Hi @tim1028,

I can completely understand your worry – any news concerning the heart can be so scary! I'd like to offer some information, provided by Cardiology at Mayo Clinic:

Calcification in the coronaries indicates coronary artery disease – if you do have calcium, you have plaque. Having a stress test is a good start, not to discern whether the plaque is normal or not, but to inform whether a person is at greater risk to have a heart attack.

To further explain...
Previous studies have shown that calcified, or stable plaque, is less prone to rupture than non-calcified, or soft plaque.
Calcium scoring measures how much calcified plaque a person has, but it doesn't measure non-calcified or soft plaque. A CT is accurate in detecting high calcification volumes, but may not tell whether that plaque is vulnerable or not.

Until then, the best way to predict whether calcification in the coronaries will result in a heart attack is to do stress testing. With plaque, even if the stress test is normal, aggressive risk factor modification is recommended – stop smoking, engage in an exercise regimen, and aggressive management of diabetes and hypertension, and lowering of total cholesterol, especially bad cholesterol (LDL) is recommended. If the CT scan shows no coronary calcium on CT scan, your cardiologist will recommend that you be periodically reassessed.

To summarize, if you have negative coronary calcium, the chances of you developing a heart attack are small. If you have a positive scan – then yes – we don’t know who will develop a heart attack amongst these patients, but stress testing will help differentiate. There are new diagnostic tests that have been developed to assess plaque vulnerability (the plaque that is likely to rupture and result in a heart attack), and clinical trials to show that a coronary computed tomography angiography (CCTA) can capture the full anatomy of the coronary arteries in a single heartbeat, and can provide a picture of the total amount of plaque throughout the arteries of the heart. https://www.medicalnewstoday.com/articles/316408.php

@tim1028, I encourage you to watch these videos where Mayo Clinic cardiologists offer detailed information; I sincerely hope this will help alleviate some of your concerns:
– Coronary Calcium Score: Basics and Beyond https://www.youtube.com/watch?v=rP7cyrjYwic
– The Pathogenesis of Plaque Rupture (Vulnerable Plaque) https://www.youtube.com/watch?v=FtinJfbE0Q8