Just found out my calcium score is 474. Next steps uncertain.

Can't read the article without a subscription, so maybe you can quickly summarize the main point?

The article is about a person with very healthy life style discovering his very high CAC of 2750. He went to a lipidologist and upon extensive studies diagnosed him with a condition called, "Sitosterolemia, a hereditary disease that allowed the fatty parts of plants—the sterols and stanols—to enter my bloodstream. Most people process and excrete these substances into the GI tract. My body absorbs these plant sterols, which wind up as calcified plaque in my coronary arteries. " Per his doctor, “I see this frequently.” She suspects the disease might help explain why some young athletes die unexpectedly of heart attacks."
"the diet I had been prescribed was exactly the wrong diet for Sitosterolemia. The sterols and stanols that caused the calcium lining my arteries were in fact most common in the nuts and vegetables I had been feasting on for months. They are also found in high levels in canola oil and olive oil, the fats routinely recommended for heart patients." His doctor switched him to Zetia from Rosuvastatin. Each case is different

Since I am on a heart healthy diet for years with an active lifestyle and a high CAC, I am going to look into testing for Sitosterolemia. The insurance may not cover it. If I have the condition, I am on the wrong diet. At least I want to rule it out. Once you have a high CAC, nothing can reverse it, but I want to do what I can from this getting worse.

I looked it up. Sitosterolemia is extremely rare. A few years ago, there were only 100 or so confirmed cases. I did read that it sometimes goes undiagnosed, and that it might affect 1 in 200,000 people. That's still very rare. Of course you can test to rule it out, but it's not something I'd be overly worried about.

Thank you. I agree. Since I heard about this and my diet had been so heavy on plant sterols for many years, I am keen to rule it out for my peace of mind. Otherwise every time I reach for those nuts for snacking, baking, and everything else, I will be worried. I consume many other high sterol food items every day. Hope it is not a very expensive test. I will start looking into it tomorrow.

Marta,

My understanding is that lower LDL will decrease cholesterol buildup, but other factors determine the calcification of cholesterol - ex: calcification of cholesterol on you arteries is increased by statins - this is a positive thing as it decreases the likelihood of chunks of cholesterol breaking off.

Thank you for added comment!

You might want to ask about your cholesterol numbers. Not playing doctor here, but both your LDL and total C are higher than recommended, and since you’re having symptoms, I’m surprised you’ve not been put on some aggressive therapy.

I have a calcium score nearly twice yours with no symptoms, exercise and diet are by the book, and my LDL goal, from my cardiologist, was to get the number under 50. I am considered high risk due to family history, so a statin, Zetia, and Repatha got it all where it’s supposed to be.

Good luck in your journey

I sent article to my cardiologist and he said it was very rare condition and he didn't even know a lab in the DC area that tested fir it.
Maybe he will look further, or maybe I will, but it does sound like a longshot. However I fit the description in article except i never had angiogram

Yes, I fit the description too. I never had an angiogram. But per CT/stress, there is no block.
I am heavy on the so called cardiac healthy diet for years. Keep us posted on your success with testing for this. I will do the same.

AS mentioned in the article, the prevalence may be more than expected since patients are rarely tested for this condition.