Is plaque to blame?

When it comes to damage or disease in the heart’s major blood vessels, plaque is often to blame.

Plaque is fatty deposits of cholesterol, calcium, and other substances that build up in the artery walls. As the artery walls thicken, blood flow is reduced, threating vital organs and other parts of the body. This condition is called atherosclerosis, or hardening of the arteries.

A hardening of the arteries can cause heart attack, stroke, heart disease, chest pain, or chronic kidney disease. When arteries that carry blood to the heart become restricted or blocked, it is called coronary artery disease (CAD).

A standard measurement of CAD is a heart scan (coronary calcium screening), which measures the amount of calcified plaque in the coronary arteries. The screening uses computerized tomography (CT), which is a quick and safe test using low-dose X-rays.

A coronary calcium score of zero indicates no plaque in the arteries, and a low risk of heart disease. When calcium is present, the higher the score, the higher the risk of heart disease or stroke.

A coronary calcium screening is beneficial for people with an intermediate risk of CAD. The scan can help determine follow-up testing and behavior modification, if necessary. However, the scan does not show soft plaque (which does not contain calcium) that is “hidden” inside the artery walls. Soft plaque rupture is responsible for up to 75 percent of acute coronary events, according to the American Heart Association.

A coronary CT angiogram is a more detailed look at the coronary arteries, as well as the chambers and valves of the heart. A contrast agent is administered, which fills the coronary arteries and identifies plaque, both hard and soft. This exam is appropriate for people who have multiple risk factors, are experiencing chest pain, or have had an inconclusive stress test.

People can reduce their risk of coronary artery disease by eating a healthy diet, exercising, stopping smoking, limiting alcohol use, and taking certain medications.

Horizon Health offers coronary calcium screening. To determine whether a screening is recommended for you, take a free quiz at MyHorizonHealth.org/Cardiology.