What Is Coronary Artery Calcification?

Calcium is naturally present in your body — mostly in your bones and teeth. However, about 1 percent of your body’s calcium is circulating in your blood.

Researchers believe that coronary artery calcifications may occur due to the release of calcium when smooth muscle cells die in the heart’s arteries.

Also, macrophages (immune system cells) in the arteries may release inflammatory compounds that allow calcium to deposit more easily. Over time, the calcium deposits combine to form “speckles” or spots that can later develop into sheets or fragments.

Coronary artery calcification is a concern because it’s a precursor for atherosclerosis. This is a buildup of plaque in the arteries that causes blood to flow less effectively. The plaque can also break off and cause a heart attack or stroke.

Some medical conditions can cause genetic changes that result in coronary artery calcifications. These conditions can often cause a person to develop coronary artery calcifications at a much earlier age. Examples include:

• Gaucher’s disease type 3C
• Hutchinson-Gilford progeria syndrome
• idiopathic basal ganglia calcification
• pseudoxanthoma elasticum
• Singleton-Merten syndrome

Coronary artery calcification is most common in older adults, with calcium buildup starting around age 40. Researchers estimate that by age 70, 90 percent of men and 67 percent of women have coronary artery calcification.

Men experience coronary artery calcifications at a younger age than women, about 10 to 15 years earlier. Researchers think this is due to estrogen being protective against calcium deposits.

In addition to rare medical conditions that cause calcifications in young people, some chronic medical conditions can increase your risk. Examples include:

• metabolic syndrome
• hypertension (high blood pressure)
• diabetes
• dyslipidemia (irregular cholesterol levels)
• obesity
• chronic kidney disease

Tobacco use is also a risk factor for coronary artery calcification.

The presence of coronary artery calcifications doesn’t usually cause symptoms. But these calcifications tend to occur alongside other heart conditions that do have symptoms.

Symptoms of atherosclerosis and CAD include:

• chest pain
• chest tightness
• shortness of breath

If you’re experiencing these symptoms, your calcifications may have advanced to the point of atherosclerosis or CAD. If this is the case for you, talk with a doctor as soon as possible.

If your calcifications advance to CAD, it could lead to a heart attack. Heart attack symptoms also include weakness, nausea, shortness of breath, and pain in the arms or shoulder.

Doctors can diagnose coronary artery calcification using imaging studies. Unfortunately, they may only be able to see the calcification when there is significant calcium buildup in the coronary arteries.

If you have high cholesterol and your doctor suspects coronary artery calcifications, they’ll likely order a computed tomography or CT scan. A CT scan is a painless imaging test that allows doctors to “score” the amount of calcium present.

More invasive tests for coronary artery calcifications exist. These tests usually involve threading a small, thin catheter through your thigh or forearm to your coronary arteries. Examples include cardiac intravascular ultrasound and intravascular optical coherence tomography.

Treatments for coronary artery calcification depend on how severe the calcifications are. If the calcifications don’t show signs of severe disease, a doctor will usually recommend risk factor modification. This means you change aspects of your lifestyle to reduce the chance more calcium will build up.

However, doctors may recommend more immediate treatments for severe coronary artery calcification. This may involve using special devices to remove calcifications and plaques from the arteries.

One such treatment is intravascular lithotripsy. This new approach involves threading a catheter to the coronary arteries and using a special device that breaks up the calcium in the arteries. After eliminating the calcium, a doctor will insert a stent into the coronary artery to keep the artery open so that blood can flow more easily.

Maintaining a healthy lifestyle and managing chronic health conditions can help reduce your risk of coronary artery calcifications. Examples of risk reduction techniques include:

• taking medications to reduce high blood pressure
• taking medications to reduce high cholesterol
• reducing dietary cholesterol intake by avoiding high-fat foods, such as fried foods
• managing diabetes, if you have it

Heart-healthy habits, including a low-fat diet and exercise, can help reduce your risk of calcifications and other chronic health conditions.

The presence of coronary artery calcifications increases your risk of heart problems. Their effects include:

• reduced blood flow to the heart
• reduced elasticity in your arteries
• higher pressures in the heart’s blood vessels

Severe CAD with calcifications increases your risk of cardiovascular events, such as a heart attack.

With early treatment and lifestyle modifications, you can help to lower your risk for more serious complications.

The following are some commonly asked questions regarding coronary artery calcification.

Can too much vitamin D cause coronary artery calcification?

Vitamin D is a vitamin found in some foods. Your body also creates it when you expose your skin to sunlight. The body needs vitamin D to be able to absorb calcium.

Animal studies have connected excess vitamin D supplementation with a higher risk of calcium deposits in the arteries. But researchers don’t yet know if excess vitamin D causes coronary artery calcification in humans.

Can calcium supplements cause coronary artery calcification?

Your body works to maintain appropriate calcium levels so you can have healthy teeth and bones. Taking calcium supplements can increase your body’s calcium levels so significantly that your body may have a harder time adjusting.

A large, long-term study identified a link between calcium supplementation and coronary artery calcification. The use of calcium supplements increased the risk of calcification. However, calcium intake can decrease the long-term risk for atherosclerosis, which can have a protective effect on your heart.

Can you reverse calcification in your arteries?

Reversing calcification in your arteries is a complicated topic. Most of the time, you likely won’t be able to reduce calcification without surgical interventions. However, you can choose lifestyle measures that prevent it from building up more.

Can calcified arteries be stented?

Calcified coronary arteries can be more difficult for a doctor to stent. Stenting is an approach to help open blood vessels that have become too narrow. A doctor may have difficulty getting a stent through because of the calcium.

If this is the case, they can use special kinds of stents, balloons, or lasers that help move through or remove the calcium.

Do statins prevent calcification?

Statin medications are cholesterol-lowering drugs that also can reduce plaque buildup from atherosclerosis. Medication examples include atorvastatin, rosuvastatin, and simvastatin.

Studies are conflicting about if statins also help to reduce coronary artery calcifications. However, statins do help to reduce the risk of coronary events, such as heart attacks.

Coronary artery calcification can be a sign that you have atherosclerosis and heart disease. A CT scan can help your doctor determine the extent of calcifications and recommend interventions.

If your doctor diagnoses coronary artery calcifications, you can take steps to prevent further buildup. It’s important to follow any recommended lifestyle measures and manage any underlying conditions.