk of heart disease. A game plan for the heart can then be
determined based on the score. Scores of zero are extremely low risk for heart disease. Scores
of 10-100 and less than 75 percent for age are considered intermediate risk, meaning a 10-20
percent chance of heart disease is present per decade. Scores of 100 and greater than the 75
percentile for age show a high risk for heart disease over the next ten years. The heart score
can then be added to other data to assess risk for each person.
      The heart score is one piece of data that should be part of a more complete plan. This plan
should include labs like C-reactive protein , homocysteine , testosterone (for men), cholester
ol , family
history and diabetes risk. The plan should also target optimal nutrition to decrease inflammation
and supplements to help maintain the health of the arteries.

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 Vitamin K
,
vitamin D
and
essential fatty acids
are important for heart health. Vitamin K in particular is essential for helping the calcium go to
the bones where it is needed and not the arteries where it is associated with heart
disease. Patients with many risk factors, such as a high heart score and diabetes, should
discuss with their health care team all the options available to help prevent further heart
disease.
      The one drawback to CT heart scores is the radiation exposure. The test itself is fairly
quick. Relative to other types of heart tests, this scan can be done for a very reasonable price.
A simple chest x-ray is similar in radiation exposure to smoking one cigarette. A CT scan will
have noticeably more radiation [5]. There may soon be other types of heart tests like heart rate
variability, which can gauge stress on the heart noninvasively without radiation. Currently, there
is no readily available or commonly used diagnostic test beyond the heart scan.
      The heart score offers an option for those wishing to better understand their risks for heart
disease. A doctor cannot assess your risk through just a stethoscope or even an EKG. To truly
know if you are at a high risk for heart disease there has to be some kind of in-depth study. The
heart score does have the risk of radiation from the CT, but it is otherwise noninvasive and
much cheaper than many standard medical tests. It can help provide more constructive
guidance for the patient and physician by knowing how aggressive the heart disease prevention
program should be.

References:
1. Rumberger, JA. (2009). Practical tips and tricks in cardiovascular computed tomography:
non-contrast “heartscans” – beyond the calcium heart score. J Cardiovasc Comput Tomogr,
3(1):52-6. 
2. Hopkins, PN. (2006). Association of coronary artery calcified plaque with clinical coronary
heart disease in the National Heart, Lung, and Blood Institute's Family Heart Study. Am J
Cardiol, 97(11):1564-9.
3. Shaw, LJ. (2003). Cost effectiveness of screening for cardiovascular disease with measures
of coronary calcium.  Prog Cardiovasc Dis, 46(2):171-84. 
4. Rumberger, JA. (2003). Clinical use of coronary calcium scanning with computed
tomography. Cardiol Clin, 21(4):535-47.
5. Jerijan, K., Brant-Zawadzki, MN. (2001). Radiation dose in coronary calcium: comparison of
multi-slice and electron beam CT scanners. Radiology, 221:365.

Other Trusted Source:

Mayo Clinic

Disclaimer:
This website and its pages are based upon the opinions of our physicians and other

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professionals. The information on our website is general health information and is not to be
considered as medical advice. The information is in no way intended to replace a one-on-one
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and information from the experience of Pure Health MD's professional contributors.

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