How young is too young to have measurable plaque buildup in the coronary arteries?

A coronary artery calcium score exam has been proven to be very reliable at predicting the likelihood of a coronary event such as a heart attack, one to three years out from having the exam.

I wondered, however, if a person can be too young to have a buildup of calcium in their coronary arteries; I don’t mean as in toddler young, but more like young adulthood or teenage-hood.

“I think you mean at what age does calcified plaque develop,” responds Dr. Larry Santora, MD, cardiologist, medical director of cardiac CT, and medical director of the Vascular and Wellness Center, Saint Joseph Hospital, Orange, CA, and author of “OC Cure for Heart Disease.”

“It is rare to see calcified plaque in men younger than 30 or woman younger than 35,” continues Dr. Santora.

“We start to develop very minor ‘fatty streaks’ as the earliest development of atherosclerosis in our early 20s.”

Atherosclerosis is the term for plaque buildup in arteries.

Shutterstock/ Designua

Dr. Santora continues, “This was determined during autopsies on Korean War Vets. We usually do not do EBCT scans on men younger than 35 or woman younger than 40 since it is unusual to see calcification in the plaque at ages younger than this.”

EBCT is electron beam computed tomography, a type of CAT scan that is used for calcium scoring (and other imaging studies). EBCT emits lower radiation than does the more common 64-slice CAT scanner.

“The radiation is equivalent to 2-3 chest X- rays using EBCT scanners, vs, 10-15 chest X-rays for conventional CT scans,” says Dr. Santora.

“In addition, the radiation beam comes from behind the back, exposing very little radiation to breast and thyroid, using EBCT, whereas the X-ray beam encircles the body when using conventional CT.”

There are exceptions when it comes to getting coronary calcium buildup at an early age, continues Dr. Santora.

He explains, “…dialysis patients, juvenile diabetics who smoke, anabolic steroid abusers, and those with familial hyperlipidemias who have family history of heart attacks in their 30s.” Hyperlipidemia is excess fat in the circulating blood.

• About 75 percent of women age 45 to 49 are found to have a coronary calcium score of zero, meaning no measurable atherosclerosis.

• Over 95 percent of women age 30-34 have a coronary calcium score of zero.

• For men in this age group, it’s close to 90 percent.

• For men under 30 it’s 99 percent.

Dr. Santora says, “Atherosclerosis is a very unusual cause of death in someone under 25 years old.”

This doesn’t mean that young adults and teens have a green light for living on a junk food diet, smoking and avoiding exercise.

A young adult may have a zero coronary calcium score, and thus think he or she can get away with regularly eating heart-harmful foods and not exercising.

But the predictive factor of calcium scoring is short-term (1-3 years), and 10 years down the road, that young adult who feels invincible may end up having a growing problem inside his arteries.

Dr. Santora’s areas of interest include interventional cardiology – coronary stenting, cardiac CT – CT angiography, and coronary calcium screening with EBCT.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image: ©Lorra Garrick