A CT angiogram is one way of detecting calcium deposits in the coronary arteries. — Los Angeles Times/TNS
Yes, there is; it is called coronary artery calcification.
It is a build-up of calcium deposits inside your coronary (heart) arteries.
If the build-up or collection is large enough, it can lead to narrowing of your coronary arteries, and eventually, to chest pain.
Coronary artery calcification usually happens after you have had plaque formation for around five years.
The plaque is also called atherosclerosis.
Coronary plaques are divided into three types:
> Low-density non-calcified plaques
These are also called soft plaques; they contain fat and fibrous tissue.
They are the most dangerous and risky type as they can easily break off and cause a blood clot.
This blood clot can then block one of your coronary blood vessels and cause chest pain (angina) or a heart attack as the heart muscles are deprived of oxygen.
However, it’s not good to have a plaque that does not break off either.
These atherosclerotic plaques can cause narrowing of your coronary blood vessels, which limits the amount of blood (and oxygen) that can flow through.
This causes chest pain during the times when you exert yourself and need more blood flow (i.e. angina pectoris).
If the plaques become larger, then more and more blood flow is blocked off, and your angina gets worse and worse.
> Non-calcified plaques
These have fibrous tissue and have some risk of breaking off.
But their risk of breaking off is not as high as the low-density ones.
> Calcified plaques
These plaques are mostly comprised of calcium.
They are the least likely to break off and cause a heart attack.
This is as they are more stable.
The amount of calcification you have in your coronary arteries is an indicator of how bad your atherosclerosis (plaque build-up) is.
The calcification can be within the three layers of the coronary artery wall itself.
It can sit in the inner layer (tunica intima) of the wall or the middle layer (tunica media).
After you reach 40 years of age, calcium that is from your bloodstream can settle in certain parts of your body, such as damaged arteries.
Your arteries, by then, are more likely to be damaged by wear and tear, as well as by many aspects of your lifestyle and concomitant disease that you may have.
Calcium deposition can start in your 20s, but may not be sufficient for it to show up in a CT (computed tomography) angiogram.
Microcalcification in the inner layer of your artery wall, for example, starts when smooth muscle cells die.
This calcification makes your arteries stiff and harder to expand and contract, making blood flow to your heart more restrictive.
This can lead to complications like angina pectoris and other cardiac (heart) issues.
If you need a stent, this makes stenting harder to do as well.
No, there are certain risk factors associated with it, such as:
- Age
If you are older than 70 years, you are more likely to have coronary artery calcification.
In fact, it is postulated that over 90% of men and 67% of women over 70 have some degree of it.
Women before menopause are protected by the effects of oestrogen.
But after menopause, the risk of this calcification increases as the amount of oetrogen in their body decreases.
- High LDL (low-density lipoprotein) cholesterol and low HDL (high-density lipoprotein) cholesterol
- Male sex
- High blood pressure
- High body mass index (BMI)
- Diabetes mellitus
- Chronic kidney disease
- Family history of coronary artery calcification
- Smoking
- High blood calcium and/or phosphate.
Most of the time, you will not have symptoms.
But if it gets bad over time, then you may have symptoms of angina pectoris, such as chest pain and shortness of breath during exertion.
This may progress to chest pain and shortness of breath even when you are not exerting, as your blood vessels become more and more blocked, leading to a possible heart attack.
There are many types of diagnostic tests.
A cardiac CT scan can show up calcification, including the location and size of the deposits.
This type of CT scan is known as a coronary artery calcification test.
A higher score in this test means that you are more likely to get cardiac disease or stroke.
There is also the cardiac intravascular ultrasound.
However, this test is more invasive as it uses a catheter-directed ultrasonic probe that is inserted through your blood vessels.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
