Understanding Coronary Calcium Scoring

Understanding Coronary Calcium Scoring — A Smart Start to Protect Your Heart

Most people think heart disease happens suddenly — a sharp chest pain, a rushed trip to the hospital. But in reality, heart disease begins quietly, often developing years before symptoms appear. The coronary artery calcium (CAC) score is one of the simplest and most powerful ways to detect those early changes inside your arteries, long before they cause trouble. This quick, painless test can reveal how healthy your heart really is and guide your next steps in protecting it.

A calcium score is measured through a specialized CT scan that looks for calcium deposits in the walls of your heart’s arteries. These calcium spots are a sign of plaque buildup — the same process that can eventually narrow arteries and increase the risk of heart attack. The scan itself is fast and straightforward. There are no injections or contrast dyes involved. You simply lie on the scanner table while it takes images of your heart, and within minutes, you’ll have a result. The score reflects the total amount of calcium in your arteries — the higher the number, the greater the buildup and the higher your long-term risk. A score of zero means no calcium is detected and your arteries are clean. A small score suggests mild early plaque, while higher scores indicate more advanced buildup and the need for closer attention to prevention.

Many people are surprised to learn that heart disease doesn’t only affect older adults. The process of plaque buildup, known as atherosclerosis, can begin in your twenties or thirties, especially if you have high cholesterol, diabetes, a family history of early heart disease, or if you smoke. For younger adults, a calcium score can be eye-opening. A result of zero can be very reassuring — it means your short-term risk of a heart attack is extremely low, and you may not need medication just yet. However, even a small amount of calcium can serve as an early warning sign to take action through lifestyle changes, improved diet, and better control of cholesterol and blood pressure. It’s one of the few tests that can truly shift heart care from being reactive to preventive — giving you the chance to act early, while it still makes a lasting difference.

One common question that often comes up in clinic is whether someone should take Aspirin to prevent a heart attack. In the past, Aspirin was often prescribed for everyone as a preventive measure. Today, we know that it’s not suitable for everyone, because while Aspirin can reduce heart attack risk, it also increases the risk of bleeding. The calcium score helps personalize that decision. If your calcium score is zero, Aspirin usually isn’t recommended because your risk of a heart attack is already low and the potential side effects outweigh the benefit. But if your calcium score is 100 or higher, that means significant plaque buildup, and Aspirin may be helpful in reducing future cardiovascular events — provided you don’t have a bleeding risk. For scores in between, the decision depends on your overall health, cholesterol levels, and family history. In other words, the calcium score allows your doctor to tailor prevention — using the right tools for the right patient at the right time.

The calcium score isn’t just for people with symptoms. It can be a smart option for anyone who wants to understand their true heart risk, particularly those with risk factors or a strong family history. Even for individuals in their thirties and forties, this scan provides a valuable baseline of their heart health. The results can then guide future check-ups, help fine-tune treatment plans, or simply offer peace of mind. For some, the test confirms that they’re on the right path; for others, it’s a wake-up call to take action sooner rather than later.

After the test, the most important step is knowing what to do with the results. A low or zero score may mean you simply continue healthy habits and recheck your heart after a few years. Higher scores may prompt lifestyle adjustments such as adopting a heart-healthy diet, exercising regularly, or starting medication to manage cholesterol or blood pressure. In some cases, your doctor may recommend further tests like a CT coronary angiogram or a treadmill stress test to get a clearer picture. The calcium score isn’t about labeling you as “sick” or “healthy” — it’s about helping you make informed, proactive choices to protect your long-term cardiovascular health.

At our clinic, we often describe the calcium score as a “time machine for the heart.” It allows us to look into your future and understand what’s happening inside your arteries today, so we can act before problems appear. For many of our younger patients — busy professionals, parents, or anyone wanting to stay active and healthy — this scan offers both clarity and motivation. It transforms uncertainty into insight, and fear into focus. Prevention doesn’t start when disease appears; it starts with awareness. Taking a few minutes for a simple scan today can help you safeguard your heart for decades to come.

Coronary artery calcium (CAC) scoring is a non-invasive CT scan that detects and quantifies calcium deposits in the coronary arteries. These calcium deposits are markers of atherosclerotic plaque and can help predict future cardiovascular events. The test provides a calcium score that helps doctors assess cardiovascular risk and guide treatment decisions. A score of zero indicates very low risk, while higher scores suggest increased risk and may warrant more aggressive preventive measures.