Extremely high calcium score at 42 - is there any positive here??

Posted by steveny @steveny, Jul 8, 2022

I'm a 42-year-old male. Exercise regularly, not overweight, non-smoker. While not overweight, I will say that my diet is crap -- way too much fast food, pizza etc. I guess I still eat like a high schooler.

Anyway, I saw a cardiologist figuring after age 40 this would be wise. He took bloodwork which was basically all fine. The cholesterol was *slightly* elevated and he recommended getting a heart calcium score. Told me he expected it would show nothing but that he just wanted to be thorough. Turns out the score came back at 397.

Obviously, this caught me totally flat-footed. I figured with my diet there might be some plaque, but this number places me in the 99.999th percentile for my age. And everything I have read online sound pretty dire about my long-term prognosis now -- that significant damage has been done, that it can't be reversed and can only get worse and that the statistical linkage between a number like this and heart attack-stroke is profound.

Weirdly, the cardiologist did not seem to be conveying any alarm when he told me the score, though. He was extremely matter of fact about it. Just said it was "very, very high" and that he would put me on a statin (which I've already started) and that I should take daily baby aspirin (doing that too). He said I should focus on improving diet and continue exercising (I already run 4-5x a week) but he was also pretty emphatic that "this must be genetic." (There is a history of heart problems on my father's side of the family -- though he is 76 and has yet to have any heart trouble himself.)

This was all a lot to get hit with at once. From the doctor's casual, matter of fact tone, I left the office a little confused, wondering if maybe this score wasn't that big of a deal and was a very manageable thing. Why else would the doctor not seem that disturbed by it? But then I started reading everything I could find on the subject and it's been pretty devastating.

Obviously, I'm ready, willing and able to implement the dietary changes, but for the score to be this bad at this young of an age (and with no smoking history, not being overweight, and doing regular exercise), it seems like I'm in serious trouble here. So upsetting to read that I can't bring this number down.

I guess I'm just posting this in the hopes that others here might have some experience and insight and be able to offer something, anything that is encouraging? When I read all of the medical material online about high CAC scores, am I missing something? This has all been playing out over the last 24 hours and I feel like I've basically just found out that I could drop dead of a heart attack at any moment and that my life expectancy has been drastically reduced with this news -- and that there's no way to get it back to normal. I now have a million questions for the cardiologist, but when I called his office today I was told he's just started his vacation and won't be back until August.

Any encouragement or practical advice would be greatly appreciated. Thanks.

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@dizzyprizzy

My score is 50 and my cardio isn't worried. Some people report scores over 200. Apparently there isn't any way to get the calcium out of the blood once it is there. We can make the effort to stop it from accumulating in the blood. Diet, exercise, low sodium diet, D3 helps the mechanism in the body process calcium eaten go to the bones instead of the blood. Just my experience to go on. My calcium hasn't gone up since I started D3 at 2-3, 2000IU pills per day. Good luck. Every body is different.

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My personal research (not intended as advice) indicates that Vitamin D3 along with Vitamin K2 (M-7) synergisticly helps the calcium to be used by the bones and thus, reduce the amount available to calcify your arteries. My CAC score has increased from 378 to 798 in 4 years. Thus, I have shifted to a plant based diet along with some selected seafood like salmon. In on month, my cholesterol when down to desired levels along with the statins I have been taking for over 30 years. However, my Lipoprotein a is over the top at 289. To reduce these risks, I hope to keep my High Sensitivity C-Reactive Protein level below 2 mg/mL. I am currently at 0.26. Inflammation and a healthy lifestyle is apparently very important to manage heart disease. I am 79 and still very active and overall very healthy. The key is to make the best of each day knowing they are limited and a gift.

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@doddr

My personal research (not intended as advice) indicates that Vitamin D3 along with Vitamin K2 (M-7) synergisticly helps the calcium to be used by the bones and thus, reduce the amount available to calcify your arteries. My CAC score has increased from 378 to 798 in 4 years. Thus, I have shifted to a plant based diet along with some selected seafood like salmon. In on month, my cholesterol when down to desired levels along with the statins I have been taking for over 30 years. However, my Lipoprotein a is over the top at 289. To reduce these risks, I hope to keep my High Sensitivity C-Reactive Protein level below 2 mg/mL. I am currently at 0.26. Inflammation and a healthy lifestyle is apparently very important to manage heart disease. I am 79 and still very active and overall very healthy. The key is to make the best of each day knowing they are limited and a gift.

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doddr,

The statin has certainly contributed to the high CAC score - calcifying the cholesterol in your arteries - lower risk of pieces breaking off.

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Any update on your health and regime for high calcium score ?
Have you done a stress test ?
Has your cardiologist given you advice and future outlook ?

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@lp77

Any update on your health and regime for high calcium score ?
Have you done a stress test ?
Has your cardiologist given you advice and future outlook ?

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First time reader and responder. Me. I am 76. Feel perfectly healthy. Bike 10 miles hard out several times a week, work out hard, walk miles a day.... no problems. Got my score Friday...3609. I am still here. No symptoms. For a few days, I thought I am going to die any minute...just like you guys. I read up a lot. The total score is not scientifically going to tell you your likelihood of a real problem. I have been taking statins for 30 plus years with no side effects. Doubled the dose a few years ago. If yours causes problems, try any of several others. Now I am on the other...zetia maybe... in addition. Then, I decided that I will wake up every day and be happy and live that day to the fullest...rather than pout and worry. Do that. What do you think my score was when I was 42? For the last 6 years, I have be great at exercising and not eating beef or refined foods. For the last two, I am into fruits, vegetables, oats, brown rice, etc. Read the book about how not to die by Edgars. It will make frys look like poison. I truly enjoy my diet with much less meat, zero added sugar...no refined foods. I am not talking about fake refined veggie burgers...just great whole food. Anyway, bottom line, and why I am writing this is that....your score can go up to over 3600 and you can live at least up to my age of 76. Decide to be happy. Every day.

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@rsimmon712

First time reader and responder. Me. I am 76. Feel perfectly healthy. Bike 10 miles hard out several times a week, work out hard, walk miles a day.... no problems. Got my score Friday...3609. I am still here. No symptoms. For a few days, I thought I am going to die any minute...just like you guys. I read up a lot. The total score is not scientifically going to tell you your likelihood of a real problem. I have been taking statins for 30 plus years with no side effects. Doubled the dose a few years ago. If yours causes problems, try any of several others. Now I am on the other...zetia maybe... in addition. Then, I decided that I will wake up every day and be happy and live that day to the fullest...rather than pout and worry. Do that. What do you think my score was when I was 42? For the last 6 years, I have be great at exercising and not eating beef or refined foods. For the last two, I am into fruits, vegetables, oats, brown rice, etc. Read the book about how not to die by Edgars. It will make frys look like poison. I truly enjoy my diet with much less meat, zero added sugar...no refined foods. I am not talking about fake refined veggie burgers...just great whole food. Anyway, bottom line, and why I am writing this is that....your score can go up to over 3600 and you can live at least up to my age of 76. Decide to be happy. Every day.

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Morning, your post intrigued me. I’m 67, had zero (known) heart issues, great resting heart rate, EKGs all came back great, low cholesterol, BP in check.
Heart scan revealed an Agatston score of 2397. Cardiologist recommended an angiogram where they found 90%+ blockage in 4.
Had quadruple bypass. This all in about 3 weeks!!!
I am recovering nicely but…I’ve been a pescatarian for over 10 years. No beef, fowl, pork, etc. Only fish, veggies, fruits, plant based protein (PBP). However, much PBP has really changed for the worse. Overly processed, high sodium, ridiculous amounts of fat.
Can you share your diet with me? I have to cut out these Impossible Burgers, etc.
I would be very grateful.

REPLY
@rsimmon712

First time reader and responder. Me. I am 76. Feel perfectly healthy. Bike 10 miles hard out several times a week, work out hard, walk miles a day.... no problems. Got my score Friday...3609. I am still here. No symptoms. For a few days, I thought I am going to die any minute...just like you guys. I read up a lot. The total score is not scientifically going to tell you your likelihood of a real problem. I have been taking statins for 30 plus years with no side effects. Doubled the dose a few years ago. If yours causes problems, try any of several others. Now I am on the other...zetia maybe... in addition. Then, I decided that I will wake up every day and be happy and live that day to the fullest...rather than pout and worry. Do that. What do you think my score was when I was 42? For the last 6 years, I have be great at exercising and not eating beef or refined foods. For the last two, I am into fruits, vegetables, oats, brown rice, etc. Read the book about how not to die by Edgars. It will make frys look like poison. I truly enjoy my diet with much less meat, zero added sugar...no refined foods. I am not talking about fake refined veggie burgers...just great whole food. Anyway, bottom line, and why I am writing this is that....your score can go up to over 3600 and you can live at least up to my age of 76. Decide to be happy. Every day.

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Clearly, the statins are working since you have high CAC score.

Have you had:
1 Stress test with echo?
2 Nuclear stress test?
3 Advanced lipids panel?

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@leaddogy2k

Morning, your post intrigued me. I’m 67, had zero (known) heart issues, great resting heart rate, EKGs all came back great, low cholesterol, BP in check.
Heart scan revealed an Agatston score of 2397. Cardiologist recommended an angiogram where they found 90%+ blockage in 4.
Had quadruple bypass. This all in about 3 weeks!!!
I am recovering nicely but…I’ve been a pescatarian for over 10 years. No beef, fowl, pork, etc. Only fish, veggies, fruits, plant based protein (PBP). However, much PBP has really changed for the worse. Overly processed, high sodium, ridiculous amounts of fat.
Can you share your diet with me? I have to cut out these Impossible Burgers, etc.
I would be very grateful.

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lead,

Even with high CAC, it is a bit unusual to do an angiogram without other factors like breathlessness or pain or other heart factors ... did you have other factors which pushed your doc in that direction?

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@mayoconnectuser1

lead,

Even with high CAC, it is a bit unusual to do an angiogram without other factors like breathlessness or pain or other heart factors ... did you have other factors which pushed your doc in that direction?

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Yes. Getting very winded and some chest pains recently. Immediate family history of heart issues (parents, siblings)

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@leaddogy2k

Yes. Getting very winded and some chest pains recently. Immediate family history of heart issues (parents, siblings)

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Wow/ active board. Thanks for your interest. How Not to Die by Dr. Michael Greger and his free online videos appear to be the perfect way to diet. He donates the proceeds of his book. Seems to do this genuinely. However, I only recently found this and the main change I have made is to reduce eating chicken breasts. Apparently, all animals, including fish, are bad oxidizers. He does have a video showing that a reduced amount of animal food still substantially increases lifespan. The best way is plant based diet...the more the better. My current favorites are brown rice, microwaved with bananas and add cinnamon and real oatmeal cooked 5 min with bananas and blueberries. Dr. Greger in his book How Not to Diet mentioned that only 1/8th cup of blackberries as an antioxidant can offset somewhat of meat consumption so I eat fresh or frozen blackberries after those meals. I also regularly eat mangos, pears, strawberries, thawed out brand name expensive $13 frozen blueberries (big bag from Walmart), beans, mostly navy, with crushed walnuts, and sometimes covered with salsa, cashews, pistachios, 72% dark chocolate (mixing the pistachios with the dark chocolate makes a great snack, go wild and get the honey roasted pistachios, kiwis, oranges (sometimes blended in a bullet with a shot of vodka for a nightcap); sometimes low carb wraps; for lunch daily fish cooked in olive oil on stove with butterlettuce, tomato, and cucumber salad with olive oil and Pompean redwine vinegar dressing; but being bad and eating out at night with seafood and vegetables, but filet mignon once a week.
However, we do not yet know if I have been doing this long enough, though not much beef or processed food for years. I still have the stress test to do and the results of a pulmonary function test.
I had Hodgkin's Lymphoma in 2012 with chemo and mediastinal radiation which has likely caused these high numbers in my left anterior descending artery and right coronary artery and extensive calcified plaque in the thoracoabdominal aorta. The radiation treatments put me at a disadvantage now, but cured the cancer.
It seems that it is the softer calcium that more often breaks loose. So I am hoping mine is spread all over and solid because of the statins (now 40 mg simvastatin) and without any narrowing enough to cause a procedure. The radiation also caused lung damage and the thoracic stenosis and maybe other fibrosis in the arteries that prevents bypass and other things which I do not really comprehend.
I have zero symptoms, biking hard out still, and hoping that the stress test does not require more choices.
As of now, I choose to be happy and live each day to the fullest because this stuff motivates me that direction.
Thank you for listening as it is good to talk to others with similar issues. Hope this is helpful even though I am just a patient. I did want all of you to know that you can still be living and active with high numbers. Hope to keep active here for years. We'll find out.

REPLY
@rsimmon712

Wow/ active board. Thanks for your interest. How Not to Die by Dr. Michael Greger and his free online videos appear to be the perfect way to diet. He donates the proceeds of his book. Seems to do this genuinely. However, I only recently found this and the main change I have made is to reduce eating chicken breasts. Apparently, all animals, including fish, are bad oxidizers. He does have a video showing that a reduced amount of animal food still substantially increases lifespan. The best way is plant based diet...the more the better. My current favorites are brown rice, microwaved with bananas and add cinnamon and real oatmeal cooked 5 min with bananas and blueberries. Dr. Greger in his book How Not to Diet mentioned that only 1/8th cup of blackberries as an antioxidant can offset somewhat of meat consumption so I eat fresh or frozen blackberries after those meals. I also regularly eat mangos, pears, strawberries, thawed out brand name expensive $13 frozen blueberries (big bag from Walmart), beans, mostly navy, with crushed walnuts, and sometimes covered with salsa, cashews, pistachios, 72% dark chocolate (mixing the pistachios with the dark chocolate makes a great snack, go wild and get the honey roasted pistachios, kiwis, oranges (sometimes blended in a bullet with a shot of vodka for a nightcap); sometimes low carb wraps; for lunch daily fish cooked in olive oil on stove with butterlettuce, tomato, and cucumber salad with olive oil and Pompean redwine vinegar dressing; but being bad and eating out at night with seafood and vegetables, but filet mignon once a week.
However, we do not yet know if I have been doing this long enough, though not much beef or processed food for years. I still have the stress test to do and the results of a pulmonary function test.
I had Hodgkin's Lymphoma in 2012 with chemo and mediastinal radiation which has likely caused these high numbers in my left anterior descending artery and right coronary artery and extensive calcified plaque in the thoracoabdominal aorta. The radiation treatments put me at a disadvantage now, but cured the cancer.
It seems that it is the softer calcium that more often breaks loose. So I am hoping mine is spread all over and solid because of the statins (now 40 mg simvastatin) and without any narrowing enough to cause a procedure. The radiation also caused lung damage and the thoracic stenosis and maybe other fibrosis in the arteries that prevents bypass and other things which I do not really comprehend.
I have zero symptoms, biking hard out still, and hoping that the stress test does not require more choices.
As of now, I choose to be happy and live each day to the fullest because this stuff motivates me that direction.
Thank you for listening as it is good to talk to others with similar issues. Hope this is helpful even though I am just a patient. I did want all of you to know that you can still be living and active with high numbers. Hope to keep active here for years. We'll find out.

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Also, going into my last physical where there was maybe a heart murmur, leading to an echo which showed mildly elevated pulmonary pressure ( the lowest number), which caused the CT Scan, and then the Calcium Scan, every single number in all of my blood tests for lipids, liver, kidney, etc. were perfect. I thought I was good to go.

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