In an editorial on “The Potential and Pitfalls of Coronary Artery Calcium Scoring,” published in JAMA Cardiology in October, Dr. Khan and her co-author Dr. Ann Marie Navar, cardiologist at the University of Texas Southwestern Medical School, said that for middle-aged and elderly adults like my friend, the calcium test is one of the best and safest ways to detect the presence of otherwise hidden atherosclerosis.
Why Younger Adults Should Care.
The results of a calcium scan can also be important to younger men and women – and sometimes to their doctors, who may not take risk factors in younger patients as seriously as they should.
“Given the robust association between coronary calcium and cardiovascular disease,” said Drs. Khan and Navar wrote, “The presence of coronary artery calcium in young adults should be a warning sign of a high-risk patient.” Khan stated in an interview: “The presence of any Calcium in the coronary arteries is a sign of heart disease. “
When atherosclerosis first develops, the arterial lesions called plaque are not calcified, explained Dr. Philip Greenland, also a preventive cardiologist at Northwestern. Rather, over time, the lesions acquire the bony deposits that gradually increase as the plaque cracks and is repaired. The healing process causes calcification, he said.
Dr. Greenland cautioned patients and doctors never to assume that zero calcium means there is nothing to worry about. He said that in men under 40 and women under 50, “coronary artery calcium cannot be relied on alone because levels are usually zero, even with atherosclerosis.”
He and Dr. Rather, Kahn said that for younger adults, follow-up exams and medical advice should be based on the patient’s level of cardiovascular risk, including whether they have symptoms of heart disease, such as shortness of breath when climbing stairs or chest pain when exerting themselves.
The good news and bad news about zero calcium.
Dr. Greenland said that people with “a profile with low risk factors and zero calcium have some sort of guarantee that they will not have a heart attack in 10 years.”