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Heart disease kills more American men and women than any other disease. For 150,000 Americans each year, the first and only sign of coronary disease is a fatal heart attack. Heart disease is a very treatable condition when it is detected early. Frequently, treatment consists only of changes to diet and exercise habits. Sometimes medication is necessary. The earlier heart disease is detected, the better the chance of managing it and preventing a heart attack.

What is a CT scan for coronary calcium scoring?
A cardiac CT scan is a non-invasive way of obtaining information about the location and extent of calcified plaque in the coronary arteries—the vessels that supply oxygen-containing blood to the heart wall. Plaque is a build-up of fat and other substances, including calcium, which can, over time, narrow the arteries or even close off blood flow to the heart. The result may be painful angina in the chest or a heart attack.

Because calcium is a marker of coronary artery disease, the amount of calcium detected on a cardiac CT scan is a helpful diagnostic tool. The findings on cardiac CT are expressed as a calcium score. Another name for this test is coronary artery calcium scoring.

Who should consider having the test?

For individuals with no risk factors, men should consider it if they are over 45 years old and, for women, the age is 50 and older. Younger people with the following risk factors should consider getting the test earlier:

• High blood pressure
• Abnormally high cholesterol
• Diabetes
• History of tobacco use
• Sedentary lifestyle
• Overweight or obese
• Family history
• Significant stress
• Other vascular disease

What should you do before the test?
No special preparation is necessary in advance of a cardiac computed tomography (CT) examination. You may continue to take your usual medications, but should avoid caffeine and smoking for four hours before the exam. If your heart rate is 90 beats a minute or higher, you may be given a drug to slow the rate in order to obtain accurate CT images.

You should wear comfortable, loose-fitting clothing to your exam. You may be given a gown to wear during the procedure.

Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work.

Women should always inform their physician or technologist if there is any possibility that they are pregnant.

How is the procedure performed?
The technologist begins by positioning you on the CT examination table, usually lying flat on your back or possibly on your side or on your stomach. Straps and pillows may be used to help you maintain the correct position and to hold still during the exam.

Electrodes (small metal discs) will be attached to your chest and to an electrocardiograph (ECG) machine that records the electrical activity of the heart. This makes it possible to record CT scans when the heart is not actively contracting.

Next, the table will move quickly through the scanner to determine the correct starting position for the scans. Then, the table will move slowly through the machine as the actual CT scanning is performed. Patients are periodically asked to hold their breath for periods of 20 to 30 seconds while images are recorded.

When the examination is completed, you will be asked to wait until the technologist determines that the images are of high enough quality for the radiologist to read.

The actual CT scanning is usually completed within 10 minutes.

Who interprets the results?
A physician, usually a radiologist with expertise in supervising and interpreting radiology examinations, will analyze the images and send a signed report to your primary care physician or the physician who referred you for the exam, who will discuss the results with you.

A negative cardiac CT scan shows no calcification within the coronary arteries. This suggests that CAD is absent or so minimal it cannot be seen by this technique. The chance of having a heart attack over the next two to five years is very low under these circumstances.

A positive test means that CAD is present, regardless of whether or not the patient is experiencing any symptoms. The amount of calcification—expressed as the calcium score—may help to predict the likelihood of a heart attack in the coming years and helps your medical doctor or cardiologist decide whether you may need to take preventive medicine or undertake other measures such as diet and exercise to lower the risk for heart attack.

Why Middletown Medical?
Middletown Medical’s Philips Brilliance 16-Slice CT scanner is the industry standard for CT scanning. This incredible machine opens new doors for assessing some of today’s most pressing health care conditions such as stroke, heart disease and lung cancer. The Brilliance 16-Slice gives sixteen crystal clear images per rotation, while older machines took only one image. This means that you receive a much more accurate diagnosis than ever before possible. The Philips Brilliance 16-Slice scanner is the region’s most advanced scanner. It is fast, accurate and able to perform more studies with incredible clarity. In addition, our technologists are highly trained, caring and ready to help you.

Additionally, if you do require follow-up care, our exceptional cardiologists are board certified in cardiology, interventional cardiology, cardiovascular disease, echocardiography and nuclear cardiology. We offer state-of-the-art diagnostic procedures and equipment for both invasive and non-interventional cardiology, as well as personalized treatment plans for cardiac conditions.

Diagnostic testing procedures include nuclear stress testing, echocardiography, Holter monitoring, BP monitoring, T-wave alternans testing.