CT coronary calcium score
Informed by recognized medical guidance
Overview
A CT coronary calcium score is a special type of CT scan that takes pictures of your heart's arteries to measure the amount of calcium in them. Calcium in the arteries is a sign of plaque buildup, which can increase your risk of heart disease. The result is given as a number (Agatston score) that helps your doctor estimate your future heart risk.
Key facts
- It is a quick, painless scan that does not require any dye or needles.
- The result is a number that tells you how much calcium is in your heart arteries.
- A higher score means more calcium and a greater chance of having a heart attack in the future.
- It is often used for people who have risk factors but no symptoms of heart disease.
CT coronary calcium scoring is becoming more common as a screening test for people at intermediate risk of heart disease. It is not yet a routine test for everyone, but many doctors recommend it for patients with certain risk factors.
It is typically recommended for adults aged 40 to 75 who have risk factors such as high cholesterol, high blood pressure, diabetes, smoking, or a family history of early heart disease, and who do not already have known heart disease.
Symptoms
- Chest pain or pressure that lasts more than a few minutes or goes away and comes back.
- Pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
- Shortness of breath with or without chest discomfort.
- Breaking out in a cold sweat, nausea, or lightheadedness.
- ⚠New chest pain that happens when you exercise and goes away with rest.
- ⚠Unexplained shortness of breath that is getting worse.
- ⚠Feeling your heart race or skip beats, especially if you have other risk factors.
Common symptoms
- This test is usually done for people without symptoms, but your doctor might suggest it if you have: a family history of heart disease, high cholesterol, high blood pressure, diabetes, or if you smoke.
Symptoms in children
- CT coronary calcium scoring is not used in children. Heart calcium buildup takes many years to develop and is extremely rare in children.
Symptoms in older adults
- In older adults, the same symptoms that may lead to this test include shortness of breath, chest discomfort on exertion, or fatigue. The test helps clarify risk when symptoms are unclear.
Causes
Main causes
- The calcium seen on the scan comes from plaque (a mixture of fat, cholesterol, and other substances) that builds up inside the walls of the heart arteries over many years. This process is called atherosclerosis.
Risk factors
- High LDL cholesterol (the 'bad' cholesterol)
- High blood pressure
- Smoking or exposure to tobacco smoke
- Diabetes or prediabetes
- Obesity or being overweight
- Not getting enough physical activity
- Unhealthy diet high in saturated fats and processed foods
- Family history of early heart disease (father or brother before age 55, mother or sister before age 65)
- Being over 40 (for men) or over 50 (for women)
When to see a doctor
See a doctor urgently if:
- If you have any of the emergency symptoms listed above, call your local emergency number right away.
Book a routine appointment if:
- If you have risk factors for heart disease and want to know your personal risk, ask your doctor if a CT coronary calcium score might be helpful for you.
- If you already have a high score, make a plan with your doctor to manage your heart health.
Diagnosis
The CT coronary calcium score itself is the diagnostic test. A special CT scanner takes multiple images of your heart, and a computer calculates the amount of calcium in your coronary arteries.
Tests that may be done
- CT coronary calcium scan (the main test)
- If the score is high, your doctor may recommend further tests such as a stress test, echocardiogram, or coronary angiogram to get more details.
What to expect at your appointment
You lie on a table that slides into the CT scanner. You may be asked to hold your breath for a few seconds while the images are taken. The scan is painless and takes about 10 to 15 minutes. You do not need to fast, but your doctor may ask you to avoid caffeine on the day of the scan.
Treatment
There is no treatment for the calcium score itself. Instead, the score helps your doctor decide how aggressively to treat your heart disease risk. Treatment focuses on lowering your chances of a heart attack or stroke.
Self-care at home
- Quit smoking and avoid secondhand smoke.
- Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
- Get at least 150 minutes of moderate exercise each week.
- Maintain a healthy weight.
- Limit alcohol intake.
Medical treatments
Depending on your score and overall risk, your doctor may recommend medications to lower your cholesterol, blood pressure, or blood sugar. Treatments such as low-dose aspirin or other blood thinners may also be considered. Always follow your doctor's advice and take any prescribed medicines exactly as directed.
When is surgery considered?
A high calcium score alone rarely requires surgery. However, if further tests show significant blockages, procedures such as angioplasty (opening a blocked artery with a balloon) or bypass surgery might be needed. Your doctor will discuss these options if they apply to you.
Living with this condition
If you have a high calcium score, your daily life may involve being more careful about heart health. This can mean checking your blood pressure at home, taking your medications consistently, and paying attention to any new symptoms.
Lifestyle tips
- Follow a heart-healthy diet low in saturated fats and salt.
- Stay physically active with walking, swimming, or cycling.
- Manage stress through relaxation techniques or hobbies.
- Get enough sleep (7-9 hours per night).
- Avoid smoking and limit alcohol.
Diet and exercise
Aim for a balanced diet that includes plenty of vegetables, fruits, whole grains, and lean protein. Limit red meat, fried foods, and sugary drinks. For exercise, try to get at least 30 minutes of moderate activity most days. Even a brisk walk helps your heart.
Mental health and emotional wellbeing
Learning you have a high calcium score can be worrying. It is normal to feel anxious or stressed. Talk to your doctor about your concerns. If feelings of anxiety or depression persist, reach out to a mental health professional or a crisis helpline in your area.
Prevention
You cannot reverse the calcium already in your arteries, but you can prevent further buildup by managing your risk factors. A CT calcium score helps you know where you stand so you can take action early.
Screening programmes
The CT coronary calcium score is itself a screening test. It is not recommended for everyone, but your doctor may suggest it if you have an intermediate risk of heart disease based on your age, blood pressure, cholesterol, and other factors.
Complications
If left untreated
- If the underlying risk factors are not managed, a high calcium score indicates a greater chance of having a heart attack or stroke.
- Plaque can continue to build up, narrowing arteries and reducing blood flow to the heart.
Long-term outlook
Having a high calcium score does not mean a heart attack is certain. It is a warning sign that gives you a chance to act. Many people with high scores can greatly reduce their risk through lifestyle changes and medical care. With your doctor’s help, you can protect your heart and live a full, active life.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 16, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.
Guidance may differ by country or region. Confirm local recommendations with a qualified healthcare provider.