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Question:
What are the relative benefits and drawbacks of Coronary Calcium Scans?
Some articles in popular magazines warn about the relative benefits of Coronary Calcium Scans in the sense that its result could lead either to unnecessary treatments or misleading conclusions. What can you tell me about it?
submitted by Pierluigi from Mexico City, Mexico on 3/6/2013
Answers:
by Texas Heart Institute cardiologist, Neil E. Strickman, MD 
There is very little indication for this test in an asymptomatic patient. An abnormal result may lead to an unnecessary heart catheterization. Even if calcium is seen, it does not always correlate with severe blockage.
by Texas Heart Institute cardiologist, Patrick J. Cook, MD
I think it can be a useful test, but only when rather narrowly applied. I do agree that it is NOT a good screening test, and should not be used as such. There is some thought that it can be useful in determining how aggressive to be with CV risk management in a patient that's more or less a "tweener", i.e., at intermediate risk. In that patient, a score of or near zero can spare that patient the (albeit small) risk and expense of pharmacologic treatment of high cholesterol if diet, etc, didn't work. If there is a lot of calcium in the coronaries, it's probably prudent to treat risk factors (cholesterol) quite aggressively. The test would not be useful with a patient at high or low risk.
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Updated March 2013
