What would you do in my situation? Should I be worried?

You should probably only worry if your score continues to rise with each periodic evaluation of the extent of deposition in your LAD. It can be slowed with some treatment, maybe including backing off on the fruit. Fruit has a lot of fructose, and it's a demanding conversion for the liver to change it to glucose, which spikes insulin levels. High serum sugar levels cause damage to the endothelial lining of arteries due to inflammation, and inflamed tissues are a better surface for cholesterol to adhere to.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8267750/
Good job keeping a lid on your weight gain. Still, though, if you're doing a better job at keeping calories in check, but still eating the wrong types of calories, won't you still get some unwanted events in your body?

It could be unrelated to your diet, but may be related to some other condition/pursuit/pathogen/disorder in you, and you still have a significant amount of inflammation. Your doctor can order tests, such as a CRP, to see if your titers are high, outside of range. CRP is 'C-reactive protein', a biomarker for inflammation. There are others, but CRP is easy and a good start.

Finally, your number, any number, would make the bearer sit up and take notice. Some have scores three, four, six times as high as yours, and they're still kickin'. The score doesn't signify a trend, or directionality...it only shows what was in the picture when the image was taken. Yours is rather low, in my very non-expert opinion. Again, discuss this with a physician, maybe a cardiologist.

Thanks, what do you make of the comment by the technican "CARDIOVASCULAR FINDINGS: Vessels: Aorta and pulmonary artery are not significantly dilated. Heart and Pericardium: Normal. Extra-coronary Calcification: None"

1. Your aorta and pulmonary arteries have not been 'bent out of shape, or enlarged, by pulses by the two big pumps, the ventricles. IOW, those pumps are not beating too strongly for the condition of your aorta and pulmonary arteries (the latter takes venous blood, oxygen poor, from the right ventricle back to the lungs. The pulmonary veins, four of them, take newly oxygenated blood from the lungs back to the left atrium where it is pumped through the mitral valve and down into the left ventricle. The left ventricle pumps the enriched blood up the aorta, through the aortal valve, and on to the rest of the body. Remember, if this sounds confusing, veins all take blood back to the heart, even the pulmonary veins with the oxygen-rich blood, and arteries take blood away from the heart, including the pulmonary arteries that take spent blood back to the lungs for a resupply).

2. Your heart and pericardium, the bag around the heart, all appear healthy and normal, not scarred, holed, diseased.

3. Not entirely sure about this, but extra-coronary means not-of/in-the-heart, and this suggests that your carotid and femoral arteries are clear. Good for you if that is the case.

Please find an "experienced" good Cardiologist unless you have one to monitor that condition and follow his advice and instructions regarding diet and any potential medication that he may prescribe you. I will not be alarmed but action taken ahead of time can avoid big head aches later. Good luck to you and relax.

I am not a doctor but I was under the impression that statins will increase the calcium score but not in a bad way. It hardens it making it less easy to break off and cause a MI.

@guyrien I guess my big question is how do you feel health wise? Sounds like you are doing a lot of the right things. Sometimes heart issues can emerge from genetics than your own physical health. My doctor would celebrate if I weighed a 190 pounds by the way!

Calcium scores are a enigma to me. Like @gloaming said, I have heard people talking about really high calcium scores and seem to be doing fine. Interestingly, my score was 128 and every spot where there was an indication of plaque build-up was stented a year later...go figure.

Knowing what I know now and if I was in your shoes, I would not be greatly worried because you sound like you are good shape physically, but I would want to have a treatment plan to address your heart health like dietary changes (maybe), medication (would not be surprised), stress reduction (if needed), and self monitoring (being mindful of emerging symptoms like shortness of breath and/or chest pain).

It is possible to keep your heart healthy and address this. I did better on my cardiac diagnostics last month than I did four years ago. To be honest, I feel pretty good.

Thanks, that what I didn't understand. The score puts me in the 88% percentile but the commentary is all positive which is weird no?

Statins, diet and exercise all important.
Control the blood pressure and good sleep helps.
Have carotid ultrasound and know your Hs- CRP. Stress management
and good social connections are the finishing touches.

It’s important to find a skilled and experienced cardiologist—if you don’t already have one—who can monitor your condition and guide you on the right path. Follow their advice on diet and any medications they may recommend. There’s no need to panic, but taking proactive steps now can help prevent bigger issues down the road. Wishing you the best—take care and try to stay relaxed!

I'm very inexpert in all of this. I don't know what the 88 %ile refers to: is it that your LACK OF calcification puts you in the top 88% of all people, so very low risk, or does it put you among the riskiest of people?