CT Calcium Scoring: A 10-Minute Scan to Assess Heart Risk

In an increasingly health-conscious world, the CT Calcium Score has emerged as a critical tool for assessing heart disease risk, yet remains largely unknown to many. This 10-minute scan offers a direct visual measure of calcium deposits in the coronary arteries, providing vital information that traditional tests, such as cholesterol checks and ECGs, cannot. With heart disease being the leading cause of death in India, understanding this test could be life-saving.

Understanding CT Calcium Scoring

The CT calcium scoring test, also known as the coronary artery calcium (CAC) score, uses advanced imaging technology to identify calcium deposits in the arteries supplying blood to the heart. These deposits signify atherosclerosis, a condition marked by the gradual build-up of fatty plaque that narrows arteries and increases the likelihood of heart attacks and strokes. The procedure involves no needles, dyes, or overnight hospital stays; patients simply lie in a CT scanner for about ten minutes to capture images of their heart.

A radiologist then calculates the calcium score, which indicates the amount of calcified plaque present. Scores are categorized as follows:

– **0**: No detectable plaque; very low risk of a heart event.
– **1–99**: Mild plaque; some risk — lifestyle changes recommended.
– **100–299**: Moderate plaque; significant risk of heart attack.
– **300 and above**: Extensive plaque; high risk — aggressive medical management needed.

Recent findings from the University of Copenhagen suggest that CT calcium scoring outperforms traditional risk calculators in predicting future cardiac events, particularly in middle-aged adults who may otherwise appear healthy.

The Importance of CT Calcium Scoring in India

India is currently facing a cardiovascular crisis, with heart disease accounting for nearly one in every four deaths, according to the Indian Council of Medical Research (ICMR). Alarmingly, younger adults are increasingly affected, with heart blockages being diagnosed in individuals as young as 35. Many of these cases occur in patients who do not smoke or drink and have normal cholesterol levels. The CT calcium score can identify latent risks that are otherwise overlooked by standard blood tests, which provide only temporary readings.

Individuals of South Asian descent are genetically predisposed to conditions such as central obesity and insulin resistance, which accelerate plaque build-up. For these populations, the CT calcium score can reveal hidden risks long before symptoms manifest. Consequently, cardiologists are increasingly recommending this test for Indians aged 30 to 50 with a family history of early heart disease.

The cost of a CT calcium score test in India ranges from Rs 3,000 to Rs 8,000, depending on the city and healthcare facility. While some premium insurance plans now include it as part of preventive screening, many policies do not. Individuals falling into moderate-risk categories or possessing multiple lifestyle risk factors should discuss this test with their healthcare provider.

The results of a CT calcium scan serve as a critical roadmap for future heart health. A score of zero indicates clear arteries, correlating with less than a 1% chance of experiencing a cardiac event in the next five years. Scores between 1 and 99 indicate mild plaque formation, prompting recommendations for heart-healthy lifestyle changes. Scores exceeding 100 suggest a need for aggressive preventive treatment, such as statins or frequent monitoring.

While a calcium score is informative, it should not be viewed in isolation. It must be interpreted alongside other health parameters, including LDL cholesterol and blood pressure. A low score does not provide immunity against unhealthy lifestyle choices, nor does a high score inevitably signal doom. Instead, it serves as an urgent call to action.

The benefits of CT calcium scoring include early detection of potential heart issues, enabling patients to implement lifestyle changes that can avert heart attacks. Patients who see the physical manifestation of plaque in their arteries often feel motivated to adjust their habits accordingly. However, the test is not universally appropriate; it involves a small amount of radiation, making it unsuitable for routine screening of very young or low-risk individuals. It also does not reveal “soft plaque,” which can still rupture and cause blockages.

Experts caution against over-testing, warning that widespread availability of CT calcium scans could lead to unnecessary anxiety and overtreatment. In a diverse country like India, where access to healthcare varies significantly, doctors emphasize that the decision to conduct the test should be based on individual risk assessment rather than marketing pressures.

Addressing the Indian Healthcare Challenge

In India, preventive heart screenings often commence too late. Standard health packages typically include ECGs and cholesterol checks, which may not detect early signs of atherosclerosis. Current screening guidelines, largely based on Western populations, may not fully accommodate India’s unique risk profile. South Asians tend to develop heart disease nearly a decade earlier than their Western counterparts, often without the typical symptoms.

Experts advocate for integrating advanced risk assessment tools like CT calcium scoring into healthcare systems for at-risk adults. This approach could mirror the standardization of mammograms and colonoscopies for cancer screening. There is a compelling argument for including the scan in government or insurance-backed preventive check-ups for individuals with diabetes, hypertension, or obesity.

Moreover, the economic rationale is significant. Early detection through CT calcium scoring can substantially reduce future hospital costs. A single hospitalisation for a cardiac event can cost between Rs 300,000 and Rs 500,000, while a preventive scan is comparably affordable.

The rising incidence of cardiac arrests among young Indians highlights a notable gap in awareness regarding heart health risks. The CT calcium score has the potential to bridge that gap. While it is not yet a routine test, its significance in redefining preventive health practices in India cannot be overstated. For those balancing work stress, sedentary lifestyles, and occasional late-night meals, this brief scan could unveil critical insights that even modern smartwatches may miss. Understanding the state of one’s heart health is vital, as heart disease often develops silently, layer by layer. For many, knowledge of their calcium score could ultimately lead to longer, healthier lives.