Atherosclerosis can develop in the arteries of the heart for years without causing symptoms.
CT imaging can help doctors look for signs of this disease before it becomes clinically apparent.
One type of CT test measures calcium within atherosclerotic plaque in the coronary arteries — the arteries that supply blood to the heart. The result is called a coronary calcium score.
Another examination, coronary CT angiography, uses a contrast agent to provide a more detailed view of the coronary arteries.
It can show whether atherosclerotic plaque is present, where it is located and whether it is narrowing an artery. It can also show plaque that is not calcified and therefore is not measured by a coronary calcium score.
A study published in 2026 examined 269 people who had no cardiovascular symptoms but were considered to be at higher cardiovascular risk. Detailed coronary CT imaging found high-risk coronary plaque in 30.9% and significant coronary narrowing in 28.0%.
These findings do not mean that everyone without symptoms should have coronary CT angiography. The choice of examination depends on a person’s cardiovascular risk factors, previous test results and clinical assessment.
For selected patients, looking directly at the coronary arteries can provide information about atherosclerosis that cannot be obtained from a calcium score alone.
