Q. Why should I be screened? I feel fine.

A. In its earliest and most treatable stages, heart disease rarely reveals itself through symptoms. For many people, a heart attack is the first clue of any heart problems.

Q. What is the HeartSaver CT?

A. The HeartSaver CT, also known as a coronary calcium scan, provides images of your heart's arteries (coronary arteries). Doctors use the images to search for calcium in the coronary arteries and identify blockages. The result of this test is often called a coronary calcium score.

The HeartSaver CT may indicate your risk of having a heart attack or other cardiovascular problems before obvious symptoms of heart disease are present. Coronary calcium scans are not for everyone, though.  The protocol section of this document explains who should receive this screening.  Routine use of coronary calcium scans on people who do not have symptoms of heart disease is not recommended by the American Heart Association or the American College of Cardiology.

Q. What makes HeartSaver CT different from traditional tests?

A. Traditional risk-factor tests do not always predict coronary artery disease. For example, it's been shown that a significant number of patients with elevated cholesterol levels will never develop a coronary event. Yet, at the same time, many with normal cholesterol levels do develop significant disease.

Q. Isn't a stress test enough?

A. Graded exercise stress tests can uncover certain problems, especially if heart disease is so advanced that danger is imminent. Oftentimes, however, stress tests miss the problem and patients go undiagnosed. Because a treadmill test will detect only major flow-obstructing lesions, it is not appropriate for preventative testing or for screening patients who do not have symptoms. The HeartSaver CT offers crystal-clear images that identify coronary calcium, ranging from the mild to severe.

Q.  Why is HeartSaver CT a Screening Tool?

A.  The HeartSaver CT is a noninvasive technique used to measure the amount of calcium in the walls of your coronary arteries - the arteries that supply your heart with blood. Having calcium in the walls of your arteries could mean that you have a type of heart disease called coronary artery disease.

Coronary artery disease is a leading cause of heart attacks. Coronary artery disease occurs when plaque builds up and narrows your arteries (atherosclerosis). The plaque is made of fat, cholesterol and calcium. It is the calcium in the plaque that the coronary calcium scan can detect.  Researchers believe the amount of calcium present can be used to calculate a score that, when combined with other health information will determine your risk of coronary artery disease or heart attack.

The HeartSaver CT may not be an appropriate screening tool for those individuals who fall into a low risk category for heart disease or those who have previously been identified as high risk for heart attack.  The American College of Cardiology and the American Heart Association have created guidelines to determine if a coronary calcium scan may be useful in deciding whether you need to take action to prevent a heart attack within three to five years.  The guidelines are based on risk factors for coronary artery disease, such as age, sex, cholesterol levels, blood pressure and tobacco use.  More information can be found at www.americanheart.org.

Q.  Who should receive the HeartSaver CT Screening?

A. The State of Texas governs who may receive a coronary calcium scan without a referring physician's order.  The following are requirements to receive the screening without a physician's order:

1. Males must be forty (40) to sixty-five (65) years of age.
2. Females must be forty-five (45) to seventy (70) years of age.
3. The self-referred screening candidate must have one of the following risk factors:
1. Diabetes,
2. Current Smoker,
3. Obesity,
4. Family history of heart disease,
5. Cholesterol level greater than 160/LDL,
6. Blood pressure greater than 140/90

Only if an individual meets the above requirements can a coronary calcium scan be performed at the request of a patient.  If a physician refers the patient (written physician order) for the study, then the test can be performed on any individual in any risk and age category.

Q. How long does the HeartSaver scan take?

A. The HeartSaver CT usually takes less than an hour of your time. The procedure itself takes about 7 minutes in most cases.

Q. Are needles involved?

A. There are no needles with the HeartSaver CT. There are no catheters, no injections, no dyes. The procedure is painless, noninvasive and in fact, you don't even have to change clothes.

Q. How accurate is HeartSaver CT?

A. Studies indicate an accuracy of 95 to 98 percent. Even more significant, the reliability increases with your age.

Q. What do the results mean?

A. Results include photographic images and a calcium score (reflecting amount of calcium within the coronary arteries) with guidelines that help you and your physician discuss the results. Your score is identified as very low risk, low risk, moderate risk, high risk or very high risk. Based on this calcium score, you can look at ways to change your diet, lifestyle or medication to better combat heart disease.

Q.  Are there risks associated with the screening?

A.  To perform a coronary calcium scan, Heart Hospital of Austin utilizes a technology called electron beam computerized tomography (EBCT).  This technology produces a significantly lower dose of radiation compared to spiral scanner (MDCT) technology found in many hospitals.  However, EBCT scanners do have some risk.  According to some literature references, one EBCT scan of the heart is equivalent to 23 to 33 chest x-rays.  However, the EBCT scanner at Heart Hospital of Austin has a confirmed measurement of dosage equal to 15 chest x-rays (1.5 mSv).  Heart Hospital of Austin performs routine measurements of the radiation emitted by the EBCT scanner.  The chart below shows the average measured dose and compares it with the dose from a chest x-ray, air travel and natural exposure from the environment.

Repeated scans over time could expose a patient to excessive levels of radiation and thereby increase the risk of cancer caused by radiation.  Pregnant women are not eligible for a coronary calcium scan.

If you would like to determine your risk for heart disease or heart attack, speak with your doctor to determine if this screening tool is right for you.  If you obtain a HeartSaver CT scan without a doctor's order, be sure to provide a copy of the results to your primary care physician for follow-up.  He or she can help you decide what steps you may need to take to improve your heart health and prevent a heart attack.