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Cardiologist explains why having a calcium score of zero does not make a person ‘heart attack proof’

Calcium score is a risk assessment tool and not a diagnostic test, as such, it cannot guarantee no chance of heart attack, explains Dr Yaranov.

Updated on: May 25, 2026 07:54 PM IST
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Having a low calcium score is reassuring. However, it does not make a person immune to heart attacks. Taking to Instagram on May 13, Dr Dmitry Yaranov, a US-based cardiologist specialising in heart failure and transplantation, explained why that is and what can be done about it.

A zero calcium score does not guarantee the heart's safety. (Unsplash )
A zero calcium score does not guarantee the heart's safety. (Unsplash )

Also Read | Is your heart beating too fast or irregularly? Cardiologist shares 6 major signs of arrhythmia

What does calcium score mean?

To understand why a low calcium score is good, but does not guarantee that a person will not experience a heart attack, it is important to understand what a calcium score actually is and what it signifies.

Having a calcium score of zero has the following significance in low-risk patients:

  • Lower short-term heart attack risk
  • Lower likelihood of significant calcified plaque
  • Reassuring prognosis

However, a calcium score of zero does not mean that there is zero plaque in the vessels, or that the person is completely risk-free and has zero chances of a heart attack, cautioned Dr Yaranov.

Risks that stay hidden in calcium score

Some forms of plaques are not detected in the calcium score, noted Dr Yaranov. These include:

  • Soft plaque
  • Inflamed plaque
  • Non-calcified plaque
  • Unstable plaque

Such plaques can also cause blood vessels to rupture, even though the calcium score with them can appear to be zero.

“Some patients develop dangerous plaques before calcium develops,” noted the cardiologist. Patients with higher risk include the following groups:

  • Younger patients
  • Smokers
  • Diabetics
  • People with strong family history
  • People with inflammatory disease
  • Patients with symptoms

Detecting soft plaque with CT angiography

To detect the soft plaque that is missed by the CT calcium score test, a CT angiography comes in handy, noted Dr Yaranov.

Highlighting the usefulness of both, the cardiologist noted that the calcium score test is quick, low radiation, no contrast, and measures calcium only and estimates long-term risk.

On the other hand, CTA uses IV contrast, looks directly at the coronary arteries, can see soft and calcified plaque, and evaluates narrowing and plaque burden.

While the first asks how much calcified plaque is present, the second seeks to answer what the arteries actually look like. The purpose of both is to help doctors protect the heart.

According to Dr Yaranov, “Calcium scoring is great for prevention and risk refinement,” while “CTA is better when symptoms, higher suspicion, or anatomy matter.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

This report is based on user-generated content from social media. HT.com has not independently verified the claims and does not endorse them.

 
ABOUT THE AUTHOR
Debapriya Bhattacharya

Debapriya Bhattacharya is a Content Producer at Hindustan Times. He started his career in 2022, working in newsrooms in beats like education, US news, trending stories, and entertainment. In his new role in the lifestyle desk, he seeks to deliver a balanced blend of research-driven reporting and creative storytelling from health and recipes to art and culture. Science, philosophy, food and pop culture are what pump his veins and help bring heart to his stories. Debapriya tries to see out subjects that will allow him and readers to explore new frontiers and improve the quality of life for all. The explorations can be both external and internal, as thoughts seek to be as chaotic as the greater universe. As a citizen of the world, Debapriya has been fascinated by the lives of people across the globe throughout time. His curiosity leads him to explore new linguistic and cultural landscapes to broaden his horizons and deepen his understanding of global narratives. Beyond the newsroom, Debapriya loves to participate in debate and theatre, spaces that he considers to be holy grounds for nuance and self-expression. A graduate from Ashutosh College, University of Calcutta, Debapriya completed his Master's degree from the same university in 2022. An ambiverted bibliophile, he loves his solitude as much as he adores stimulating conversations. And despite his reverence for tech, libraries continue to be his favourite place for research.

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