A Woman’s Heart, the CT Heart Scan

Since I have several risk factors for developing cardiovascular disease, my doctor recommended that I have a CT heart scan. While I had heard of a CT heart scan, I was not really familiar with exactly what a CT heart scan was or what benefit it provided.

What is it? Was it expensive? Invasive? What does it show? How will the results help me and my doctor? In other words, why should I have this test? Inquiring Mary wanted to know!

What is a CT heart scan?*

Simply put, a CT heart scan (also referred to as “computed tomography”) combines multiple X-ray images together with the use of a computer. The scan does not require you to have an IV. The result is a “picture” that provides your doctor with a very detailed view of your heart, arteries, pulmonary veins, coronary circulation, etc. Because the view is so detailed, the scan is able to show your doctor the amount of calcium deposits (plaque), if any, which are in or around your heart. The test is advertised as simple, quick, painless, and non-invasive. Since the CT heart scan can detect calcified blockages in the arteries (from atherosclerosis) before symptoms prevent themselves, it can be an excellent preventative diagnostic tool. As with most diseases, early detection and treatment can impact the long-term outcome of disease progression. Heart disease lends itself particularly well to treatment when detected early.

Research indicates that the coronary calcium scores provided by the CT heart scan are better in terms of predicting risk for heart disease than other diagnostic measurements, including HDL/LDL and total cholesterol count. The test score also provides a measurable, trackable risk index. A calcium score of zero indicates that you have no measurable calcium buildup in your arteries and therefore a low 5-year risk for heart disease. A higher score would indicate an increase in the risk level of a cardiac event.

It should be noted that the CT heart scan only detects calcified plaque, which is an indicator of heart disease. It will not detect soft plaque (non-calcified deposits). Soft plaque is also an indicator of heart disease.

Is it expensive?
That depends upon how you look at it. At the time that I had the CT heart scan, the test cost about $200, which as tests go, was relatively inexpensive. However, because it was considered a “preventative” diagnostic test, it was not covered by my insurance so I did have to pay for the test out-of-pocket. Texas has since passed a law requiring insurance companies in Texas to cover the cost of the CT heart scan for certain age groups and persons with certain risk factors.

Is it invasive?
Not at all. The entire test was quick, painless and non-invasive. The technician took brief history before beginning the test (ie. Do I smoke? If so, how much? Any family history of heart disease? High blood pressure? etc.). The test consisted of lying on my back comfortably (pillows and everything!) while the technician and I cracked jokes with one another. The entire procedure took less than 10 minutes. I didn’t even have to change clothes! (How cool is that?)

Was it worth it?
For me, yes, it was. I have several risk factors for developing cardiovascular disease, including a strong family history of heart disease. The CT scan was able to provide my doctor with a clear picture of my “state-of-the-heart.” Understanding the current state of my heart was a key benefit to us in making a “next steps” decision in terms my heart health.

As with any newer technology, not everyone is on board with the use of the CT scan. Some concerns have been expressed regarding the exposure to radiation or that clinics that purchase the scanners will order unnecessary tests on their patients just to pay for the machine. The use of the CT scan also seems to be more accepted and prevalent in certain regions of the US (like the south) than other regions. Other physicians have expressed concern that the CT heart scan would lead to other unnecessary procedures. (I’m not sure I “buy” into this concern because doctors are the ones who order additional tests, not the CT scan tool. A doctor who abuses the results doesn’t negate the value of the tool!)

Whether or not a CT heart scan is the right preventative test for you is a decision that only you can make. Hopefully, this gives you some additional information for your decision-making toolbox!

Until next time, here’s wishing you a healthy heart…

(Disclaimer: I am not a physician and nothing in this article should be construed as giving medical advice. As with any medical decision, please consult your physician.)
*(NOTE: A CT heart scan should not be confused with a CT coronary angiography. These are two different tests with different results and different radiation exposure levels. I found the terms used interchangeably in many articles that I read in researching for this one but they are two different tests.)
Sources:
The Heart Hospital of Austin, http://www.hearthospitalofaustin.com/Default.aspx?tabid=1017
Dr. William Davis, A Victory for SHAPE, CT heart scans, and doing what is RIGHT, The Heart Scan Blog, 24 June 2009, http://heartscanblog.blogspot.com/2009/06/victory-for-shape-ct-heart-scans-and.html

Diagnosing Heart Disease With Cardiac Computed Tomography, WebMD, http://www.webmd.com/heart-disease/guide/ct-heart-scan

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