February 19, 2019
Radiologist consoling senior female patient

Cautions About Coronary Calcium Testing

by Wellness Letter  

If you are considering having your coronary artery calcium (CAC) measured to better assess your cardiovascular risk, you should know its downsides:

  • Radiation. The CT scans produce radiation, albeit relatively low levels—similar to the amount of naturally occurring radiation the average American is exposed to over 4 to 12 months. The long-term risk of cancer as a result of CAC scans remains uncertain. For more about the risks of radiation from medical imaging, see Reducing Radiation from Health Scans.
  • Misleading results. In some people, an elevated CAC score can lead to unnecessary invasive diagnostic procedures (such as coronary angiography) as well as needless worry. And even if your scan shows that you have no calcification—a zero score—that doesn’t mean your risk of a heart attack is zero, just that it is probably low. Moreover, the scans don’t identify non-calcified “soft” plaques, which are most likely to cause a heart attack.
  • Incidental findings. The CT scans may find abnormalities in nearby tissue (most commonly lung nodules) that usually turn out to be harmless. Such incidental findings can lead to more testing and often unnecessary treatment.
  • Cost. Most health insurance plans and Medicare don’t cover CAC screening, which can cost anywhere from $100 to $400.

This article first appeared in the UC Berkeley Wellness Letter.