Norm of Cardiac Calcium Scoring (Coronary Artery Calcium Scoring)
No evidence of plaque in the coronary arteries
Presence of Coronary Artery Plaque
Chance That Heart Disease Is Present
|0||No evidence of plaque||<5% (low)|
|1–10||Minimal evidence of plaque||<10% (low)|
|11–100||Mild evidence of plaque||Moderate|
|101–400||Moderate evidence of plaque||Moderate to high|
|>400||Extensive evidence of plaque||>90% (high)|
Usage of Cardiac Calcium Scoring (Coronary Artery Calcium Scoring)
Helps assess for the presence of plaque in the coronary arteries in clients with some risk factors for heart disease. This CT scan of the heart can provide an early indication of the presence and severity of heart disease. May also be used to help predict risk of coronary artery disease. Not recommended for use in clients with known heart disease or clients with no risk factors for heart disease.
Description of Cardiac Calcium Scoring (Coronary Artery Calcium Scoring)
Cardiac calcium scoring is a term used to describe an assessment of the quantity of calcified plaque in the coronary arteries using electron beam tomography (EBT). Because detection of calcium with EBT can be affected by heart motion, newer techniques add the use of multislice computed tomography or the use of ECG-gated multidetector tomography, which helps provide additional accuracy.
Professional Considerations of Cardiac Calcium Scoring (Coronary Artery Calcium Scoring)
Consent form NOT required
While the test is an x-ray, the risk from radiation is minimal.
- For clients with atrial fibrillation or tachycardia, a negative inotropic drug may be ordered before the test.
- Client must disrobe and wear a gown. Remove jewelry present on the client's chest.
- ECG electrodes are applied to monitor heart rate during the test.
- The client is positioned supine, with his or her head secured and resting on a headrest on a motorized handling table.
- The client must lie motionless as the table slowly advances through the circular opening of the scanner.
- The table will slide into the scanner; the scanner may make some noises, which are normal. The client may be asked to hold their breath at times.
- The test should take between 10 and 30 minutes.
- None, as this is a noninvasive test.
Client and Family Teaching
- Do not smoke and avoid caffeine for 4 hours before the test.
- You must lie motionless during the scan. Because this can be a frightening test, it should be described carefully to the client before he or she enters the CT room.
- A radiology technician will be in the control room monitoring you closely throughout the scan.
- Sometimes a medication may need to be given to slow the heart rate if the heart rate is faster than 90 beats per minute.
- If the scoring is high, the client will need to take steps to lower the risk of heart attack. These can include reducing risk factors such as smoking and high blood pressure, losing weight, and exercising, all of which should be discussed with the health care professional.
Factors That Affect Results
- Caffeine, smoking, and rapid heart rate reduce the accuracy of the results because they cause motion artifact. Combination scans as described previously can help improve the accuracy of the results when a great deal of motion artifact occurs.
- False-negative results may occur if the type of coronary artery plaque present has not been present long enough to harden and be detected by the scan.
- Results indicate only the amount of calcified plaque present, but cannot reveal the stability of the plaque.
- This test should be used in combination with physical examination and other diagnostic tests to determine a client's heart disease status; it is not the definitive test for heart disease and should not be used alone.