super high coronary calcium score

Posted by robmtk @robmtk, Jul 25 12:54pm

I’m an active 79 yr old man with various heart ailments. Been feeling a shortness of breath for what feels like minor exertion, so I had a coronary CT scan done last week. My CAC number is 6195 which is freaking me out.
RCA is 3882 with less than 40% stenosis.
LAD is 2111 with less than 25% stenosis.
I’ve been on warfarin for past 20yrs due to aortic dissection surgery with aortic mechanical valve replacement. Read that warfarin can cause excessive aortic calcium but I’ve been told there is no alternative to warfarin.
Have pending follow-up with cardiologist. Looking for any suggestions or recommendations from anyone who has been through this.
Additionally, I had an echo a few months ago. EF is between 50-55%. Left atrium is severely dilated (6.07cm). Due to AV blocks, a pacemaker was installed about 3 yrs. ago. Also taking 200mg of amiodarone and started 5mg of rosuvastatin at beginning of year.

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robmtk | @robmtk | Aug 1 11:17am

In reply to @vaniag "My cardiologist recommended an angiogram when I started having chest pain during my usual exercise routine...." + (show)

thanks
i've heard this may be next step needed.
Does anyone know if there are alternatives to angiogram, such as nuclear stress test?

gloaming | @gloaming | Aug 1 3:02pm

In reply to @robmtk "thanks i believe dr. will recommend this, if not, i'll ask why." + (show)

There are at least three ways (that I know of) to assess stenosis in the arteries, provided they are close enough to the skin for the procedure to be accurate. Angiogram has been mentioned, but it doesn't need to be close to the surface. Doppler ultrasound can be done on the carotid arteries, as an example, and other imagery can show narrowing. The Doppler measures speed. If the blood moves through a narrowing, where plaque has built up, it must speed up in order to keep the pressure and volume constant along the entire path of movement. This speeding volume of blood squeezing past a narrowing shows up on Doppler, and the speed change can be calculated, and from there the extent of narrowing.

robmtk | @robmtk | Aug 2 10:02am

In reply to @gloaming "There are at least three ways (that I know of) to assess stenosis in the arteries,..." + (show)

thanks for this information.
Can an ultrasound doppler be used on arteries? is it different than the CT scan i had done?
Rob

gloaming | @gloaming | Aug 2 4:11pm

In reply to @robmtk "thanks for this information. Can an ultrasound doppler be used on arteries? is it different than..." + (show)

The Doppler Ultrasound is what they used on both my dad and me to assess stenosis in our carotid arteries, the arteries that run up either side of our necks to feed the brain and head. However, I think Doppler works best in proximity, meaning the assessed vessel needs to be fairly close to the 'wand'. I'm not positive about this, though.

lesterholland | @lesterholland | Aug 4 1:07pm

In reply to @njx58 "One way is when you have an angiogram, they can see the plaque inside your artery,..." + (show)

Problem is that if you are totally blocked they can't risk a stent. There is some discussion about a combination of vitamins K2 and D3 disolving calcium plaque. There are believers and also some that call it witchcraft. Anyone have any first hand experience?

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