Dr. Wy, why should I get one of those heart CT scans I see advertised on TV all the time? I’ve never had a heart problem.

Ask Dr. Wy…

Richard Wyderski, MD, FACP

Dr. Wy, why should I get one of those heart CT scans I see advertised on TV all the time? I’ve never had a heart problem.

Some advertisements say that everyone should get a heart CT scan. Though it can help physicians reduce the chances of a heart attack, it isn’t for everyone. The test itself is simple. You lie down and the doughnut-shaped scanner quickly makes images of your heart. That’s it!

A computer then calculates the amount of calcium in the heart arteries and provides a “CAC” score. A zero score means there’s hardly any cholesterol in the heart arteries. A score of over 400 means there’s a LOT of buildup, though it doesn’t tell you where or how tight the blockages are. And the higher the score, the more likely someone is to have a heart attack.

The American College of Cardiology has guidelines to help decide when the heart CT scan is useful. It’s only valid in people aged 40 to 75 years. High risk people always need treatment with a statin. If someone has a negative stress test, it may be wrong, and the CAC score may indicate the need for statin treatment. And people at medium risk on the fence about starting a statin should probably start one with an elevated score. We don’t want heart attacks!

Statins prevent heart attacks in part by infusing MORE calcium into cholesterol blockages that PREVENT heart attacks, so a high CAC score can be misleading. So if you have been on a statin, DON’T get a heart CT!

Sounds confusing? It’s complicated, so please talk to you doctor about whether it’s right for you!

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