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990 calcium score but all bloodwork, EKG/stress are fine what next?
Hello group,
I'm new to this forum but have read many posts about people with high calcium CT heart scores and steps being taken to reduce risk of heart attack which I greatly appreciate what I've learned from this group.
I'm a 54 year old male and my calcium heart CT done in June 2025 was very high at 991 (LAD 633, RCA 358 and 0 for other 2 arteries) which I was shocked to hear since my blood work and annual physicals have been excellent for years with no indicators of heart disease and no shortness of breath or issues at all. My cholesterol is low at 156 (LDL 81 and HDL 65) and other tests on lipoprotein, apolipoprotein, CRP, blood pressure etc all excellent along with no issues on EKG test and Echo stress test which showed well above average for my age.
I exercise / lift heavier weights 3-4 days per week religiously, never smoke, drink alcohol in moderation and eat a diet primarily focused on lean protein, vegetables with some carbs and fats which has kept my weight at 205lbs and the same for nearly 30 years since college when i was a football player. Also i dont take any supplements aside from a multi-vitamin and have never touched steroids in my life so I am assuming my high calcium score must be genetic as my father had 2 heart surgeries (bypass and stint) but i dont hvae his records to see which arteries those were done on.
After the calcium CT test my doctor put me on 20mg of rosuvastatin which caused significant muscle cramping, dizziness and nausea and impacted my sleep and exercise as i was constantly feeling achy and sore. After the Echo stress test results showed my heart function was normal/above average and no blood flow issues my doctor said to stop the rosuvastatin for 3 weeks and to restart it but on lower dose of 5mg or 10mg. I've been off rosuvastatin for 5 days and i feel fantastic again but am now waiting for my 2nd and 3rd opinion appointments with other cardiologists to better understand whats going on and my options.
My question is - for those with similar high calcium scores especially in the LAD artery (the widow maker as its called) but otherwise all normal/good health profile (low cholesterol, liproproteins, CRP, echo stress test normal) what other tests / steps / medications should I be considering to understand why my CAC and LAD artery score was so high and what can i do to reduce my risk of a heart attack?
thank you and apologies for the long summary here...
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@johnv66 I wanted to share another update as I received the results back from my Angio CT a couple weeks ago.
As I expected with having a 1000 calcium score across 2 arteries they did find "stenosis' in a few areas including the following:
- left main trunk less than 30% stenosis
- LAD 50% heavily calcified proximal stenosis and moderate sized first diagonal with under 50% stenosis
- Right coronary artery (RCA) less than 50% proximal stenosis
- all other arteries were 0% / no stenosis
- estimated LV ejection Fraction 65% (A normal EF is usually 55–70%. At 65%, your EF is in the normal–high normal range, indicating your heart’s pumping function is strong)
I am seeing my cardiologist again next week to review this and ask additional questions as when the nurse called me to review this she said "everything looks great" but I assume thats because the stenosis was under 70% and not requiring a stent at this time which in their view is good (to me that is still quite concerning!) At this point I believe I have covered about all of the possible tests one can do (ekg's, echo stress test, angio CT, bloodwork etc) and also the Repatha statin appears to be working as my cholesterol is further reduced to 142 and LDL at 71 so not much more I can do there (prior to this my cholesterol was 158 and LDL 81 and never had any issues with it).
I will talk more with my cardiologist about how best to manage my situation going forward as my biggest concern is the LAD (widow maker artery) with the severe calcification and over 50% stenosis as I dont know if that means I should take more precautions/restrictions on weight training and only focus on cardio or if its nothing to worry about until it gets to 70%.
I appreciate everyone's input and sharing on this thread and will provide another update after my next cardiologist visit. Hope everyone is feeling good and healthy and taking care of your health!
@johnv66 With some variance between patients and their consulting cardiologist/heart surgeons (if you're friends with, if you're healthy otherwise, no comorbidities making the heart surgery iffy/risky, the experience and skills of the surgeon, etc) the 50% LAD is not currently a problem, only an indication that you may benefit from altered living style/practices, maybe some medications. If your genetics are the cause of most of the deposition of plaque, then there's not a helluva lot you can do unless you're prepared for a severe alteration of the way you eat and live....and still no guarantees. So, you 'should' be able to continue with your weight lifting, but remember that straining increases blood pressure, sometimes a lot, and that isn't beneficial to aged, and to heavily atherosclerotic, blood vessels that stiffen with age alone. That the plaque is calcified is actually a good thing! It helps to keep it put....where it is.
Most surgeons won't put you in a lineup for bypass surgery until the LAD occlusion approaches 70%. You have a ways to go, but again...it depends on the surgeon, you, and your relationship with each other.
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1 Reaction@ johnv66 / just to prevent confusion, let me point out that Repatha is not a statin. It is a PCSK9 inhibitor. That class of drugs works differently from statins (from Drugs.com: “Its mechanism involves binding to and blocking a protein called PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) in the liver.”)
I’m glad it has worked well for you.
I am 78 and had a heart attack three months ago. I had a 90% blockage and had angioplasty with three stents. I have high cholesterol but my calcium score was 75. I also cannot take statins due to many side effects. I am now on Repatha injections every two weeks. I am on my third injection and am experiencing hives, dizziness, tiredness. I am hoping my body will adjust to it as I don’t want another blockage from calcification. I am very healthy and active as well as eat Mediterranean diet and all organic. Anyone have any reaction to repatha?
Hi johnv66
I guarantee your statin prescriber did not tell you these 2 points, to gain your consent.
1 - The number one side effect of statins is muscle aches, at 95% and not ‘just 1 of 12’ or 8%, as the leaflet tells you.
See Taylor and Francis online, which states the above.
2 - Don’t exercise at an athletic level (gentle exercise like walking the dog is ok) because athletes do not tolerate statins.
See the landmark 2004 Sinzinger and O’Grady ‘Athletes and Statins’ study which confirms this.
All the best
Col de Sarenne