Not everyone needs a CAC scan. In fact, it’s not typically recommended for people without any risk factors or for those already diagnosed with heart disease. Instead, the scan is designed for those who fall into a middle-risk category—people who may have some risk factors but aren’t certain about the severity of their heart disease risk. Understanding whether you fall into this category can be life-saving.

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Here are some signs that a CAC scan might be right for you:

• You’re between ages 40 and 70.
• You have one or more traditional risk factors for heart disease: family history, high blood pressure, high cholesterol, smoking, obesity, or diabetes.
• You are uncertain about whether you need to start or intensify medication like statins.
• You and your doctor aren't sure how aggressively to pursue treatment because your overall health profile is somewhere in the moderate-risk zone.

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Several leading health organizations, including the American College of Cardiology and the American Heart Association, endorse the CAC scan for these types of cases. Studies have shown that adding a CAC score into the decision-making process often leads to better-tailored treatments—either sparing you from unnecessary medications or prompting more aggressive therapy where warranted.

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For example, one major study found that even among people with zero classic risk factors, those with high CAC scores had a significantly increased chance of experiencing heart attacks or other serious cardiovascular events years later. On the other hand, people with a CAC score of zero had an incredibly low 5- to 10-year risk of incidents, often lower than many risk calculators would predict.

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If you’re standing at a crossroads, wondering whether you’re really at risk, a CAC scan could be the map you need to chart the right course forward.

Getting a CAC score is surprisingly simple. The test itself takes about 10 to 15 minutes and is entirely non-invasive. There’s no need for contrast dye or injections, and the radiation exposure is relatively low—similar to that of a standard mammogram. Typically, you'll change into a hospital gown, lie down on a scanning table, and maybe have a few electrode patches placed on your chest to monitor your heart rate.

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As the machine quickly tracks your heartbeat, it snaps high-resolution images of your coronary arteries. A computer then calculates your total plaque burden and produces your CAC score.

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Once you have your number, interpretation becomes crucial. Here's a realistic breakdown:

• A CAC score of 0 is highly reassuring. Your risk of a cardiac event over the next 5 to 10 years is extremely low—generally under 2%.
• A score between 1 and 99 doesn't mean panic—it suggests some early atherosclerosis. Your doctor might recommend intensified lifestyle changes or medication, depending on your other risk factors.
• A score of 100 or greater indicates more substantial plaque buildup. In this case, the likelihood of coronary events rises notably, sometimes dramatically, and your doctor may suggest starting or intensifying cholesterol-lowering and blood pressure medication.

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Intriguingly, a high CAC score doesn't automatically mean you have critical blockages right now. What it does mean is that you have significant underlying heart disease—a marker for potential future events.

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Importantly, the CAC score can steer your clinical care beyond simple guesswork, providing a literal snapshot of the health of your arteries. In personal stories across the medical world, people credit the CAC scan with enabling life-saving preventive measures—years, sometimes decades, before tragedy would have struck.