The heart is where a screening programme most often runs one test and quietly implies it has covered the organ, when it usually has not. There are three common heart tests in a Korean checkup, and each answers a different question. A coronary calcium score asks how much hardened plaque has built up. A cardiac CT angiogram asks what the arteries actually look like. An echocardiogram asks how well the heart is pumping. Running one of them tells you about one of those things, and the gap between “my heart was checked” and “one question about my heart was answered” is worth closing before you book.
Three tests, three questions
A coronary calcium score is the screening number. It is a rapid CT that takes about five minutes, uses roughly 1 mSv and needs no contrast injection. It measures calcified plaque in the coronary arteries and returns a single figure used alongside your other risk factors. Its limit is built into what it measures. It is blind to soft, non-calcified plaque, and a score of zero lowers your estimated risk without ruling out disease.
A cardiac CT angiogram is the map. It uses contrast and a fast CT to image the coronary arteries directly, showing where plaque sits and how much it narrows the vessel, including the soft plaque a calcium score cannot see. That detail costs something: a contrast load and a real radiation dose of 3 to 7 mSv, which is why it is an escalation rather than a casual add-on. It also stops at the anatomy. It shows a narrowing without telling you whether that narrowing is actually limiting blood flow, which is a functional question for a stress test.
An echocardiogram is the working picture. It is an ultrasound of the heart while it beats, about twenty minutes, no radiation, showing chamber sizes, wall thickness, valve movement and pumping function. It is the standard first test for a murmur, breathlessness or suspected heart failure. What it does not do is image the coronary arteries, and it is the misread that comes up again and again, because a normal echocardiogram sits comfortably alongside serious coronary disease.
What that means for a programme
The three are complementary, not interchangeable. The arteries and the pump are two separate questions, and a checkup that includes only an echocardiogram has answered the pump and left the arteries untouched. If coronary risk is your reason for screening, the calcium score is the entry point, and the angiogram is there when the score or your symptoms warrant it.
| Test | Question it answers | Dose | Price (Severance) |
|---|---|---|---|
| Coronary calcium score | How much hardened plaque has built up | ≈1 mSv | ₩234,000 (≈$174) |
| Cardiac CT angiogram | What the coronary arteries look like | 3–7 mSv | ₩520,000 (≈$387) |
| Echocardiogram | How well the heart pumps | 0 mSv | ₩390,000 (≈$291) |
Korean law requires Severance to publish its non-covered (비급여) prices, so the three figures above are that one centre’s own, carried in our price ledger at version 2026-09-13 and quoted in won because won is what the centre charges. The full breakdown for each test sits on its own page: the coronary calcium score, the cardiac CT angiography and the echocardiography.
How to choose
For most people with no cardiac symptoms, the sensible order is a calcium score first, read against blood pressure, cholesterol and family history, with the CT angiogram held in reserve for a score or a symptom that justifies the extra dose. An echocardiogram is the right test when the question is how the heart is working, a murmur or breathlessness rather than artery risk. It helps to remember that none of the three is a complete heart check on its own. Each is a real answer to a real question, and none of them is the answer to the other two.
If imaging elsewhere is also on your mind, the same escalate-on-a-reason logic runs through the abdominal CT and the whole-body MRI. Whichever tests you settle on, the written report usually reaches you two weeks later (one week at the soonest, three at most), with a consultation on preliminary findings before you leave on the day.
