Heart disease has earned its reputation as a “silent killer” because atherosclerosis, the buildup of plaque in arterial walls, can progress for decades without causing any noticeable symptoms. The coronary arteries have remarkable compensatory mechanisms that maintain adequate blood flow even as plaque accumulates, masking the underlying disease until a critical threshold is reached. Tragically, for many people, the first sign of heart disease is a heart attack or sudden cardiac death, which is why approximately 50% of individuals who die from coronary artery disease had no prior symptoms.

This silent progression makes proactive screening absolutely essential, particularly for individuals with risk factors such as family history, high blood pressure, elevated cholesterol, diabetes, or a history of smoking. Advanced cardiac imaging can detect plaque buildup years before it becomes dangerous, providing a window of opportunity for intervention. The calcium score test, for example, can identify calcified plaque with a simple, quick scan that involves no injections or invasive procedures. By identifying disease early, patients and their physicians can implement aggressive prevention strategies that may include lifestyle modifications, medications, and regular monitoring to halt or reverse disease progression.