◆ OUR SERVICES / CORONARY ARTERY CALCIUM SCORE & CTA

Coronary artery calcium score — your heart attack risk in numbers.

A coronary artery calcium score reveals what’s actually happening inside your arteries — years before symptoms appear. This quick, non-invasive scan detects hidden plaque buildup that standard cholesterol tests miss entirely. At our practice, we use CAC scoring and CT angiography as essential tools to catch heart disease early, when it’s most reversible.

Coronary artery calcium score — your heart attack risk in numbers

What if you could see inside your arteries and know — with certainty — whether plaque is building up? What if you didn’t have to wonder whether your “normal” cholesterol numbers actually meant you were safe?

Here’s a truth that keeps integrative cardiologists up at night: most heart attacks happen in people with “normal” cholesterol. Standard blood tests tell you what’s floating in your bloodstream — but they can’t tell you what’s already deposited on your artery walls. That’s like checking your oil level but never looking under the hood to see if the engine is damaged.

A coronary artery calcium (CAC) score changes everything. It’s the closest thing we have to a crystal ball for your heart — a direct window into whether atherosclerosis is silently progressing, even when every other test says you’re fine.

0
A CAC score of zero means no detectable calcified plaque — and a very low risk of heart attack in the next 10–15 years. Any score above zero tells us atherosclerosis is already present and demands attention. Coronary calcium scoring research

What is a coronary artery calcium score?

A coronary artery calcium score is a specialized CT scan that measures calcified plaque in the arteries feeding your heart. The scan takes less than 10 minutes, requires no injections or dye, and delivers a precise number that tells us whether — and how much — atherosclerosis has already developed.

Think of calcium deposits as the body’s attempt to stabilize damaged areas of your arteries. Where there’s calcium, there’s been inflammation and plaque formation. A CAC score of zero means no detectable calcified plaque and a very low risk of heart attack in the next 10–15 years. Any score above zero tells us that atherosclerosis is present and demands attention.

Important
Non-calcified, or “soft,” plaque cannot be identified by a CAC score. Soft plaque is the unstable kind most likely to rupture — which is why we sometimes pair the calcium score with CT angiography to see the full picture.

CT angiography (CTA): seeing beyond calcium.

While a CAC score reveals calcified plaque, CT angiography (CTA) takes imaging a step further. Using contrast dye and advanced CT technology, a CTA visualizes your entire coronary artery tree — showing not just calcium, but soft plaque (the unstable kind most likely to rupture and cause heart attacks), narrowing of the arteries, and the overall anatomy of your coronary circulation.

We may recommend a CTA when:

  • Your CAC score is elevated and we need to assess the extent of disease.
  • You’re experiencing symptoms like chest discomfort, shortness of breath, or unusual fatigue.
  • We need to evaluate whether blockages are significant enough to affect blood flow.
  • You have risk factors but inconclusive stress test results.

Together, CAC scoring and CTA give us a complete picture of your arterial health — something blood tests alone simply cannot provide.

UNDERSTANDING YOUR CAC SCORE

A single number, four levels of risk.

Your CAC score places you on a clear gradient — from a pristine zero to extensive plaque. Each range points to a different prevention strategy, which is exactly why we test instead of guess.

0
Very Low Risk

No calcified plaque

No identifiable calcified plaque. Very low risk — this is the score we want to maintain.

1–99
Mild

Early atherosclerosis

Mild calcified plaque buildup. Early atherosclerosis is present — the ideal window for aggressive prevention.

100–399
Moderate

Disease developing

Moderate calcified plaque. Significant disease is developing — intensive lifestyle and medical intervention is warranted.

400+
High Risk

Extensive plaque

Extensive calcified plaque. High risk of cardiac events — comprehensive treatment and close monitoring are essential.

A CAC score delivers two critical metrics: a risk assessment based on the categories above, and a coronary artery age measurement that identifies how fast atherosclerosis is progressing — interpreted in the context of your unique biology. That’s exactly the kind of personalized read we provide at Holistic Heart Centers.

WHO IT’S FOR & WHAT TO EXPECT

Precision data for a data-driven approach.

CAC scoring is most valuable for people who want definitive answers about their cardiovascular risk — and we make the process clear and comfortable from start to finish.

WHO SHOULD CONSIDER CAC SCORING

People who want data, not guesswork.

  • Adults 40–75 with risk factors — high blood pressure, elevated cholesterol, diabetes, family history, or a high-risk genetic profile.
  • Those in the “intermediate risk” category where the right treatment path isn’t clear.
  • Anyone wanting definitive answers about whether statin therapy is truly necessary.
  • People with a strong family history of premature heart disease who want early detection.
  • Patients told their labs are “fine” who still feel uncertain about their heart.
  • Those committed to precision prevention who want data, not guesswork.
WHAT TO EXPECT DURING YOUR SCAN

Quick, painless imaging.

  • CAC score — you lie on a table while a CT scanner images your heart in about 5–10 minutes. No needles, no dye, no fasting. Return to normal activities immediately.
  • CT angiography — an IV injection of contrast dye, a 15–20 minute scan. A beta-blocker beforehand slows your heart rate and nitroglycerin dilates the arteries for clearer images; avoid caffeine that morning.
  • Comprehensive review — we personally review your images and explain not just what they show, but what it means for your health and what to do next.

Why early detection changes everything.

In conventional medicine, we often wait for symptoms before taking heart disease seriously. But here’s what most people don’t realize: by the time you feel chest pain or shortness of breath, decades of damage have already occurred. The first symptom of heart disease is too often a heart attack itself.

A CAC score catches the disease in its silent phase — when intervention is most effective and outcomes are best. The question isn’t “Do I have symptoms?” — it’s “Is disease developing that I can’t yet feel?” That’s the difference between reactive medicine and precision prevention. We don’t guess — we test. And when you know your score, you can finally replace the anxiety of uncertainty with clarity and a real plan.

How we use your CAC score in your care.

At Holistic Heart Centers, a CAC score isn’t just a number we file away — it’s a cornerstone of your personalized treatment strategy. We integrate your imaging results with advanced blood work, genetic testing, and a thorough assessment of your metabolic, hormonal, and lifestyle factors.

If your score is zero
We cautiously celebrate — and focus on maintaining that pristine score through optimized nutrition, metabolic health, and proactive monitoring. A zero today doesn’t guarantee a zero forever, and soft plaque can still be present, so we stay vigilant.
If your score is elevated
We shift into action. Using our Fit in Your GENES® approach, we identify the root causes driving plaque formation — inflammation, oxidative stress, metabolic dysfunction, hormonal imbalances, or genetics — and build a plan to slow, stop, or potentially reverse disease progression.
Safe, low-radiation imaging
Modern CAC scoring uses very low radiation — roughly equivalent to 10 chest X-rays, or about 6–12 months of natural background radiation. For most people the diagnostic benefit far outweighs this minimal exposure, and we only recommend imaging that will meaningfully inform your care.
FREQUENTLY ASKED QUESTIONS

Your CAC questions, answered.

01 How often should I repeat the CAC scan? +
For most patients, a repeat scan every 3–5 years is reasonable to track progression. If you’re making significant lifestyle or treatment changes, we may recommend retesting sooner to assess whether interventions are working.
02 My CAC score is high — does that mean I’ll have a heart attack? +
Not necessarily. A high CAC score indicates atherosclerosis is present, which increases risk — but risk is not destiny. With aggressive intervention targeting the root causes of plaque formation, many patients stabilize or even improve their cardiovascular outlook. The score gives us the information we need to act decisively.
03 Can a CAC score decrease over time? +
Calcium scores typically remain stable or increase slowly. What we aim for is slowing progression and stabilizing plaques so they’re less likely to rupture. Some research suggests that with optimal treatment, the rate of calcium accumulation can be dramatically reduced. The goal is protecting your arteries from further damage.
04 Is CAC scoring covered by insurance? +
Coverage varies by insurer and indication. Many patients pay out-of-pocket for CAC scoring, as it’s often considered a screening test. The cost is typically $100–300 — a modest investment for such powerful diagnostic information. CTA may be covered when ordered for specific clinical indications.
05 I’m young and healthy — do I really need this? +
For individuals under 40 with no risk factors, CAC scoring may not be necessary. However, if you have a strong family history of premature heart disease, elevated Lp(a), or other concerning risk factors, earlier testing can provide valuable information. We’ll help you determine the right timing based on your individual situation.
◆ TAKE THE FIRST STEP

See inside your arteries — and take control.

Health is wealth. Don’t wait for a crisis to find out where you stand. Schedule a free Heart Health Strategy Session to discuss whether CAC scoring or CT angiography is right for you — we’ll review your risk factors, answer your questions, and show how advanced imaging fits into a comprehensive approach to cardiovascular protection.

Free, private strategy session.  ·  Call or text 877-511-5166

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Medically Reviewed
Reviewed by Dr. Regina Druz, MD, MBA, FACC, FMCP-M
Last reviewed: June 2026
Medical disclaimer. This content is for educational purposes and does not substitute for medical advice. If you are experiencing a medical emergency, call 911.

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