Heart Disease and the Heart CT Scan

Medically Reviewed by James Beckerman, MD, FACC on April 06, 2023
3 min read

A heart computerized tomography (CT) scan, also called a calcium-score screening heart scan, is used to find calcium deposits in plaque of people with heart disease. They’re an effective way to spot atherosclerosis before symptoms develop.

The more coronary calcium you have, the more coronary atherosclerosis you have. That gives you a higher chance of cardiovascular problems in the future.

Some kinds of coronary disease don’t show up in a CT scan, so it’s important to remember that this test can't completely predict things like a heart attack.

In addition to a CT scan, your doctor may order a coronary CT angiogram (CTA) to get more detailed pictures of the arteries of your heart.

You can continue to take your medications. But you should avoid caffeine and smoking for 4 hours before the test. CT scanners use X-rays, so this is not recommended if you are pregnant. Tell your technologist and your doctor if you are:

You will change into a hospital gown. The nurse will record your height, weight, and blood pressure. You may have blood taken for a lipid analysis.

You’ll lie on a special scanning table. The technologist will clean three small areas of your chest and place small, sticky electrode patches there. Men may expect to have their chest partially shaved to help the electrodes stick. They are attached to an electrocardiograph (EKG) monitor, which charts your heart's electrical activity.

You may also get a shot of contrast material. This will help your coronary arteries to show up.

During the scan, you’ll feel the table move inside a doughnut-shaped scanner. The high-speed CT scan gets many images, in sync with your heartbeat.

A computer program, guided by the cardiovascular radiologist, analyzes the images to look for calcification in your coronary arteries. If there isn’t any, it’s considered a negative exam. But there could still be soft, noncalcified plaque.

If there is calcium, the computer will create a score that estimates how much coronary artery disease you have.

The whole thing takes only a few minutes.

You can do what you normally do and eat what you usually do after the scan.

The results will be reviewed. Your doctor will then know:

  • The number of calcified coronary plaques in the coronary arteries and how dense they are
  • Your calcium score

A team of cardiovascular specialists will review your heart CT scan results. They will evaluate the calcium score and your CT angiogram, along with things like your blood pressure and lipid analysis. They’ll then recommend any changes in your lifestyle and medications, plus other cardiac testing you should get.

You and your primary care doctor will get the full report outlining your risk assessment and follow-up recommendations.

Because this CT scan is a screening exam for heart disease, it is not covered under most insurance companies. Medicare does pay for some CT angiograms.