Calcium-score screening can detect heart disease, even in adults with no symptoms

PHILADELPHIA (WPVI) -- Even with COVID-19, heart disease continues to be the biggest health threat to Americans. But there's a non-invasive test which can find heart disease, even in adults with no symptoms.

Dr. Kate Hawthorne of Main Line Health sees it every day - people who seem very healthy, but face a real chance of a future heart attack or stroke.

"You can see how there's this really bright white piece," she explained.

That's plaque, hardening of the heart's main artery, detected by a calcium score test.

"It's a quick CAT scan, so you lay on a CAT scan table," said Dr. Hawthorne. "There's no IVs, there's no contrast. The test itself lasts about 10 minutes."

It looks inside heart arteries for fatty plaque buildups which have hardened, or become calcified.

"The most common cause of a heart attack is in a person who has plaque, where a piece of it breaks off and exposes that underlayer, which causes a blood clot to form. And then it obstructs blood flow," explained Dr. Hawthorne.

The more plaque, the higher the score, the more risk. Zero to 10 means no or minimal evidence of coronary artery disease, 100 to 400 is moderate evidence and over 400 indicates extensive buildups in the arteries.

"We get to see all three major blood vessels, and in this patient, we found a lot of plaque in each," said Dr. Hawthorne.

Dr. Hawthorne says a calcium scan is considered for those over age 45 who don't have symptoms, but have an increased risk due to family history, being a past or present smoker, have a history of high cholesterol, diabetes or high blood pressure, are overweight, or have sedentary lifestyles.

She says seeing is believing for patients who need healthier habits, or cholesterol medication.

"Now that I've seen there is disease there and I can truly do something to prevent bad things from happening, there's some motivation," said Dr. Hawthorne.

Most insurance companies don't cover calcium scoring. However, it's fairly inexpensive. The average cost is $100 to $200 and many years of studies have shown its value.