Archive · 8 Sep 2026
Coronary Calcium Scores Reveal Risk, Not Artery Blockage
A calcium scan looks for hardened calcium inside the heart arteries.
Calcium usually forms as part of plaque buildup.
A high score means a person may have a higher risk of heart disease, but it does not say exactly how blocked an artery is.
For example, one patient had a very high score but only small blockages.
Another patient had a score of zero but a serious blockage made from plaque without much calcium.
This means a zero score does not always prove that the arteries are clear.
CT coronary angiography can look for both hardened and softer plaque and can show narrowing.
Doctors also consider symptoms, diabetes, cholesterol, age, and other risks.
Calcium in the arteries is not simply caused by eating too much calcium or taking vitamin D.
A coronary calcium score measures calcified plaque, not the percentage of artery narrowing.
A man in his mid-30s had a score around 900 but only minor blockages that did not require stenting.
A 38-year-old man with diabetes had a calcium score of zero but a 90% blockage requiring a stent.
Non-calcified or soft plaque can cause significant disease without appearing on a calcium-score scan.
CT coronary angiography can show plaque and narrowing, while treatment decisions depend on symptoms and overall risk.
- Who
- Two male patients described by Dr Shetty, including a 38-year-old man with diabetes, were used to explain the issue.
- What
- The article explains that coronary calcium scores indicate calcified plaque and cardiovascular risk but do not directly measure artery blockage.
- When
- The article does not provide dates; it describes the patients' evaluations and treatment.
- Where
- The cases were discussed by Dr Shetty, lead cardiologist and medical director at Sparsh Hospital in Bengaluru.
- Why
- The explanation aims to clarify why high or zero calcium scores can each fail to show the full extent of coronary artery disease.
- Calcium score of zero
- Indicates no detected calcified plaque, but does not rule out non-calcified plaque or significant disease.
- High calcium score
- A score above 400 is described as high and is associated with greater cardiovascular risk.
- Score around 900
- One patient had this score but only relatively minor blockages that did not require stenting.
- 90% blockage
- A 38-year-old man with diabetes had this narrowing despite a calcium score of zero.
- Calcium-score scan
- Detects and quantifies calcified deposits in the coronary arteries.
- CT coronary angiography
- Can visualize coronary plaque, including non-calcified plaque, and assess artery narrowing.
- Treatment decisions
- Statin or aspirin use depends on the person's symptoms, risk factors, age, diabetes status, cholesterol, and clinical assessment.