What is a calcium score test (CAC)?
A calcium score test, also known as coronary artery calcium (CAC) scoring or a coronary calcium scan, is a non-invasive imaging procedure that measures the amount of calcium in your coronary arteries. This calcium present in your heart's arteries is a marker of plaque buildup, which can narrow or block your arteries.
This, in turn, escalates the likelihood of a heart attack or stroke. The test uses a specialised computed tomography (CT) scan to detect and quantify these calcium deposits, resulting in a score that helps estimate your risk of coronary artery disease (CAD).
When do I need a calcium score test?
A calcium score test is typically recommended for adults between the ages of 40 and 70 who have an increased risk of heart disease or currently possess risk factors for it, such as:
High blood pressure
High cholesterol
Obesity
Smoking
Family history of heart disease
The test helps guide decisions about preventive treatments and lifestyle changes. It may be beneficial to get a calcium score test every three to five years if you had a normal score the first time and want to know if your risk is still low.
It is also important to note that a calcium score test may not be helpful if you:
Are pregnant
The test uses CT scans, which involve radiation that can harm a foetus.
Don't possess any risk factors for heart disease
If you are at very low risk, the test is unlikely to change your management or provide useful information.
Have a high risk of heart disease
If you are already at high risk or have symptoms, you need more definitive testing and treatment, not a screening test like calcium scoring.
Are diagnosed with coronary artery disease or have symptoms that may suggest CAD
The test is not useful for people with known CAD or symptoms such as chest pain; other diagnostic tools, such as electrocardiograms (EKGs) or CT coronary angiography, are preferred.
Received previous treatment for CAD
If you have already had a heart attack or coronary interventions, calcium scoring will not help guide further management.
Want to know if your treatment for heart disease is working
The test does not monitor response to therapy or progression of disease after treatment.
Please speak with your healthcare provider about the current symptoms you are experiencing and if you are considering taking a calcium score test. Request an appointment with Thomson Medical today.
How is a calcium score test done?
The test is performed using a CT scanner. Areas in your coronary arteries that have calcification show up on the scan. The CT scan itself takes only a few minutes and is painless. No dye or injections are required. The CT scan takes only a few minutes, but the entire procedure may take about 10 or 15 minutes.
How do I prepare for a calcium score test?
Before your calcium score test, here are some things you may need to do:
Tell your provider what allergies you have, which medications you are taking, and whether you are pregnant.
Avoid consuming foods, drinks, caffeine, and tobacco products for at least four hours before your calcium score test.
You may need to remove any metals from your body, including jewellery and glasses.
You will need to change into a hospital gown.
You will need to lie on your back on a special table that slides into the CT scanner.
A provider will clean (and possibly shave) three small areas of your chest.
They may place small, sticky electrode patches on the prepared areas. The electrodes attach to an electrocardiogram (EKG) monitor, which charts your heart's electrical activity during the test and allows providers to time pictures with your heartbeat.
What should I expect during a calcium score test?
During the test, the operator will ask you to lie still and hold your breath for a few seconds while taking images. You can talk to and hear the person operating the machine in another part of the room. They can see you through a glass section of the wall. If at any point you feel claustrophobic or uncomfortable, please inform the healthcare provider helping you take the scan.
A high-speed CT scan captures multiple images that are synchronised with your heartbeat. You may need to hold your breath for 10 to 20 seconds. A sophisticated computer program analyses the images for calcification within your coronary arteries. After the scan, you can resume your normal activities immediately.
What do my results mean?
The Agatston score, a numerical value, represents your calcium score. The score is the total area of calcium deposits and the density of the calcium. The higher the score, the more calcium is present, and the greater your risk of heart disease.
A score of 0 indicates the absence of calcium in the heart. It suggests a low chance of developing a heart attack in the future.
A score of 100 to 300 means moderate plaque deposits. It's associated with a relatively high risk of a heart attack or other heart disease over the next 3 to 5 years.
A score greater than 300 is a sign of more extensive disease and a higher heart attack risk.
The test score may also be presented as a percentage. The number is the amount of calcium in the arteries compared to other people of the same age and sex. Calcium scores of about 75% have been linked with a significantly higher risk for heart attacks.
Your doctor will discuss your results and may recommend lifestyle changes, medications, or further tests depending on your score.
What are the risks of a calcium score test?
The calcium score test is very safe. It involves a small amount of radiation, similar to other CT scans, but the risk is minimal. There are no injections or dyes used, so allergic reactions are not a concern. Occasionally, the discovery of incidental findings unrelated to your heart may necessitate further investigation. Tell your healthcare provider if you are pregnant. Your healthcare provider may delay the test until after your pregnancy.
What is the cost of a calcium score test in Singapore?
A stand-alone CT calcium score test in Singapore typically costs around S$381.50. However, if it's part of a CT coronary angiogram, the price can range from S$1,000 to S$1,200. Additionally, if you're getting a more comprehensive heart screening package, the cost can be significantly higher.
A more detailed breakdown is listed below:
Stand-alone CT calcium score:
Around S$381.50
CT coronary angiogram (including calcium score):
From S$1,000 to S$1,200
Heart screening packages:
Can range from $688 to $1099, depending on the included tests
Doctor's consultation:
Separate consultation fees may apply.
FAQ
What is a normal calcium score?
A normal calcium score is 0, meaning no calcified plaque is detected in your coronary arteries. Most people develop some plaque as they age, but a score of 0 indicates a very low risk of heart disease.
How can I lower my calcium score?
While it is not always possible to reduce the actual calcium score, you can lower your risk of heart attack by:
Adopting a heart-healthy diet
Exercising regularly
Managing blood pressure, cholesterol, and diabetes
Stopping smoking
Taking prescribed medications
In some cases, medical procedures or interventions may be recommended.
What foods can reduce your calcium scores?
The following foods support heart health and may help stabilise your calcium score:
Fruits and vegetables
Wholegrains (e.g., brown rice, oats)
Lean proteins (e.g., fish, nuts, seeds)
Low-fat dairy
Foods high in fibre and healthy fats (e.g., olive oil, avocados, flaxseed)
Avoid foods high in saturated and trans fats, such as processed meats, full-fat dairy, and fried foods.
Can high calcium go back to normal?
Calcium deposits themselves are generally permanent, but you can prevent further buildup and reduce your overall heart risk through lifestyle changes and medications. In some cases, medical procedures may help reduce plaque, but the main goal is to stop progression.
Can I live a long life with a high calcium score?
Yes, many people with a high calcium score live long lives, especially if they make healthy lifestyle changes and follow their doctor’s recommendations. A high score indicates increased risk, but proactive management can significantly reduce the likelihood of heart attack or stroke.
Are there side effects to a calcium score test?
A coronary calcium score generally has very few side effects. The primary risk is radiation exposure, but the amount of radiation used is relatively low and considered safe
The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.
For more information, contact us:
Thomson Specialists Paragon (Health Screening)
- Mon - Fri: 8.30am - 5.30pm
- Sat: 8.30am - 12.30pm
Call: 6735 0300
See Health Screening Packages