It is an Computed Tomography scan of the coronary arteries ( the vessels which carry blood and oxygen to the heart muscle ).

The scanner detects and measures calcium in the coronary arteries, which is the marker for atherosclerosis ( the accumulation of cholesterol plaque in the arteries ). The test is non-invasive with no pain, using no injections, chemicals or incisions. You just lie on a table, hold your breath for a few seconds and let the scanner take pictures of your heart. The complete process only takes a few minutes.

The non-invasive CT scan (CAS) measures coronary disease in a way which many doctors now believe is more important than the percentage of blockage ( referred to as stenosis or occlusion ). The scan measures the amount of calcium plaque within your coronary arteries. This measurement indicates the level of atherosclerosis in a person, i.e., the more calcium you have, the more plaque you have and therefore the greater the chance that you will suffer a heart attack or need surgery in the future unless you take early steps to prevent this.

Many authoritative studies have shown that an CT scan is highly sensitive for detecting Coronary Artery Disease. A negative test is also a very powerful indicator that the patient does not have heart disease.

Most other tests in cardiology, such as exercise stress ECG or stress thallium or stress echocardiograms detect abnormality in heart function and therefore only reliably detect heart disease when the disease is so advanced that it hinders your heart from working properly.

A CT scan of heart looks directly at the coronary arteries and measures the plaque burden and it can detect heart disease at a very early stage, usually many years before a person becomes symptomatic.

CT Heart Scan ( Coronary Calcium Scan )
+ blood test package @ RM 750.00

Can a calcium scan tell me how blocked my arteries are?

CT Heart Scan ( coronary artery calcium scan - CAS)

A plaque detector or coronary artery calcium scan (CAS) will be able to tell you whether you have heart disease. It can detect heart disease at its very early stage, even before any cardiac symptoms are noticeable and even before your stress test indicate any abnormality. This is especially beneficial for those who have no symptoms but who may have one or more of the following cardiac risk factors :

1. ) age ( males above 40, females above 45 )
2. ) smoker
3. ) high cholesterol
4. ) inactive lifestyle
5. ) family history of heart disease
6. ) high blood pressure
7. ) overweight
8. ) diabetes

If you wish to find out how blocked your arteries are, a non-invasive CT Angiogram ( CTA ) will be able to do so to an accuracy of greater than 90%. This involves the use of non-ionic ( to minimize risk of allergies ) contrast or dye injected through a vein in the arm. The computer then reconstructs the images to enable you and your doctor to visualize the coronary arteries in 3D. The CTA will give valuable information to the patient and his doctor prior to a traditional invasive angiogram and is useful for certain indications depending on the condition of the individual.

A normal CTA means that the patient does not have to undergo an invasive angiogram. However an invasive angiogram may still be needed when severe obstructive coronary artery disease is diagnosed and when it is necessary to undergo angioplasty or bypass surgery.

The indications for CTA are as follows :-

- "Symptomatic" patients with mild  to moderate coronary calcification
- "Sub-clinical" patients with severe coronary calcification
- Follow-up of coronary angioplasty, coronary bypass
- Follow-up of coronary patency post MI or stent
- Assessment of coronary artery congenital or acquired anomalies
- "Low risk" patients with abnormal stress tests

You can ask your family doctor to do a cardiac assessment on you to determine your cardiac risk, ie whether you are in the low, intermediate or high risk category. You can also come directly to our centre.  Our consultant will be able to advise you on whichever scan you will need.

The prevalence of coronary atherosclerosis increases with age.

A coronary artery scan (CAS) can both detect and measure the extent of coronary calcification, and can identify those people at greatest risk of a heart attack. However, it should be noted that there are many people between 50 and 70 who have no coronary calcium whatsoever, which means that they have a very low risk of having obstructive Coronary Artery Disease or heart attacks.

A patient is only subjected to a small amount of radiation, approximately equivalent to the radiation received during one abdominal x-ray.  As such, the scan is safe for everyone, although pregnant women are advised against doing so to avoid any radiation.

The CTA involves injection of a non-ionic dye and carries a small risk of allergic reactions, e.g rashes.

Each test in cardiology serves a specific purpose. Coronary Artery Scanning (CAS) is the best available screening test for detecting early heart disease, and is usually performed before any of the other cardiac tests, including a stress test.  The stress test still has a role to play, and it is useful to determine whether a patient has ischaemia due to severe obstructive coronary artery disease which requires urgent angioplasty or bypass surgery.

Men over the age of 38 and women over the age of 45 should actively consider taking a CAS scan. The more risk factors for heart disease you have, e.g. high cholesterol, high blood pressure, smoking, diabetes, obesity, sedentary lifestyle, high stress lifestyle, family history of heart disease, etc., the more important it is that you ask your doctor to recommend you for a scan. If you are younger than 38, then upon your doctor’s recommendations, you may also take the CAS scan if you have multiple risk factors. 

The results show, on an artery-by-artery basis, the amount of any calcium deposited. The total amount of calcium ( the calcium score ) is then compared to the scores of other individuals of your age. If you do have calcium deposits, your doctor will consider your overall health condition and advise and/or treat you accordingly. The main objective is to ensure that your risk of heart attack is reduced and your heart disease does not progress to a significant late disease stage.

For individuals who have had a heart attack, bypass operation or angioplasty, an CT Angiogram can be done to check the conditions of the patient’s heart arteries, the patency of post-bypass grafts or post PTCA vessels. The calcium score is also useful for it can provide a benchmark against which your doctor can measure any future progression of the heart disease. It is also important that anyone who has had a heart attack, coronary angioplasty or bypass surgery should inform his/her siblings and/or grown-up children about the availability of this test because heart disease is often a hereditary disease.

This means that your heart function is normal, even when you are pushed to peak exertion. But it does not mean that you have no coronary atherosclerosis. Your coronary arteries may not be clean, i.e. you may have plaque build up but it is not causing any obstruction to blood flow yet. There are patients who die suddenly of a heart attack despite having a negative stress test. This fact, first published in The New England Journal of Medicine in 1989, seems paradoxical. Most people still believe that heart attacks happen when coronary arteries become severely blocked. In reality, most heart attacks occur due to plaque rupture or ulceration, and can happen even when the blood vessel is not even 50% blocked.

Atherosclerosis is the name for the cholesterol plaque buildup inside your coronary arteries. The presence of atherosclerosis in your coronary arteries means the presence of Coronary Artery Disease. The greater the amount of plaque build up, the higher would be the risk of a heart attack because most heart attacks are due to plaque rupture or ulceration. When atherosclerosis advances to a stage where the blockage prevents normal blood flow to the heart muscle, it is called obstructive Coronary Artery Disease.