A high calcium score does not mean that you have a blockage or where that calcium is. In fact, the calcium is not the problem - the soft plaque that is implied by the high score is.

The only way to be certain is to do a CT angio where a cath allows the DR to view your arteries. Otherwise a CT scan w contrast is sometimes used as a less invasive option. If you’re not experiencing discomfort, chances are a cardiologist will simply treat w medication and lifestyle changes.

I would also add that people live long, normal lives w high CAC. Again, soft plaque is the bigger concern since these can break off and cause MI and stroke. However, statins have a long, proven track record in helping to mitigate this risk.