Your father died of a heart attack at 58. Your cholesterol is “borderline high,” so your doctor ordered a calcium score.
The test came back zero. Your doctor told you that’s great news – no calcified plaque, low heart attack risk.
But here’s what that calcium score didn’t tell you. Calcified plaque is stable, old plaque that’s been there for years.
The plaque that causes heart attacks is soft, vulnerable, and invisible to calcium scoring.
You could have dangerous, rupture-prone plaque lining your coronary arteries right now, and a calcium score of zero would completely miss it.
Patients come in with “reassuring” calcium scores, only to discover through advanced imaging that they have significant non-calcified plaque, putting them at immediate risk for cardiac events.
The Cleerly heart scan changes this completely.
Using AI-powered coronary CT angiography, the Cleerly heart scan doesn’t just tell you if plaque exists. It quantifies exactly how much plaque you have, identifies which lesions are vulnerable to rupture, and predicts your actual risk of having a heart attack in the next few years.
This is information that calcium scoring and stress tests simply cannot provide.
Here’s what you need to understand about the Cleerly heart scan: how this technology identifies dangerous plaque that standard tests miss, who should consider this advanced imaging, and why it represents the most significant advancement in cardiac risk assessment in decades.
What Is the Cleerly Heart Scan and How Does It Work?
The Cleerly heart scan is an AI-powered analysis of coronary CT angiography (CCTA) imaging.
It’s not a different type of scan. It’s a revolutionary way of analyzing CT angiography data using artificial intelligence trained on thousands of cardiac CT scans to identify, measure, and characterize every bit of plaque in your coronary arteries.
Here’s how the Cleerly heart scan process works:
First, you undergo a coronary CT angiography. This specialized CT scan uses contrast dye to visualize your coronary arteries in extraordinary detail.
The scan itself takes about 10 minutes. You receive IV contrast, and the CT scanner captures hundreds of high-resolution images of your heart and coronary arteries.
Then, Cleerly’s AI platform analyzes these images with precision no human radiologist can match.
The software identifies every plaque deposit in your coronary arteries. It measures the volume of different plaque types. It assesses which lesions show characteristics of vulnerability.
The Cleerly heart scan output provides metrics you won’t get from any other cardiac test:
- Total Plaque Burden: Complete volume of all plaque in your coronary arteries, measured in cubic millimeters
- Plaque Composition: Breakdown of calcified, non-calcified, and low-density non-calcified plaque (the most dangerous type)
- Stenosis Quantification: Precise measurement of how much each plaque narrows your arteries
- Vulnerable Plaque Identification: Specific lesions showing characteristics that predict rupture and heart attack
- Vessel-by-Vessel Analysis: Detailed assessment of each coronary artery with individual risk stratification
This level of detail transforms cardiac risk assessment from educated guessing to precise quantification.
The Cleerly heart scan doesn’t just say “you have some plaque.” It tells you exactly how much plaque, what type of plaque, where it’s located, and which deposits are most likely to cause a heart attack.
How the Cleerly Heart Scan Quantifies Plaque Standard Tests Miss
The revolutionary aspect of the Cleerly heart scan isn’t just that it finds plaque. It’s that it quantifies and characterizes plaque in ways that fundamentally change risk assessment.
Standard cardiac testing has massive blind spots.
Calcium scoring only detects calcified plaque. Stress tests only identify significant blockages causing reduced blood flow.
Neither test can identify the soft, lipid-rich plaque that causes most heart attacks.
The Cleerly heart scan closes these gaps completely. The AI platform measures three distinct types of plaque:
| Plaque Type | Characteristics | Risk Level |
|---|---|---|
| Calcified Plaque | Hard, stable, visible on calcium scoring | Lower rupture risk |
| Non-Calcified Plaque | Soft, fibrous, invisible to calcium scoring | Moderate rupture risk |
| Low-Density Non-Calcified Plaque | Lipid-rich, highly vulnerable, completely invisible to calcium scoring | Highest rupture risk |
Low-density non-calcified plaque is what cardiologists call “vulnerable plaque.”
This is the plaque that ruptures, triggers blood clot formation, and causes heart attacks. A calcium score of zero tells you nothing about this dangerous plaque.
The Cleerly heart scan identifies and quantifies it precisely.
Research shows that patients with significant non-calcified plaque have 3-5 times higher risk of cardiac events compared to those with equivalent amounts of calcified plaque.
Beyond plaque volume and composition, the Cleerly heart scan identifies specific high-risk plaque characteristics:
- Positive Remodeling: When arteries expand outward to accommodate plaque – a sign of vulnerability
- Spotty Calcification: Small calcium deposits within soft plaque indicating instability
- Napkin Ring Sign: A thin rim of calcification around a lipid-rich core, highly predictive of rupture
- Low Attenuation Plaque: Very soft plaque with lipid content, the most dangerous type
These features identify lesions at imminent risk of causing a heart attack. Standard testing provides no information about these characteristics.
The Cleerly heart scan makes them visible and quantifiable.
Identifying Vulnerable Lesions: What the Cleerly Heart Scan Reveals
The most important capability of the Cleerly heart scan is its ability to identify vulnerable lesions – specific plaque deposits that are likely to rupture and cause heart attacks.
Not all plaque is equally dangerous.
You can have extensive calcified plaque that sits quietly in your arteries for decades. Or you can have a small amount of vulnerable plaque that ruptures next month and causes a fatal heart attack.
The Cleerly heart scan distinguishes between these scenarios with remarkable accuracy.
The AI platform analyzes each lesion for characteristics associated with vulnerability and rupture risk.
💡 Clinical Significance
Studies show that 70% of heart attacks occur in arteries with less than 50% blockage. These are lesions that stress tests would call “normal” and that don’t cause symptoms. The Cleerly heart scan identifies these dangerous lesions before they cause events.
When I review Cleerly heart scan results with patients, I can point to specific lesions and explain why they’re concerning.
“This lesion in your LAD has significant low-density plaque with positive remodeling. This combination puts it at high risk for rupture. We need to address this aggressively.”
This level of specificity is impossible with calcium scoring or stress testing.
Who Should Consider a Cleerly Heart Scan
The Cleerly heart scan provides value for anyone wanting to understand their true cardiac risk.
But certain individuals have particularly strong reasons to pursue this advanced imaging.
You should strongly consider a Cleerly heart scan if you have:
✓ Ideal Candidates for Cleerly Heart Scan
- Strong Family History: Parent or sibling with heart attack before age 60 (men) or 65 (women)
- Calcium Score of Zero with Risk Factors: “Reassuring” calcium score but elevated cholesterol, diabetes, or hypertension
- Intermediate Risk: 10-year ASCVD risk of 5-20% where treatment decisions are unclear
- Unclear Chest Pain: Symptoms that might be cardiac but stress test is normal
- Very High LDL or Lp(a): Genetic dyslipidemia requiring aggressive treatment decisions
- Metabolic Syndrome: Multiple risk factors including insulin resistance and obesity
The calcium score zero scenario deserves special attention. Many patients receive false reassurance from a zero calcium score.
Studies show that 10-15% of people with calcium scores of zero have significant non-calcified plaque. Some have vulnerable lesions putting them at immediate risk.
If you have risk factors – family history, high cholesterol, diabetes, smoking history – a calcium score of zero doesn’t mean you’re safe.
The Cleerly heart scan provides the complete picture calcium scoring cannot.
At our Tulsa,and Tampa locations, we’re one of the few practices offering Cleerly heart scan technology.
This gives our patients access to the most advanced cardiac risk assessment available. We integrate Cleerly results into comprehensive prevention plans, combining imaging data with advanced lipid testing.
Cleerly Heart Scan vs Calcium Scoring: Understanding the Difference
Calcium scoring and the Cleerly heart scan both use CT technology, but they provide fundamentally different information.
Calcium scoring measures the amount of calcified plaque in your coronary arteries. The test is quick, inexpensive, and requires no contrast dye.
It produces a single number – your calcium score – that correlates with total plaque burden.
The Cleerly heart scan uses coronary CT angiography with contrast to visualize all plaque types.
It measures total plaque volume, plaque composition, stenosis severity, and vulnerable lesion characteristics. Instead of a single number, you get a comprehensive report detailing every aspect of your coronary atherosclerosis.
| Factor | Calcium Scoring | Cleerly Heart Scan |
|---|---|---|
| Plaque Detection | Calcified only | All types including vulnerable |
| Vulnerable Plaque | Cannot detect | Identifies and characterizes |
| Risk Prediction | General risk category | Precise risk with lesion-specific data |
| Best For | Initial screening | Comprehensive assessment, strong family history |
The clinical implications of these differences are profound. Calcium scoring tells you about historical plaque accumulation.
The Cleerly heart scan tells you about current risk and future events.
Cleerly Heart Scan vs Stress Testing: Different Questions, Different Answers
Stress tests and the Cleerly heart scan serve different purposes in cardiac evaluation.
Stress tests evaluate blood flow to your heart muscle during exertion. They identify significant blockages (typically >70% stenosis) that limit blood flow and cause symptoms.
The Cleerly heart scan evaluates the coronary arteries themselves. It identifies and characterizes plaque regardless of whether that plaque causes reduced blood flow.
Here’s the critical distinction. Stress tests answer “Do you have significant blockages causing reduced blood flow right now?”
The Cleerly heart scan answers “What is your risk of having a heart attack in the future, and which lesions are most likely to cause it?”
Most heart attacks don’t occur from progressive narrowing of arteries.
They occur from sudden rupture of vulnerable plaque in arteries that weren’t significantly blocked. Stress tests cannot identify these lesions because they don’t cause reduced blood flow.
The Cleerly heart scan identifies them specifically.
Early Intervention Potential: Why the Cleerly Heart Scan Changes Everything
The ultimate value of the Cleerly heart scan lies in its ability to guide early, aggressive intervention that prevents heart attacks rather than just predicting them.
When we identify vulnerable plaque years before it would cause an event, we have time to stabilize that plaque and eliminate rupture risk.
Plaque stabilization is achievable through aggressive lipid management. When you lower LDL cholesterol below 70 mg/dL, particularly with high-intensity statins, vulnerable plaque becomes less vulnerable.
The lipid-rich core shrinks. The fibrous cap thickens. Inflammation decreases.
Studies using serial imaging show that aggressive treatment can reduce plaque volume and transform vulnerable lesions into stable lesions over 12-24 months.
According to research from the National Institutes of Health, intensive lipid lowering reduces cardiovascular events by 30-50% specifically in patients with vulnerable plaque identified through advanced imaging.
The Cleerly heart scan makes this targeted intervention possible.
Without identifying vulnerable plaque, we rely on risk calculators and population statistics. With the Cleerly heart scan, we know exactly which patients need aggressive treatment and can monitor whether that treatment is working through follow-up imaging.
The early intervention strategy includes:
- Baseline Cleerly Heart Scan: Identify and quantify all plaque, especially vulnerable lesions
- Aggressive Risk Factor Management: High-intensity statins, intensive LDL lowering (target <70 mg/dL, often <50 mg/dL for vulnerable plaque)
- Comprehensive Lifestyle Intervention: Anti-inflammatory diet, regular exercise, stress management, sleep optimization
- Follow-up Imaging: Repeat Cleerly heart scan in 12-24 months to document plaque stabilization
This approach transforms cardiac prevention from guesswork to precision medicine.
In our Direct Primary Care model, we have the time and flexibility to implement this comprehensive approach.
Our Longevity membership includes advanced cardiac screening as part of comprehensive preventive care, making the Cleerly heart scan accessible without insurance barriers. The Cleerly scan is also available to our Core and Vitality members at a discounted rate.
Take Control of Your Cardiac Future with the Cleerly Heart Scan
The Cleerly heart scan represents the most significant advancement in cardiac risk assessment in decades.
By identifying and characterizing vulnerable plaque that standard testing completely misses, this technology enables true prevention rather than just risk prediction.
You don’t have to wait for a heart attack to take action. You don’t have to rely on calcium scores that miss dangerous plaque or stress tests that only identify advanced disease.
The Cleerly heart scan shows you exactly what’s happening in your coronary arteries, which lesions are dangerous, and what interventions will prevent future cardiac events.
If you have a strong family history of heart disease, if you’ve received a “reassuring” calcium score despite risk factors, or if you’re in the intermediate-risk category where treatment decisions are unclear, the Cleerly heart scan provides answers that transform prevention.
Schedule a consultation at our Tulsa or Tampa locations to discuss whether the Cleerly heart scan is appropriate for your situation.
We’ll review your cardiac risk factors, explain what the Cleerly heart scan can reveal about your specific risk, and develop a comprehensive prevention strategy based on your results.
Your cardiac future doesn’t have to be determined by family history or traditional risk factors.
With the Cleerly heart scan, you can see your actual disease, understand your true risk, and implement interventions that prevent heart attacks before they happen. That’s the power of precision cardiac prevention.
