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heart disease overview > Tests & Treatments >

Electron-Beam Computed Tomography (EBCT) Heart Scan

By Paula Dranov and Catherine Winters

The electron-beam computed tomography (EBCT) scan is a variation of conventional computed tomography (CT) X-ray scans long used to examine various parts of the body. The scan takes about 30 seconds and indicates if there’s enough calcium in your arteries to put you at risk for heart disease. EBCT is somewhat different from a CT scan in that it uses harmless electron beams instead of X-rays to create multiple images of the heart. The computer then calculates the density of any calcium deposits in your coronary arteries; The deposits indicate the amount of plaque that may be collecting. The more plaque, the greater the chance that a chunk will rupture and clog an artery, blocking the flow of blood to the heart and causing a heart attack.

Who Needs It
The American Heart Association (AHA) recommends EBCT scans only for people at intermediate risk of heart disease—those with cardiac risk factors such as diabetes, smoking, family history of heart disease, high cholesterol, or high blood pressure. In 2005, the government’s Preventive Services Task Force recommended against screening healthy people or people with “low risk” of heart disease with an EBCT scan unless they have symptoms. There is no value in testing “high risk” people, because this is a preventative test.
           
Why not test everyone? “Because we just don’t know whether testing will translate into saved lives and averted heart attacks,” says Robert Bonow, M.D., former president of the AHA and chief of cardiology at Northwestern Memorial Hospital in Chicago.

And although EBCT scans look for calcium in arteries, its presence is not a perfect predictor of heart disease, says cardiologist Thomas H. Lee, M.D., editor of the Harvard Heart Letter. “It doesn’t always block arteries,” he says. Once plaque is found, further tests may be needed. Because the scan is expensive and involves injecting the patient with a contrast dye, it’s not likely to be used as a screening tool yet, Lee says. Instead, it may be substituted for other diagnostic tests, help a doctor determine if a patient is benefiting from a cholesterol-lowering drug, or confirm the presence of heart disease. Other factors should be considered before a diagnosis is made, including family history, blood pressure and cholesterol levels, and diabetes. Ultimately, prevention is key. “If someone has risk factors for heart disease, they should work to control them,” Lee says.

How It’s Done
You lie on a gurney that slides into an “open” CT machine (your head does not go inside the device).

What You’ll Learn
An EBCT scan shows whether the calcium deposits in your blood vessels are significant enough to indicate the presence of dangerous amounts of soft plaque, which is actually what ruptures and causes heart attacks. In women, however, heart attacks sometimes occur because of coronary artery spasms that block blood flow to the heart. So a clean bill of heart health from an EBCT scan doesn’t necessarily mean women are home free. Doctors don’t yet know if EBCT results predict heart disease any better than medical evaluation of cholesterol levels, blood pressure, and other risk factors.

Cost
$350–$400. Most health plans currently don’t cover this test, but this is beginning to change so it’s worth checking with your plan administrator. If you’re willing to pay out of pocket, you can get a scan at a cardiac prevention center or your local hospital. No physician referral is needed.

 
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