Savvy Senior: Do I need a coronary artery calcium scan?

Dear Savvy Senior: I just turned 58, and heart disease runs in my family. My cholesterol has been creeping up, and I’ve been hearing about a scan that can show your actual heart risk. Is that something I should look into? — Heart Worried

Dear Heart Worried: You’re smart to be thinking about this now. For years, cholesterol numbers have been the main way to estimate heart disease risk. But there’s another tool gaining attention that can offer a more direct look: a coronary artery calcium (or CAC) scan.

This quick, noninvasive test looks for actual plaque buildup in your heart’s arteries, not just the risk of developing it.

Here’s why that matters. High cholesterol suggests you might develop heart disease someday. But calcium in your arteries means some disease is already present. The higher your calcium score, the greater your risk of a future heart attack or stroke. That makes this test especially useful for people like you with a family history and borderline numbers.

How it works

A CAC scan is a specialized CT scan that takes about 10 minutes and doesn’t require needles or dyes. You simply lie on a table while the scanner takes images of your heart. It uses a small amount of radiation, similar to a mammogram.

The result is a calcium score that reflects how much plaque is in your arteries:

■ A score of zero means no detectable plaque.

■ A score from 1 to 100 indicates mild plaque.

■ A score from 100 to 299 suggests moderate buildup.

■ A score of 300 or higher points to more serious disease.

This number gives you and your doctor something concrete to work with. Instead of guessing about your risk, you can make more confident decisions about whether to start a statin or focus on lifestyle changes alone.

Who needs it

Not everyone needs a CAC scan. It’s most helpful for adults over 40 who have some risk factors, like high cholesterol, high blood pressure or a family history of heart disease, but aren’t clearly high or low risk.

If your risk level is uncertain or you’re hesitant about taking a statin, the scan can help break the tie. It can also be a strong wake-up call. Many people who see plaque on their scan are more motivated to take medication, improve their diet, lose weight and stay active.

Getting tested

CAC scans are widely available at hospitals and imaging centers that offer CT services. You’ll usually need a doctor’s order, but some centers offer self-pay screenings you can schedule yourself.

The scan typically costs about $75 to $200 out of pocket and usually isn’t something you need to repeat very often. Results are often available quickly, sometimes within a day or two.

A couple of caveats: A score of zero doesn’t mean you have no risk, and the test isn’t meant for diagnosing symptoms like chest pain. It’s just one piece of the puzzle and should be considered along with your overall health picture.

Given your age, family history and slightly elevated cholesterol, a CAC scan could be a very useful next step. It’s worth having a conversation with your doctor to see if it makes sense for you.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.