Who Should Get a Heart Scan (and Who Shouldn't)

A heart scan is most useful if you feel fine, have a reason to wonder about your heart, and want to know whether plaque is already building. That usually means adults 40 or older with risk factors such as a family history of early heart disease, high cholesterol, high blood pressure, diabetes, or smoking. A coronary CT angiogram (CCTA) shows the most, since it sees soft and hard plaque. It isn't the right scan if you have symptoms right now, are pregnant, or have already had a heart attack, a stent, or bypass surgery.

Who should consider a heart scan?

The point of a heart scan is to find plaque while you still feel well. You're a good candidate if you have no known heart disease and at least one of these:

• A parent or sibling who had heart disease young.
• High cholesterol, or a high lipoprotein(a), an inherited risk that a standard cholesterol panel doesn't measure.
• High blood pressure, diabetes, or prediabetes.
• A history of smoking.
• For women, pregnancy complications or early menopause. Our guide to the best heart scan for women explains why these count.
• You'd rather know. Plenty of people want to see their arteries instead of relying on a risk estimate.

Age matters, but it's not the whole story. Most people who get a screening scan are 40 or older, since that's when plaque becomes common. Still, a 42-year-old with a strong family history may be a better candidate than a 65-year-old with no risk factors at all. If you're under 40 with strong risk factors, a conversation with a clinician is the place to start. Our guide to the best heart scan for men covers why the 40s matter.

Who shouldn't get a CCTA?

A CCTA involves contrast dye through an IV, a small dose of radiation, and often a medicine to slow your heart for clearer pictures. In these situations it's the wrong choice, or it needs a different setting:

• Symptoms happening now, such as chest pain or shortness of breath at rest. That calls for 911, not a scan appointment.
• Pregnancy, because of the radiation.
• A past reaction to contrast dye. Some hospitals give medicine beforehand to lower the risk, so it's worth raising with your doctor.
• Severe kidney disease, including dialysis or a kidney transplant, because your kidneys clear the dye.
• Not being able to take a beta blocker, or to lie flat and hold your breath for about 10 seconds.
• A past heart attack, stent, or bypass surgery. Your cardiologist is the right person to choose your next test, partly because stents can blur the images.

A calcium score needs no dye, so a contrast allergy or kidney disease doesn't rule it out. The catch is that it only sees hardened plaque, not the soft plaque that's often newer and riskier.

What's checked before a CCTA?

Before a Veevo Scan, you answer a short set of health questions, and an affiliated physician reviews them to decide whether the scan is safe and right for you. They cover:

• Your symptoms and heart history, including any heart attack, stent, bypass, or abnormal stress test.
• Pregnancy and past contrast reactions.
• Kidney function. If you have kidney disease or diabetes, you'll need a kidney blood test (eGFR) from the last 30 days, and a result below 30 rules out the scan.
• A recent heart rate and blood pressure reading, so the physician can decide whether heart-rate medicine is safe for you.
• Your medicines, because some, such as erectile dysfunction medicine, don't mix with the medicine used during the scan.

If something on that list applies to you, a scan may still be possible. It might mean a calcium score instead, or a scan arranged through your own doctor.

The bottom line

A heart scan is for people who feel fine, carry some risk, and want to know whether plaque has started. A CCTA shows soft plaque, hard plaque, and narrowing, though it uses contrast dye and costs more than a calcium score. Neither scan replaces emergency care, or follow-up for heart disease you already know about. You can book either scan with Veevo in California and New York; see current prices.