Coronary calcium score: Meaning in a Radiology Report

Also written as: coronary artery calcium score, CAC score, Agatston score, calcium score

A coronary calcium score measures calcified plaque in the heart's arteries on a quick CT scan, to help estimate the risk of a heart attack.

What it means

The coronary calcium score measures how much calcium has built up in the walls of the heart's arteries. It comes from a quick CT scan of the heart without contrast or injections. Calcium there is a sign of atherosclerosis, the plaque that builds up slowly over years. The usual Agatston method adds up the size and density of each calcium spot into one total.

When it matters

A score of 0 means no calcium was seen, which usually means a low risk of heart attack over the next several years. 1 to 99 is mild, 100 to 399 moderate, and 400 or more high. Many reports also give a percentile against people of the same age and sex. Doctors use the score to refine heart risk and guide prevention, such as cholesterol treatment. A 0 does not rule out soft plaque, which contains no calcium.

Questions to ask your doctor

What is my total score, and what percentile is it for my age and sex?
Which arteries have the most calcium?
How does this score change my overall heart risk estimate?

General information, not medical advice. What a finding means for you depends on your symptoms, your history and the images themselves, so talk your results through with a doctor.