High calcium score: I'm in shock
Hi everyone... just wanted to share my last few days - I'm scared and lost and was just hoping to hear from some people who have been in my place. Long story short - I went in for a "routine" checkup at age 50 to make sure my heart was okay. I had a stress test two years ago that was fine. But I do have a family history, and somewhat high LDL and blood pressure so the doctor sent me for a cardiac calcium score. It came back at 407 at age 50!!! That's like the 98th percentile for my age, which is shocking. I do Crossfit and have done half marathons so it was totally unexpected. Now I'm going for another stress test in two weeks to make sure no blockages are over 70%, and I'm not sure of the steps after that.... I'm terrified of needing open heart surgery - I've gotten myself into a place of being okay with a stent if needed. I know it's better to know than not know, but I just feel like my life was suddenly ripped out from under me and to be honest I'm spinning right now... every waking second I feel like I'm going to drop over..
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That is exactly my story, too... the arrogance of youth and of the serious exerciser. In the long run, genetics is almost always more of a factor. In my case I also mistakenly believed that genetics was in my favor since my sedentary and overweight dad had never been diagnosed with a heart condition. I learnt that I was wrong about that, too, when he had his cancer scans... but by then it was too late for me. If I had been thinking about all this better I would have gone on a statin in my 40s to combat the rising cholesterol instead of waiting until my 60s.
It might be better to have an angiogram instead of a stress test. That way, they can inject a dye and visually see the blood flow in the arteries around your heart. And, if needed, they can insert a stent right then and there.
A score of 400 doesn't mean you're going to drop dead any second. Your exercise has likely helped a lot. Don't panic.
Did they check your LPA through lab test to see if there is a genetic component
No, I didn’t.
But anyway it’s late now and I’m being treated - and effectively
It is not too late to check your LPA. It is an important factor for the cardiologist to know for treatment, and a long term and short term basis.
My husband is super active and just came back with a score of 1060. It was only done because his father had a heart attack in his 70's. my husband is 62. How did everything turn out for you?
I had a lumbar x-ray and the doc noted calcification in my aorta. I asked for a calcium scan and rung the bell at 1400.
I am a fit 65 year old. I have been extremely active most of my life…miles of intense cycling, bike commuter and Peloton at home. I do endurance, HIIT and was doing fitness threshold training until my late 50s. I have had a slightly elevated LDL (123), normal HDL and low triglycerides. I eat well, have no family history of heart disease. My lived until 95.
PCP immediately put me on statins and sent me to a cardiologist. He was stumped based on the info above. He gave me a stress test, which caused zero symptoms indicating no blockage and gave me a low exercise risk. The Cardiologist thought maybe I had wacked lipoprotein (a) or apolipioprotein B. Both levels were very good.
The doctor basically said he had no idea why my CAS was astronomical, but that they were not as worried about calcium as they were about the “squishy plaque”, which he did not think I had a problem with. He recommended I keep taking 10 mg statin and 81 mg aspirin for the rest of my life and said come back if something hurts. The thing is….statins cause an increased calcification. I essence I feel like I am taking something to help with a condition that does not exist that will in turn make a condition that does exist worse.
I think a research cardiologist is my next step also.
I have a complete blockage in one part of my right coronary artery. Lifelong runner, zero symptoms., still running. Look up "collateral arteries." That may be what you have. That's what I have, thanks to running.
Statins cause calcification of existing soft plaque. You want that! It's the soft plaque that is the danger.
You need an interventional cardiologist to do an angiogram and see what the deal is. That is the only way to find out for sure.
OK, so here is your new world ... many of us have been through this:
- LDL of 134 is not slightly elevated, it is significantly elevated compared to the recommended level with heart disease
- What is your total cholesterol?
- What is your HDL?
- What was your METS score in the basic stress test?
Some goals:
- Total cholesterol below 100
- LDL below 50
- HDL as high as possible (hard to change much)
- Triglycerides below 50
Tests:
- Stress with echo (before and after stress test exertion)
- Advanced lipids panel (one company calls this CardioIQ)
- Angiogram (although lots of calcium may affect readings)
- Catheterization (although this is usually not prescribed unless you are symptomatic)
That is so unusual! I think your plan to go to another cardiologist is a good one. I got my LDL down to 17 from over 100 with Repatha within one month! I am extremely leery of your doctor only because he doesn’t know if you have squishy plaque or not, how was that tested for? Wondering if you should have your parathyroids also checked with an endocrinologist? Please keep us informed and I am thinking of you and wish you the best.