Over the past decade, electron beam computed tomography (CT) and multidetector CT have increasingly been used to identify and measure coronary artery calcification. Calcification levels can be related to the extent and severity of underlying atherosclerosis and can potentially improve cardiovascular risk prediction. However, broad use of these methods for screening is controversial. The American Heart Association (AHA) has released guidelines for the use of cardiac CT when evaluating patients for coronary artery disease.
Asymptomatic patients at low or high risk of cardiovascular disease do not benefit from coronary calcium measurements. However, these measurements may benefit asymptomatic, intermediate-risk patients by refining the risk assessment and prompting lifestyle changes and pharmacologic therapy. Coronary calcium measurements may be reasonable in some symptomatic patients, especially to determine the etiology of cardiomyopathy, to assess patients who have equivocal treadmill or functional test results, and to assess patients with chest pain who have equivocal or normal echocardiography findings and negative cardiac enzyme test results.
Amber Huntzinger AHA guidelines on cardiac CT for assessing coronary artery disease
American Family Physician, March 1, 2008