What a Calcium Score Can Tell You About Your Heart Health

Plaque can build up inside your arteries for years before you feel any symptoms. By the time chest pain or shortness of breath appears, heart disease may already be advanced.

A coronary artery calcium (CAC) score is one way clinicians look for early signs of plaque in the arteries that supply blood to your heart. It helps estimate your risk of heart disease and can guide decisions about prevention.

Plaque is a mixture of fat, cholesterol, immune cells, and other substances that collect inside artery walls. As plaque builds up, it can lead to atherosclerosis, a condition that narrows and stiffens the arteries.

Plaque formation involves several changes inside the artery:

Arteries can stretch outward as plaque builds up. This process, called positive remodeling, helps preserve blood flow for years. Because of this, many people have no symptoms until plaque becomes more advanced.

Some risk factors for heart disease can be changed. Others cannot.

• Smoking
• High cholesterol
• High blood pressure
• Diabetes

These conditions directly affect artery health and contribute to plaque formation.

• Age
• Sex
• Family history

Even though you can’t change these, they still help clinicians estimate your overall cardiovascular risk.

A coronary artery calcium score measures the amount of calcified plaque in the coronary arteries.

The test is done with a specialized CT scan called a CAC scan or calcium score test.

Here’s what to expect:

The scan detects calcium deposits in artery walls. Calcium is a sign that plaque has been present for some time.

• Score of 0: No calcified plaque detected
• Higher score: More calcified plaque and higher risk of heart disease

In general, the higher the score, the greater the risk of a heart attack or other atherosclerotic cardiovascular event.

A calcium score can:

It’s most helpful for people whose risk is not clearly low or clearly high.

A calcium score has important limits.

It does not:

You can still have non-calcified plaque even if your calcium score is zero. If you have symptoms or high risk, your clinician may recommend additional testing.

A CAC scan is not recommended for everyone.

It may be discussed if you:

It is generally not used if you:

In those situations, the test would not change treatment decisions.

A coronary artery calcium score is one tool among many. It does not diagnose heart disease by itself, but it can provide valuable insight into plaque burden and long-term cardiovascular risk.

When combined with other information, such as blood pressure, cholesterol levels, diabetes, smoking history, age, and family history, it helps create a clearer picture of your vascular health.

If you’re unsure about your heart disease risk, it may be worth asking your clinician whether a calcium score could help guide your prevention plan.