Living with high calcium score

Posted by pop77 @pop77, Oct 10, 2023

I am a 53 year old male. Just found out I have a CAC of 731. Most of it (699) is in the right coronary. I exercise 5 times a week , used to eat eggs every day (15-20 per week), cottage cheese and yogurt. Upon hearing this news, stopped eating eggs right away. Just trying to figure out what else to adjust. I don't have BP and am at a healthy weight of around 160 lbs for 5'8".
Doctor still has to reach out to me and I think most likely I will be put on Statins. I have high LDL and Apo(b), but triglycerides are under control.
The question I have is, how else should I adjust the lifestyle. I don't drink or smoke or eat meat. Should I reduce how hard I work out? I used to take my HR to 165 and whenever I did it I used to get a heartburn. I was thinking that the workout has triggered acid reflux but looks like something else is going on.
For those with high CAC , how hard do you work out? Should I stop hiking and running? Looking for some insights.

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keithl56 | @keithl56 | May 19 9:45am

In reply to @lp77 "Thank you . It has been very concerning.to us . Are you on a statin ?" + (show)

I have been on statins since they first came out over 30 years ago (mevacor, zocor, lipitor, and now rosuvastin). Before that my cardiologist had me on niacin and questor. I have had no problems with statins, other than some losing their efficacy and requiring increased dosage until changing to a newer one. I have been on the same 20mg of rosuvastatin for several years now.

I have always passed my stress tests and have been mostly asymptomatic. My last two visits my cardiologist has offered to do a cath and I have refused. I have a FFR of only 0.71 in part of my LAD but my cardio said it is non stentable, so I am afraid that a cath will end up turning into a CABG. I have an irrational fear of invasive heart surgery after watching my father go through it twice and dying within weeks of his second at 55 yo.

mpeters | @mpeters | May 19 10:32am

In reply to @lp77 "My husband had a calcium score of 846 . We were shocked . He is 65..." + (show)

Was his pth tested?

mayoconnectuser1 | @mayoconnectuser1 | May 19 7:56pm

ative1207,

If you were passing out after exercise, even with a satisfactory stress test (you don’t say what the metrics) then a cath is probably appropriate.

Sure, a high CAC score is extra, but not nearly as meaningful as passing out repeatedly.

doddr | @doddr | May 19 8:26pm

In reply to @lp77 "My husband had a calcium score of 846 . We were shocked . He is 65..." + (show)

My CAC Score went from 378 to 798 in 4 years. I am 79 but no heart symptoms, am active and overall very healthy. Passed two stress tests with flying colors. Then had them test me for Lipoprotein (a) [Lp a] and it was over the roof high at 283 nmol/L. Luckily, my high sensitive CRP is very low which says low inflammation so that is helpful to lower my risks. I take a lot of supplements and have a strong immune system. You might want to get your Lp a tested. The two together is very high risks but there are diet and lifestyle changes that look attractive until an FDA approved medicine is available; probably not until 2026.

lp77 | @lp77 | May 19 8:56pm

Cardiologist recommend Mediterranean diet and 150 min of cardio per week .

Marcy | @mkempson42 | May 20 3:04am

In reply to @mpeters "Was his pth tested?" + (show)

I was thinking the same...those high scores scream parathyroid.

usaproud | @usaproud | May 21 6:49am

In reply to @lp77 "My husband had a calcium score of 846 . We were shocked . He is 65..." + (show)

In mid- to long-term follow-up, statin therapy increases the CAC score as documented by serial non-contrast cardiac CT, suggesting that the plaque-stabilizing effect of statins may be reflected in a higher CAC score [8,9].

I agree with your cardiologist, no need for angiogram.
Don’t go for calcium score test again , statins increase calcium score .

lp77 | @lp77 | May 21 7:30am

In reply to @usaproud "In mid- to long-term follow-up, statin therapy increases the CAC score as documented by serial non-contrast..." + (show)

Thank you for that .

Many have said why wouldn’t they do an angiogram . It’s a diagnostic peace of mind

usaproud | @usaproud | May 21 8:55am

In reply to @lp77 "Thank you for that . Many have said why wouldn’t they do an angiogram . It’s..." + (show)

Angiogram has risk including blood clot.
Following is a response I found here from a cardiologist.
“ I am a cardiologist and got my calcium score just casually as I was giving a seminar on it to local drs some four years ago. It came 746! No symptoms, no risk factors, marathoner. Got stress nuclear tested. Just on statins/ aspirin. As an interventional cardiologist myself, I see most patients of heart attack have soft non calcified lesions. Moreover statins tend to increase the calcium score. So you know that it’s not as simple!
I don’t think it needs to be ever repeated. Just avoid over thinking and over treatment. “

I hope this will give a piece of mind.