Cardiac imaging · London
CT coronary calcium score (CAC) - private in London
A five to ten minute low-dose CT scan that measures calcified plaque in your coronary arteries and produces an Agatston score. The single most useful number in cardiovascular prevention if you are between 40 and 70 with intermediate risk. From £250, reported the same day, at a small vetted panel of London cardiac clinics.
What it is
A quick, low-dose CT scan that counts the calcium in your coronary arteries.
Calcium in a coronary artery wall is not a normal finding. It is the fingerprint of established atherosclerosis, and the more of it there is, the higher your future risk of a heart attack. The CAC scan quantifies that calcium precisely, producing a single number known as the Agatston score.
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Calcified atherosclerotic plaque
Calcium in the coronary artery walls is a fingerprint of established atherosclerosis. The scan quantifies it precisely.
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An Agatston score
A single number, plus a per-vessel breakdown across the LAD, LCx, RCA and left main. Reported alongside age and sex percentiles.
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Your 10-year cardiovascular risk
The score reclassifies risk up or down against your QRISK3 estimate, often changing the statin and aspirin conversation.
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A baseline for future scans
A first score at 45 or 50 gives a comparator if symptoms appear later. Progression rate matters as much as absolute number.
Who it is for
The right test in the right window.
Calcium scoring earns its keep in a specific group of people. Too young and there is nothing to see. Symptomatic and it is the wrong test. Well-chosen and it can meaningfully change the next decade of your health.
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Asymptomatic adults 40 to 70
The sweet spot for calcium scoring. Old enough for plaque to have accumulated if it will, young enough for prevention to change the trajectory.
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Intermediate 10-year risk
QRISK3 or ASCVD scores in the 5 to 20 per cent range, where the statin decision is genuinely borderline and needs an objective tie-breaker.
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Family history of premature CAD
A parent or sibling with a heart attack, stent or bypass under 55 (men) or 65 (women). Family history alone often understates individual risk.
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Statin-hesitant patients
People who would rather see the plaque before committing to a lifetime medication, or who need reassurance that lifestyle alone is enough for now.
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South Asian and mixed-heritage patients
Standard risk calculators underestimate cardiovascular risk in several ethnic groups. A calcium score is ethnicity-agnostic.
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Personalised prevention plans
Anyone building a longevity-minded prevention strategy who wants a concrete baseline rather than a probabilistic estimate.
How it works
From enquiry to same-day result.
Five to ten minutes on the scanner, no contrast, no fasting, no cannula, no exercise. Around 1 mSv of radiation, similar to six months of natural background exposure in the UK.
Phase 1 · Before your scan
Concierge, off-stage for you
Phase 2 · On the day
~30 minutes at the clinic
Phase 3 · After
Prevention plan
- 01
Before
You tell us what is going on
A short, confidential form. Age, family history, cholesterol, blood pressure, any current medications.
- 02
Before
We confirm CAC is the right test
Within one working day. If you have chest pain on exertion, we will steer you to CT coronary angiography (CCTA) instead.
- 03
Before
We arrange the appointment
Often same or next day. No fasting, no medication changes, no cannula needed for a plain CAC.
- 04
On the day
Arrival and ECG leads
Change into a gown. Three ECG dots on the chest so the scanner can gate to your heartbeat.
- 05
On the day
In the scanner
5 to 10 minutes on the table. A single breath-hold of about 10 seconds. Radiation dose around 1 mSv, similar to six months of natural background.
- 06
On the day
Straight home
No recovery time. Drive, eat and work as normal. Some clinics review the result with you before you leave.
- 07
After
Report and prevention plan
Consultant cardiologist or radiologist report, usually same day. We route it to your GP or private cardiologist for the prevention plan.
Interpreting your Agatston score
One number, four bands, a clear plan.
The score sits in one of four bands that map directly to your 10-year risk of a heart attack or coronary event, and to whether a statin (and sometimes aspirin) is worth taking.
- 0
No detectable calcium
Very low 10-year cardiovascular risk. In most cases the statin conversation can be paused and reviewed in 5 years.
- 1-99
Mild plaque
Early atherosclerosis. Lifestyle and lipid optimisation, often a low or moderate-intensity statin depending on other risk factors.
- 100-399
Moderate plaque
Above the 75th percentile for most ages. Statin therapy usually indicated, blood pressure targets tightened, aspirin reconsidered.
- 400+
Extensive plaque
High risk. Aggressive lipid targets, often a functional test (stress echo or CCTA) to rule out flow-limiting disease.
Scores are also reported as an age and sex percentile, which matters as much as the absolute number. A score of 50 is reassuring at 65, but concerning at 42.
CAC vs CCTA
When calcium scoring is the right test, and when it is not.
A plain calcium score is a screening tool for people with no symptoms. If you have chest pain, breathlessness on effort or exertional palpitations, the question is different and needs a different scan.
Choose CAC when
- You have no chest symptoms and want to quantify your future risk.
- Your QRISK3 or ASCVD score sits in the intermediate range.
- A parent or sibling had a heart attack, stent or bypass young.
- You are undecided about starting a statin and want objective data.
- You want a baseline to compare against in 5 to 7 years.
Choose CT coronary angiography (CCTA) when
- You have chest pain, tightness or pressure on exertion.
- You have new breathlessness that could be cardiac.
- Your GP or cardiologist wants to rule out flow-limiting disease.
- Your calcium score is high and treatment planning needs anatomy, not just calcium.
- Soft, non-calcified plaque is a specific concern (younger patients, familial hyperlipidaemia).
Both scans use ECG-gated cardiac CT. CCTA adds iodinated contrast through a cannula and gives a full picture of the arterial lumen and any soft plaque, at a modestly higher radiation dose.
Cost in London
Honest ranges, all-inclusive.
A plain calcium score sits between £250 and £450 across our panel. Many clinics bundle it with a lipid panel and a short consultant review, which is what most patients actually want.
| Option | Indicative range | Time at clinic | Result turnaround |
|---|---|---|---|
| CT coronary calcium score (CAC) alone | £250-£350 | 5-10 min | Same day |
| CAC bundled with lipid panel and consultant review | £400-£550 | 45-60 min | Same day |
| CAC plus CT coronary angiography (CCTA) | £650-£1,100 | 20-30 min | 24-48 hrs |
| Full cardiovascular MOT (CAC, ECG, echo, bloods, cardiologist) | £950-£1,600 | 2-3 hrs | Same day |
Screening CAC is usually excluded from standard private insurance. When a cardiologist requests it to inform treatment, cover is more likely. We check with your insurer before booking.
Where it is done
A small London panel with modern cardiac CT.
We work with a handful of CQC-registered London clinics with dedicated cardiac CT scanners and cardiologist-led reporting. Most offer same-day appointments and same-day results.
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HCA London Bridge
Modern 320-slice CT, cardiologist-led calcium scoring in the City.
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Cromwell Hospital (Bupa)
Long-established cardiac imaging unit in South Kensington.
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HCA The Wellington
North-west London cardiac hub with same-day consultant review.
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Royal Brompton and Harefield
Specialist cardiac and cardiothoracic centre in Chelsea.
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One Welbeck Heart Health
Marylebone concierge cardiac clinic, everything under one roof.
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London Medical
Marylebone clinic with a bundled prevention package including CAC.
After the scan
No recovery, just a plan.
You leave the department five minutes after the scanner stops. The point of the test is the conversation that follows.
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Result the same day
Most partner clinics issue the report within a few hours. Several offer a same-visit consultant walkthrough.
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Prevention plan, not just a number
A cardiologist or GP with special interest turns the score into specific decisions on statin, blood pressure, weight and, occasionally, aspirin.
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Routed to your GP
With your consent we send the report to your NHS GP so it sits in your notes for the long term.
Related tests and conditions
Read next.
If CAC is not quite the right question for you, one of these usually is.
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CT coronary angiography (CCTA)
The scan of choice when chest symptoms need explaining.
Read the guide -
Cardiac MRI
Gold-standard imaging of the heart muscle, scarring and function.
Read the guide -
Stress echocardiogram
Functional test of blood flow under controlled exertion.
Read the guide -
Hypertension
How high blood pressure interacts with coronary calcium and risk.
Read the guide -
Atrial fibrillation
The other common cardiac question in the same age group.
Read the guide
Frequently asked
The questions we get before booking.
Straight answers on symptoms, radiation, contrast, repeat scans and insurance.
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Do I need symptoms to have a calcium score?
No. In fact CAC is designed for asymptomatic people. If you have chest pain on exertion, breathlessness or palpitations, a plain calcium score is not the right test. A CT coronary angiogram or a stress echo will answer the question about current blood flow. We will steer you to the right scan when you enquire.
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How much radiation is involved?
The dose for a modern CAC scan is around 1 millisievert, roughly equivalent to six months of natural background radiation in the UK, or a return transatlantic flight. It is well within accepted limits for a diagnostic test and considered very low for a scan of this diagnostic value.
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Do I need contrast dye or a cannula?
No. A plain calcium score uses no iodinated contrast, so there is no cannula in the arm and no risk of contrast reaction or kidney concern. If your cardiologist wants a full CT coronary angiogram at the same visit, that does need contrast and a cannula.
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How often should the scan be repeated?
If your score is zero, most cardiologists suggest repeating in 5 to 7 years. If it is above zero, repeat scanning is less useful because treatment is already indicated, and progression is expected. The score guides the intensity of prevention, not the frequency of scans.
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Will my private insurance cover it?
Screening scans in asymptomatic patients are usually excluded from standard policies. Some corporate or premium plans include a CAC as part of a health check. When the scan is requested by a cardiologist to inform treatment, cover is more likely. We check with your insurer before booking.
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My score is zero. Am I safe forever?
A zero score means very low near-term risk but not zero risk. Soft, non-calcified plaque is not counted, and calcium can develop over the years ahead. Lifestyle still matters, and a repeat scan in 5 to 7 years is sensible if your risk factors change.
Sources and guidelines
What we rely on.
- NICE. Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238), 2023.
- European Society of Cardiology. 2021 Guidelines on cardiovascular disease prevention in clinical practice.
- Royal College of Radiologists. iRefer: Making the best use of clinical radiology.
- American College of Cardiology / AHA. 2018 Guideline on the Management of Blood Cholesterol.
This page is for information only. It is not a substitute for advice from a clinician who has assessed you in person.
Ready when you are
A CAC scan is a small, one-time investment in the next decade of your health.
Tell us your age, family history and current cholesterol. We will come back within one working day with a firm quote at two or three vetted London clinics, or a candid recommendation if CAC is not the right scan for you.
Reply within one working day. Free.