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Patient guide · Cardiology

Cardiovascular screening, from QRISK3 to coronary calcium score and CaRi-Heart AI risk profiling.

Cardiovascular screening ranges from a simple QRISK3 calculation to advanced modern tools: coronary calcium score, CT coronary angiography with CT-FFR, CaRi-Heart AI plaque analysis and lipid subfraction testing. Choose the right menu for your risk profile.

See the key facts

Reviewed by Pulse Atlas Editorial Board () · Last reviewed 2026-07-30 · Next review 2027-07-30 · 7 min read

A cardiologist reviewing a coronary CT angiogram and CaRi-Heart AI analysis in a private London clinic

Why it matters

  • 01

    Right tier for your risk

    From a simple QRISK3 calculation to advanced coronary imaging and AI plaque analysis — the menu is matched to you, not the other way round.

  • 02

    Modern tools, properly used

    Coronary calcium score, CT coronary angiography with CT-FFR, CaRi-Heart AI vascular inflammation and lipid subfractions — used only where they change the plan.

  • 03

    A plan you can act on

    Every screen ends in a structured written report and a concrete risk-reduction plan — lifestyle, lipids, blood pressure, cardiology follow-up.

Key facts

Cardiovascular screening in six lines.

A quick, plain-English summary of the screening tiers — from the QRISK3 calculator to CaRi-Heart AI and advanced lipids.

Fact Detail
Definition A stratified assessment of cardiovascular risk — from a simple calculator to advanced coronary imaging.
The primary care score QRISK3 is the NICE-recommended 10-year cardiovascular risk score for UK primary care.
Reclassifying intermediate risk A coronary calcium score reclassifies patients whose QRISK3 sits in the intermediate band.
Anatomical detail CT coronary angiography with CT-FFR (HeartFlow) images the coronary tree and estimates the pressure drop across a lesion.
Vascular inflammation CaRi-Heart AI adds a fat-attenuation index (FAI) — a plaque-inflammation signal from a standard CT coronary angiogram.
Advanced lipids Lipid subfraction analysis, ApoB and Lp(a) refine risk beyond a standard cholesterol panel.

Preparation

What to expect, step by step.

From consultation to written plan — a stratified pathway matched to your risk profile.

  1. 01

    Before

    Consultation and family history

    A structured conversation covering personal, family and lifestyle risk — the foundation on which every subsequent test is chosen.

  2. 02

    Before

    Blood pressure, lipid panel, HbA1c

    Baseline metabolic data: standing and seated BP, full lipid panel and glycated haemoglobin.

  3. 03

    Before

    QRISK3 or ASCVD score

    A 10-year cardiovascular risk score is calculated from the baseline data — QRISK3 in the UK, ASCVD as a cross-check.

  4. 04

    Imaging tier

    Choose imaging tier

    Together we choose the right imaging tier — coronary calcium score, CT coronary angiography with CT-FFR, or CaRi-Heart AI.

  5. 05

    Imaging tier

    Coronary calcium score or CTCA

    A low-dose CT quantifies calcified plaque (Agatston) or a contrast CTCA maps the full coronary tree, with CT-FFR where indicated.

  6. 06

    After

    Advanced lipids if indicated

    Where the plan depends on it, we add Lp(a), ApoB and lipid subfraction testing — one-off tests that meaningfully sharpen risk.

  7. 07

    After

    Structured written plan

    A written report and a concrete risk-reduction plan — lifestyle, lipids, blood pressure, cardiology follow-up interval.

What it shows

What a modern cardiovascular screen can pick up.

Beyond a QRISK3 percentage, imaging and advanced lipids add anatomical, physiological and inflammatory detail.

  • 10-year CV risk (QRISK3)

    The NICE-recommended score — a numerical 10-year risk of cardiovascular events from your risk-factor profile.

  • Blood pressure and lipid profile

    Standing and seated BP alongside a full lipid panel — the metabolic bedrock of any CV screen.

  • Coronary calcium score (Agatston)

    A low-dose CT quantifies calcified coronary plaque burden — a strong independent predictor of future events.

  • Coronary plaque burden on CTCA

    A contrast CT coronary angiogram maps calcified and non-calcified plaque across the coronary tree.

  • CT-FFR pressure drop

    CT-derived fractional flow reserve (HeartFlow) estimates the pressure drop across a stenosis — the physiological significance of a lesion.

  • CaRi-Heart AI FAI score

    An AI-derived fat-attenuation index that quantifies coronary vascular inflammation — a plaque-instability signal from a standard CTCA.

  • Advanced lipid subfractions

    ApoB, Lp(a) and lipid subfraction analysis refine risk beyond a standard cholesterol panel.

  • Red flag: severe left-main coronary disease

    Severe left-main stenosis on CTCA warrants urgent cardiology and cardiothoracic-surgery review.

Next steps

What happens after your cardiovascular screen.

The pathway depends on your risk band — from lifestyle alone through statin therapy, cardiology follow-up and repeat screening at a defined interval.

  • Lifestyle prescription

    A structured programme — diet, activity, sleep, smoking cessation and alcohol — the foundation on which every other therapy builds.

  • Statin therapy per NICE / ESC

    Statin therapy is titrated to LDL-C or non-HDL-C targets in line with NICE and European Society of Cardiology guidance.

  • Antihypertensive optimisation

    Blood-pressure targets and combination therapy are set to guideline-based thresholds, with ambulatory BP where useful.

  • Ezetimibe or PCSK9 inhibitor

    Where statins alone do not reach target, ezetimibe or a PCSK9 inhibitor is added under specialist supervision.

  • Anti-platelet therapy

    Aspirin or an alternative anti-platelet is considered where the balance of ischaemic benefit and bleeding risk supports it.

  • Structured cardiac rehabilitation

    A supervised exercise, education and lifestyle programme for patients with established disease or a high-risk profile.

  • Cardiology follow-up

    Ongoing cardiology review at a defined interval — annual for higher-risk profiles, longer for the reassured.

  • Repeat screening at defined interval

    The next QRISK3 or imaging interval is set at the outset, not left open-ended — three, five or ten years depending on tier.

Red flags

When cardiovascular risk needs urgent attention.

These are the features that lift a screening finding out of routine follow-up and into specialist cardiology review.

  • Family history of premature CAD

    A first-degree relative with coronary disease before age 55 (men) or 65 (women) materially raises inherited risk.

  • Familial hypercholesterolaemia

    Very high LDL-C from an inherited condition — early detection changes lifetime risk and shifts treatment thresholds.

  • Left-main coronary disease

    Significant left-main stenosis on CTCA is a high-acuity finding — urgent cardiology and cardiothoracic-surgery review.

  • Severe multi-vessel disease

    Multi-vessel disease on CTCA changes the treatment pathway from medical therapy alone to revascularisation discussion.

  • Very high Lp(a)

    Markedly elevated lipoprotein(a) is an independent, largely inherited risk factor that intensifies overall management.

  • High CaRi-Heart FAI score

    An elevated CaRi-Heart fat-attenuation index signals plaque inflammation and future-event risk beyond calcium alone.

  • Silent myocardial infarction on imaging

    Imaging evidence of a prior, unrecognised infarct meaningfully changes prognosis and management.

  • Type 1 diabetes with additional risk factors

    Long-standing type 1 diabetes combined with hypertension, dyslipidaemia or smoking sits in a high-risk bracket.

  • Chronic inflammatory disease

    Rheumatoid arthritis, SLE and severe psoriasis carry an independent excess cardiovascular risk that a QRISK3 alone under-reads.

Reading your report

A cardiovascular screening report can look intimidating. It isn’t.

Whatever the finding, the report keeps to the same four parts.

A cardiologist reviewing a coronary CT angiogram and CaRi-Heart AI analysis on a clinical workstation in Central London

A quiet reminder

The report is written for your doctor, not for you — and that’s normal.

If you would like us to talk you through it before your follow-up, just ask.

  1. 01 Header

    Indication and risk factors

    Your details, the reason for the screen, and the personal, family and lifestyle risk factors that shape interpretation.

  2. 02 Technique

    Scores and imaging performed

    Which risk score was used, which imaging tier was performed, and any advanced lipid or specialist test added.

  3. 03 Findings

    QRISK3, calcium, plaque, FAI, lipids

    The numerical findings — QRISK3 percentage, Agatston score, plaque burden, CT-FFR, FAI, Lp(a) and ApoB.

  4. 04 Impression

    The conclusion: read this first

    Your risk band and the concrete next step — lifestyle, statin, imaging follow-up interval, or cardiology referral.

Frequently asked

Everything patients ask about cardiovascular screening.

Quick answers on QRISK3, coronary calcium score, CTCA with CT-FFR, CaRi-Heart AI and advanced lipids.

  • What is cardiovascular screening?

    A stratified assessment of your cardiovascular risk — from a simple QRISK3 calculator, through coronary calcium scoring and CT coronary angiography with CT-FFR, up to AI-based plaque-inflammation analysis (CaRi-Heart) and advanced lipid testing. The point is to match the depth of the workup to your risk, not to over-test everyone.

  • What is a coronary calcium score, and who is it for?

    A quick, low-dose CT of the heart that quantifies calcified plaque in the coronary arteries (the Agatston score). It is most useful for people whose QRISK3 sits in the intermediate band, where a very low or high calcium score meaningfully reclassifies risk — and therefore treatment.

  • What is CT coronary angiography, and what does CT-FFR add?

    CT coronary angiography (CTCA) uses contrast to map calcified and non-calcified plaque across the coronary tree. CT-FFR (HeartFlow) then estimates the pressure drop across any narrowing — the physiological significance of a lesion — which helps decide whether a stenosis actually needs intervention.

  • What is CaRi-Heart AI, and why does it matter?

    CaRi-Heart is an AI-based analysis of the fat around your coronary arteries on a standard CTCA. It produces a fat-attenuation index (FAI) that reflects vascular inflammation — a signal of plaque instability and future events that calcium and stenosis alone can miss.

  • When should I have Lp(a) or ApoB tested?

    Lp(a) is a largely inherited, once-in-a-lifetime test — worth measuring when there is a family history of premature coronary disease or unexplained early events. ApoB is a more accurate measure of atherogenic particle number than LDL-C and is increasingly used to titrate lipid-lowering therapy.

  • How often should cardiovascular screening be repeated?

    The interval depends on your risk band and the tier of screen you had. A low-risk QRISK3 in a young adult may not need repeating for five to ten years; an intermediate-risk calcium score may drive annual clinical follow-up; established coronary disease is managed with ongoing cardiology review.

Sources

Where this guide comes from.

Reviewed by Pulse Atlas Editorial Board (). Last reviewed 2026-07-30. Next review 2027-07-30.

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In practice, in London

How cardiovascular screening tends to unfold when you go private

With cardiovascular screening, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for cardiovascular screening is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.

A typical private booking for cardiovascular screening in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For cardiovascular screening specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

Honesty about expectations is part of the job. A private cardiovascular screening appointment in London won’t change the underlying medicine — the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Everyone we route to is GMC-registered and works within CQC-regulated facilities.

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