Coronary calcium screening reveals hidden heart problems

"If a heart attack had occurred, it very likely could have been lethal."

By: Jenny Rackl .

Heart screening showed a high coronary calcium score.
Heart screening showed a high coronary calcium score.
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Last July, John Heitkamp and his wife went to Sanford Health in Worthington, Minnesota, to check the health of their hearts through a heart screening. It had been 10 years since Heitkamp’s last one.

“We went over there and had it done, and the gal said that my calcium score was quite high and I should have it checked out,” Heitkamp said.

A coronary calcium score measures how much calcium has built up in artery walls, creating a higher risk for heart attack or stroke. When the heart screening showed a high coronary calcium score, Heitkamp was referred to Tom Stys, M.D., a cardiologist at Sanford Health.

“The plaque in his arteries increased by about tenfold over a decade, which was a red flag,” said Dr. Stys. “We needed to make sure there wasn’t a problem that would possibly be life-threatening to him.”

But at that time, Heitkamp didn’t experience any symptoms.

“When they wanted me to go to a specialist, I kind of felt like maybe they made a mistake with the test. Because I had no chest pains, arm pains or anything. I didn’t even think I was short of breath,” Heitkamp said.

Serious problem, simple solution

But further testing with Dr. Stys revealed there had been no mistake — Heitkamp definitely had a cardiovascular problem.

“Ultimately, he did have a blockage in the main artery in the front of the heart. If a heart attack had occurred, it very likely could have been lethal,” said Dr. Stys.

Once the blockage was identified, Dr. Stys could fix it by placing a stent, a tube that props the artery open where it has narrowed from plaque build-up. The simplicity of the procedure surprised Heitkamp.

“We went into the operating room — and zip-zip and it was done. It couldn’t have been easier,” he says.

The outpatient procedure had Heitkamp back home within hours.

“And now, in a way, he has a fresh start,” Dr. Stys said. “He did not have any other major blockages. His heart function remains normal. His valves are functioning normal.”

Sold on screenings

His experience has certainly made Heitkamp an advocate for heart screenings.

“That was the cheapest thing I’ve ever done to save my life. I would encourage someone to just have it done, even if you think you’re in perfect health. I thought I was, and here I had an 80 percent blockage.”

Dr. Stys thinks it’s never too early to be screened for heart disease.

“Since it’s such a predominant condition, I believe everybody should be screened in one way or the other for cardiovascular disease,” Dr. Stys said. “I always recommend our patients consider screening not just for themselves but even their children. It’s never too early to think about cardiovascular issues.”

You can make an appointment for heart and vascular screenings at Sanford Health by calling (605) 333-1000.

Risk factors

Cardiac calcium scoring is painless and recommended for people with a number of identified risk factors, including:

  • Diabetes
  • Family history of heart disease
  • High blood pressure
  • High cholesterol
  • Obesity
  • Sedentary lifestyle
  • Tobacco use

Heart screen procedure

The noninvasive heart screen procedure involves putting small electrodes connected to an electrocardiogram machine on the patient’s chest. The person then lies on a table connected to a computed tomography, or CT, scanner, which is a large, doughnut-shaped machine. The table slides into the opening of the scanner, which moves around the body. Patients may be asked to hold their breath for 20 to 30 seconds while about 200 pictures are taken of the heart.

The scan and other parts of the test reveal a wealth of information, including blood pressure, body mass index (BMI), cholesterol, heart impulses and a Framingham score that estimates the risk of developing heart disease within the next 10 years.

Coronary calcium score

The test also produces a CT calcium score that analyzes the amount of plaque in a person’s coronary arteries. The higher the number, the more plaque:

  • 0: No plaque is present. Less than a 5 percent chance of having heart disease and a very low risk of heart attack.
  • 1-10: Small amount of plaque is present. Less than a 10 percent chance for heart disease and a low risk of heart attack. Now’s the time to quit smoking, eat better and exercise more.
  • 11-100: Plaque is present. The person has mild heart disease and is at a moderate risk of heart attack. They should talk with their physician about quitting smoking, eating better, exercising and taking other necessary treatments.
  • 101-400: A moderate amount of plaque is present. The person has heart disease, and plaque may be blocking an artery. Their heart attack risk is moderate to high, and the physician may want more tests and to start treatment.
  • Over 400: A large amount of plaque is present. It’s very likely that plaque is blocking an artery and the person’s heart attack risk is high. Their physician will want more tests and will start treatment.

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