Heart disease has long carried the reputation of being a sudden and unpredictable killer, yet the truth is that it rarely appears out of nowhere. It grows quietly in the background, often for years, without offering any obvious warning. Many of the people who suffer heart attacks had no indication that something was wrong until the very moment it struck.
This is why the conversation around heart health has shifted in recent years. Instead of reacting to symptoms, the emphasis is now on discovering problems before they begin to cause trouble. One of the most effective ways to do this is through early calcium scoring, a simple CT scan that has changed the way we understand and manage the risk of heart disease.
How does it work?
Calcium scoring looks directly at the coronary arteries to check for calcified plaque. Unlike cholesterol tests or ECGs, which offer indirect information, this scan shows the earliest physical signs of artery damage. Even tiny calcium deposits, which are far too small to cause symptoms, can be picked up with remarkable clarity. For many individuals who otherwise appear healthy on the surface, this test becomes the first real indication that plaque build-up has already begun.
The silent nature of plaque growth is what makes this tool so important. Atherosclerosis does not announce itself. It does not cause pain or fatigue in its early stages. Someone may be exercising regularly, eating reasonably well and feeling perfectly normal, yet still be carrying significant plaque because of genetics, stress, metabolic changes or long-term lifestyle habits.
A score of zero tends to be reassuring, while even a modest score can be enough to prompt a closer look at one’s overall health.
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What happens after discovering plaque is where the real value lies. People are often far more willing to make changes when they see tangible evidence. A number on a lab report may not always convey urgency, but a scan showing calcification inside the heart’s arteries has a very different impact.
It becomes a moment of clarity; one that pushes individuals to rethink their habits, their diet, and even the pace at which they live their lives. Early detection gives them the chance to step in before the disease has gained momentum.
For clinicians, calcium scoring offers a way to personalise care instead of relying on standardised guidelines. Two people with the same cholesterol level may have completely different calcium scores, and therefore very different levels of risk. With this information, doctors can fine-tune preventive strategies, adjust medications, and monitor patients more effectively. Rather than treating everyone as though they fall into the same category, calcium scoring helps identify who needs intensive intervention and who can be managed conservatively.
It also brings much-needed clarity to situations where traditional tests may not be enough. A normal ECG can give a false sense of security because it only reflects how the heart functions at that moment. Similarly, cholesterol levels may not fully capture the cumulative effect of years of stress, smoking, poor sleep or uncontrolled diabetes. Calcium scoring answers a different question altogether: what is happening inside the arteries right now? For many people with borderline reports or confusing symptoms, this single scan becomes the deciding factor in understanding their true cardiac risk.
In recent years, doctors have noticed that younger adults are showing signs of early heart disease far more frequently than before. Sedentary routines, processed diets, irregular sleep and constant stress have all contributed to this shift. With these changes, depending solely on annual check-ups or basic tests is no longer enough. Adding calcium scoring to preventive screenings, especially for those with a family history, high-stress jobs, or lifestyle-related risks, can dramatically change outcomes. Identifying plaque early means it can still be influenced, slowed down, or stabilised through timely action.
The power of calcium scoring lies in its simplicity and its ability to rewrite a person’s health trajectory. It gives individuals a chance to course-correct long before the heart is pushed to its limits. When done at the right time, this quick scan becomes more than just a diagnostic tool; it becomes a turning point.
In a world where heart attacks are occurring younger and without warning, early calcium scoring offers something rare in medicine: an opportunity to prevent a crisis before it begins.
(Dr Bilal Thangal T M is the Medical Lead at NURA AI Health Screening Centre)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
