Good morning! Can you believe it’s Friday, again?! And, ummm, we have the entire beautiful day in front of us, only to be chased by a Saturday and a Sunday. A very Happy Easter and Passover to all who celebrate. Oh, and more basketball!

You know I geek out about all the amazing work you all are doing, and together (you, Rachael, Bryan, and all the birds and the trees) are now at 718 chapters internationally. To frame that, it’s 4 more than Babe Ruth and only 37 behind the great Hank Aaron.

It indeed takes a village, and this week’s town crier was the American Heart Association. Thank you for this great piece, as we all celebrated National Walking Day on Wednesday. As we can all see, the people on the letterhead are still celebrating!

The last time we spoke, before the announcement of the April WWAD Challenge, I shared that I wanted to answer the most asked questions on Calcium Scoring. You responded thoughtfully and with great passion. I could pick any of them, so let me reach deep, deep into the mailbag and pull one out. Why do they make these bags so big?

rumple, rumple, rumple…

Okay, here we go. This one is from Madison, Wisconsin, and it says:

‘Where do I get one of these and how much does it cost?’

Access and cost are critical questions!

How to access a Calcium Score (for your coronary arteries)

In most cases, there are two pathways:

• Through your primary care provider: This is the most traditional route. They can order the scan and, importantly, help interpret the results in the context of your overall risk.
• Direct-to-consumer/self-referral: Many imaging centers now allow you to book the scan yourself without a referral, particularly if you’re paying out of pocket.

Even when self-booking is possible, I strongly recommend looping your physician in; this test is most valuable when it informs a thoughtful plan.

Cost and insurance

You’re correct to assume cost may be a factor:

• Typical out-of-pocket cost is roughly $100 (at least in Ohio, I imagine it’s similar elsewhere)
• Many insurance plans do not cover it if it’s considered a screening test
• Some centers offer it at relatively low fixed prices, sometimes even promotional or no-cost programs in certain regions

Overall, it’s one of the more affordable and accessible cardiac imaging tests we offer.

Also, a critically important question:

Is it appropriate for you?

• Most commonly ordered for those in the 40–75 range
• If there is an uncertain decision about statins
• Family history of cardiovascular disease

In those cases, the CAC score can help “break the tie”:

• A score of zero might support holding off on statins, in the right context
• A higher score would strongly favor starting statin therapy

It’s not a test for everyone, but if you are actively engaged in your health and trying to make a nuanced decision, it can be very helpful.

One important perspective

The goal of the scan isn’t just to “find something,” but to give you clarity and confidence in your next step, whether that’s continuing lifestyle measures alone or adding medication with a purpose.

If it’s something that you’re interested in, I’d suggest bringing this up with your doctor at your next visit or with a phone call. As you can see, there are pros and cons, and it helps to know what the plan would be ahead of time.

Happy Spring. Let’s light this candle!

David