Coronary Artery Calcification: Causes, Treatment, And Outlook

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Key takeaways

Coronary artery calcification occurs when calcium builds up in the arteries, potentially leading to atherosclerosis and increasing the risk of a heart attack.

Risk factors for coronary artery calcification include older age, certain medical conditions like metabolic syndrome and diabetes, and tobacco use.

Lifestyle modifications, such as managing blood pressure and cholesterol, and treatments like intravascular lithotripsy can help manage and reduce the risk of further calcification and heart problems.

Calcium is a mineral your body needs for vital functions and good health. Calcium helps keep your bones and teeth strong, but it’s also involved in heart function. Sometimes, calcium deposits can also have a negative effect on your health.

Coronary artery calcifications occur when calcium builds up in the arteries that supply blood to the heart. This buildup can lead to coronary artery disease and increases your risk of a heart attack.

Keep reading to find out why and how coronary artery calcification occurs, as well as tips for prevention and treatment.

Key terms

This article uses the following terms. They’re similar but have different meanings, so it’s important to know what each means.

Atherosclerosis is when fatty deposits called plaque build up in your arteries. Atherosclerosis can cause your artery to narrow. The plaques can break off and cause a blood clot.
Coronary artery calcification is the buildup of calcium in the arteries that supply blood to your heart. Calcification often occurs at the same time as atherosclerosis.
Coronary artery disease, also known as CAD, occurs when the heart doesn’t get enough oxygen and blood. This is usually due to atherosclerosis.

What causes 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

Who’s at risk for coronary artery calcification?

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.

What are the symptoms of 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.

How do doctors diagnose coronary artery calcification?

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.

Know your coronary artery calcium score

If you undergo a coronary artery calcium CT scan, your doctor will assign you a coronary artery calcium (CAC) score, often called an Agatston score. This measures the scale of your calcium buildup. The higher your CAC score is, the more severe your calcium buildup is. Levels of the score are:

0: no identifiable disease
1 to 99: mild disease
100 to 399: moderate disease
More than 400: severe disease

How is coronary artery calcification treated?

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.

How can I reduce my risk for calcification and coronary artery disease?

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.

What is the outlook for coronary artery disease with calcification?

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.

Frequently asked questions

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.

Takeaway

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.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Anderson J, et al. (2016). Calcium intake from diet and supplements and the risk of coronary artery calcification and its progression among older adults: 10-year follow-up of the multi-ethnic study of atherosclerosis.https://www.ahajournals.org/doi/10.1161/jaha.116.003815
Butt N, et al. (2022). Intravascular lithotripsy.https://www.ncbi.nlm.nih.gov/books/NBK560548/
Coronary artery disease. (2021).https://www.cdc.gov/heartdisease/coronary_ad.htm
Honton B, et al. (2022). Best practice in intravascular lithotripsy.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826142/
Mohan J, et al. (2022). Coronary artery calcification.https://www.ncbi.nlm.nih.gov/books/NBK519037/
Mori H, et al. (2018). Coronary artery calcification and its progression: What does it really mean?https://www.jacc.org/doi/full/10.1016/j.jcmg.2017.10.012
Rutsch F, et al. (2020). Hereditary disorders of cardiovascular calcification.https://www.ahajournals.org/doi/10.1161/ATVBAHA.120.315577
Wang J, et al. (2018). Vitamin D in vascular calcification: A double-edged sword?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986531/

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Medically reviewed by Angelica Balingit, MD — Written by Rachel Nall, MSN, CRNA — Updated on June 29, 2022

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Key takeaways

Key terms

What causes coronary artery calcification?

Who’s at risk for coronary artery calcification?

What are the symptoms of coronary artery calcification?

How do doctors diagnose coronary artery calcification?

Know your coronary artery calcium score

How is coronary artery calcification treated?

How can I reduce my risk for calcification and coronary artery disease?

What is the outlook for coronary artery disease with calcification?

Frequently asked questions

Can too much vitamin D cause coronary artery calcification?

Can calcium supplements cause coronary artery calcification?

Can you reverse calcification in your arteries?

Can calcified arteries be stented?

Do statins prevent calcification?

Takeaway

How we reviewed this article:

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