Citizens Medical Center, known locally as “the Heart Hospital”, is renowned for its diagnosis and treatment of heart disease for over 40 years. Doctors conduct thousands of heart-related procedures each year, from prescribing simple medication to performing extensive open-heart surgery.
What is Coronary Calcification?
Calcium, the body’s most abundant mineral, circulates through the body and is vital for bone strength and for many cellular functions. Calcium also deposits in the arteries as part of the atherosclerotic process. This calcification stiffens the blood vessels, a phenomenon commonly referred to as “hardening of the arteries.”
Research shows that there is a direct link between the degree of calcification in the blood vessels to the amount of artherosclerotic plaque and, therefore, the likelihood of subsequent heart attack or stroke. Heart CT Profile™ uses a CT Scan and gives doctors an idea of how advanced an individual’s atherosclerotic process is, thereby guiding the aggressiveness of treatment.
What is a Heart CT scan?
Heart CT scan is a form of the familiar CT (or CAT) scan, which captures cross-sectional images of the heart at sub-second rates. This unique CT technology allows the detection of small amounts of calcium in the coronary arteries.
With Heart CT Profile™, we can measure the build-up of plaque, if any, and compare it to the standard for your age and gender. This test, along with other indicators, presents an overall picture of your heart health. Together, this will help your physician develop an appropriate heart health plan.
Is this like a MRI scan?
No. Heart CT Profile™ is conducted on a CT or CAT (Computed Axial Tomography) scanner. It is a quick, painless procedure. Unlike MRI, which uses a magnetic field and radio frequency waves to produce images, the CT scan uses x-ray. There is no need for sedation. The exam is very comfortable and there are no enclosed areas in the scanner.
What is the test like? Is it painful or inconvenient?
Unlike many medical tests, the Heart CT Profile™ is fast, painless and non-invasive. This test and CMC’s facilities have been specifically designed with your comfort in mind.
There is no preparation necessary for a heart scan. The entire process, that includes the scan and a consultation with a healthcare professional, only takes about 45 minutes. The scan process itself takes approximately 15 minutes. We ask that you come in 20 minutes prior to your scheduled exam time to register and complete some brief paperwork. Prior to the scan, you may be asked to put on a gown. There are no needles involved and no liquids to swallow. The technologist will ask you to lay on the bed of the CT scanner and they will monitor your heart rate.
Four EKG electrodes will be placed on your chest to obtain the images at the proper cycle of your heartbeat. You will be asked to hold your breath during the scan. Your heart rate will determine how many seconds you will need to hold your breath. The scan itself takes approximately 1 minute. After your scan is completed, a health care professional will share more information with you about the scoring process and answer any questions you might have. Several days after your exam, you will receive a written report from a physician that explains the results in easy-to-understand terms.
Heart CT Profile™ is just one piece of valuable information in diagnosing your likelihood of coronary atherosclerosis. Combined with additional information, including family history, lifestyle factors and other medical history, this test will help your physician develop an appropriate medical plan for you.
What exactly do I learn from the Heart CT Profile™?
Heart CT Profile™ will give you two important pieces of information that are key to the long-term health of your heart:
- The presence or absence of coronary calcium in your heart
- The degree of calcification in your heart
Once the volume and density of the calcium is measured, a number is assigned to each area where calcium is observed, and those numbers are totaled to give you a total “calcium score.”
After your scan, a health professional will explain the process to you. A few days later, you will receive your score in the mail. It will show how you fit into various age and risk profiles and whether you have any likelihood of obstructive coronary artery disease. That score may range from zero, representing no calcium observed, to more than 400, indicating the presence of significant calcium build-up. CMC recommends sharing the results of your test with your physician to determine what, if any, follow-up steps need to be taken.
Your calcium score can help you in a number of ways:
- It can detect the buildup of calcium earlier than any other technology
- It can help your physician develop the appropriate prevention strategy
- It can provide your physician with a tool that can measure the progression or regression of calcium build-up (atherosclerosis)
- It can reduce the need for other, more expensive and invasive tests
- It can give you peace of mind
This test can help you understand the state of your heart’s health and give you the power to take some control over your own health.
What results will I receive?
You will receive a total calcium score, which, combined with your gender and age, results in being assigned to one of five “scoring categories.” Which scoring category you are in determines whether further follow-up with a physician is needed. The Heart CT scan generates hundreds of images that cover your heart from top to bottom. If calcium is present in your coronary arteries, the computer program measures the volume and density of the calcium present. A numerical score is generated for each area of observed calcium and combined to generate the total calcium score.
If you score 0 – there was not calcium observed in your coronary arteries.
If you score 1 – 10 – you have a minimally identifiable build-up of plaque.
If you score 11 – 100 – you have a mild amount of calcium present for your age, suggesting a low likelihood of obstructive coronary artery disease. However, it does correlate with the presence of coronary arteriosclerosis.
If you score 101 – 400 – there is more calcium present for your age than what is expected. If you are scored as Moderate, you should contact your physician for further examination. Many times, only lifestyle changes are necessary to reduce or reverse your chances of suffering heart trouble.
If you score over 400 – there is significantly more calcium present for your age than what is expected. If you are scored as Severe, you should follow-up with your physician who will probably perform a physical examination and some type of cardiac stress testing. Severe calcification doesn’t necessarily mean that “severe” heart disease is present, but it does mean that following-up with your physician is appropriate.
Probability of Significant Coronary Artery Disease
Implications for CV risk
|0||No identifiable plaque||Very low, generally 5%||Very low||Reassure patient, discuss general public health guidelines for primary prevention of CV disease|
|1-10||Minimal identifiable plaque burden||Very unlikely, under 10%||Low||Discuss general public health guidelines for primary prevention of CV disease|
|11-100||Definite, at least mild atherosclerotic plaque burden||Mild or minimal coronary stenoses likely||Moderately||Counsel about risk factor modification, strict adherence with primary prevention goals. Daily ASA.|
|101-400||Definite, at least moderate atherosclerotic plaque burden||Non-obstructive CAD highly likely, although obstructive disease possible||Moderately High||Institute risk factor modification and secondary prevention goals. Consider exercise testing for further risk stratification. Daily ASA.|
|400+||Extensive atherosclerotic plaque burden||High likelihood (90+%) of at least one significant coronary stenosis||High||Institute very aggressive risk factor modification. Consider exercise for pharmacologic nuclear stress testing to evaluate for inducible ischemia. Daily ASA.|
Will my physician receive the results?
There are three scenarios in which the results will be sent to your primary care physician:
- Some states require the results be sent to a physician (e.g., Wisconsin)
- You may elect to send the results to a doctor of your choice
- You were referred by your doctor
What do I do with the results?
Heart CT Profile™ is just one piece of valuable information in determining the presence of heart disease. By sharing these results with your physician you are giving him/her additional information, which they will take into consideration with your medical history and other exam results to develop the appropriate care plan for you.
Do I need to see my doctor first?
We encourage all of our patients to work with their physician in incorporating the results of this test into their own preventive health care plan. However, a physician referral for this test is not necessary.
How much does it cost? - $375.00
A $25 discount on your exam is available through our Companion Program, for two or more people who schedule their exams together (spouses, partners, friends, relatives or business associates). Discounts are also available through our Corporate Program.
Will my insurance pay for this exam?
At this time, most major health plans consider this a non-covered service. Payment is due at the time of your scan. Many convenient payment methods are available, including personal checks and most major credit cards. At your request, we will submit claims to your insurance plan and you may be eligible for a refund.
Do you have any special programs?
Yes, we offer two different incentive programs: the Companion Program and the Corporate Program. Each program is further defined below.
Companion Program. A $25 discount on your exam is available through our Companion Program for two or more people who schedule their exams together (spouses, partners, friends, relatives or business associates; these don’t need to be scheduled the same day).
Corporate Program. CMC is designed to help keep employees healthy and on the job. If you are interested in knowing more about the discount available to companies, call CMC.
Coronary Heart Disease is the leading cause of premature, permanent disability in the U.S. labor force, accounting for 19 percent of disability allowances by the Social Security Administration. In 1996, the average cost of a coronary event from hospital admission to discharge, for people under age 65, was $22,720, and the average length of stay was 4.3 days.
If you think you and your company are already paying too much for health care premiums, think what an employee population at a high risk for heart attacks could do to your rates.
The American Heart Association estimates that the total cost of all cardiovascular disease in 1998 will exceed $274 billion — more than half that amount, $147 billion, will be attributable to coronary artery disease alone. Approximately 35 percent of that will be direct medical expenses. The remaining cost ($96 billion) will result from the indirect impact of lost productivity, morbidity and mortality on businesses and families.
Where can I learn more about my heart?
For more information, you can make the following connections:
Center for Diagnostic Imaging
American Heart Association
A very comprehensive site for fighting heart disease and stroke. The AHA is a not-for-profit, voluntary health organization funded by private funds whose mission is to reduce disability and death from cardiovascular diseases and stroke. These include heart attack, stroke, and related disorders.
Heart Information Network
Uniquely designed from the perspective of the heart patient, HeartInfo is an autonomous site providing a wide range of information and services to heart patients and others interested in lowering risk factors for heart disease.
InteliHealth, one of the leading health information companies in the world, is a joint venture of Aetna U.S. Healthcare(R) and Johns Hopkins University and Health System. This site provides “consumerized” health information from more than 150 top health care organizations around the country.