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Any people in their 40s with very high CAC scores?
I’m a 47 year old woman, and in January I had a calcium scan with a score of 538.
I had started a statin last year and somewhat randomly asked for the CAC scan at my 6 month follow up visit just to see what my score was, since I had learned of CAC scoring just a few weeks before.
Needless to say, the score was shocking to me and my PCP. I do have some risk factors, so I didn’t necessarily expect a 0. Most of my adult life I have been fit and healthy, but I gave birth at age 40 and struggled after that to lose the weight. In that time, my cholesterol crept up and so did my blood pressure. I have been active in that time, since I have a young kid, but the extra weight and some other postpartum issues made exercise more difficult for much of that time. I have returned to exercise and getting more fit in the last couple of years, but my body is not even close to the shape it was in before I got pregnant. But this score is nearly unheard of for a woman my age, which of course worries me a lot.
I have seen a cardiologist (a physician assistant) and I have a CCTA, nuclear stress test, and echocardiogram scheduled over the next month or so. I also started Wegovy. I will meet with the MD after those tests are complete and then they will discuss any medication changes, procedures, etc. Their take is that the CAC is a screening test, and I have been flagged by the test for follow-up. Once they have a better idea of what is going on, then they can address it. This makes me feel better in some ways, but I also worry that more tests will bring more bad news.
In terms of my question: I’m less interested in suggestions of what to do medically, since I feel like my cardiologist’s office is taking the right steps. But I guess I wanted to know if there are others out there in their 40s who are dealing with this. As a parent of a young child, this is especially stressful. I would love to hear from others about how to cope with this news. I feel like I’m the only person this young to have this kind of score, which is scary and lonely.
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I wanted to go ahead and update this post in case it helps any others out there in a similar situation. I had a CCTA with contrast, a nuclear stress test, and an echo. I then saw my cardiologist (MD) to go over the results. The additional testing proved very reassuring. I do have mild CAD. I have 3 small plaques in the areas identified by the calcium scoring scan. Two of the plaques are minimal (0-25% blockage), one is mild (26-49%), so I had a CCTA score of CAD-RADS 2/P1. But my heart otherwise is perfectly healthy - everything is getting enough blood, no damage anywhere, etc.
So basically the main thing going forward is to make sure the CAD doesn't get worse over time. I've started taking a higher statin dose and I started Wegovy. When I go back in for the blood test to make sure I am tolerating the statin dose ok, they will also test my LP(a), since heart disease runs in my mother's family and some promising treatments for that number seem to be heading down the pike. That way I'll know that number and can advocate to start treatment down the road.
It's been a very stressful few months, but now that I have a better sense of my heart health, I am glad I got the CAC test. Since I'm otherwise so low risk (premenopausal women are not supposed to be prescribed statins even), I probably would not have had aggressive treatment until I was post-menopausal without this happening, I'm glad this condition was flagged early, well before it became more dangerous. So there is hope out there! I would just urge younger folks with high CACs to get aggressive follow up so that you learn what is actually going on in there, rather than just worrying over the CAC score.
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4 ReactionsI am on 10mg rosuvastatin which has lowered my LDL to 74. The doctor would like it to be even lower, but instead of increasing the statin dose, we've added 10mg ezetimibe. Studies show that the additional benefit of that is better than increasing the statin dose.
Thanks! I'll keep that in mind. My numbers were nearly ok on 5 mg of rosuvastatin, so just increasing to the standard 10 mg dose seemed the best first step to be more aggressive about getting the numbers even lower. But I'll see how things go from there and see if adding something else makes sense!
Just wanted to follow up on this -- I just got my Lp(a) test back and learned that mine is very high. My LDL was 72 on 10 mg of rosuvastatin, which seemed fine before I knew my Lp(a). But now my cardiologist also added 10 mg ezetimibe to push it lower given the risks of high Lp(a). I'm glad I asked for this test!
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1 ReactionI am waiting for my latest test results. I started on ezetimibe since the last test two months ago, so I want to see the effect. I will let you know!
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1 ReactionHow’s it going? I also had a kid at 41 and now two years later I find out I have a CAC score of 192. I’m freaking out and scouring the internet to try to see if I’m going to die soon. I’m in the 95+ percentile and it makes it sound like I’m definitely going to have a death by cardiac event in the next three years. I am going to try to see a cardiologist but it will probably take almost a year to get into one around here. It’s an incredibly stressful result to get and then not be able to really do anything about for months (outside of diet and exercise) . Did you get any follow up tests after spending some time on the ezetimibe?
@nagoh I'm sorry you have ended up in this boat as well! Have you spoken with your primary care doctor? They could at least start you on a statin if you aren't on one already. They might also be able to refer you into a cardiologist more quickly. It only took me about 6 weeks to see a cardiologist after my high CAC, and that felt like an eternity!
My numbers have been fine on Crestor and Zetia. At last check my LDL was 55.
I have to admit I do still worry quite a bit about having a heart attack. I've thought about seeing a therapist about it to see if that might help, since honestly my cardiologist seems proactive about keeping my numbers down but otherwise not that worried. I don't think I need to be as worried as I am, but it stresses me out quite a bit. It's been almost a year now since my CAC test, so I'm giving a bit more time to see if that helps. I think it's probably normal to have a stressful period of adjustment for this kind of diagnosis. Otherwise I take care of myself - I eat well and exercise nearly every day. I try to have fun! I'm just trying to keep on keeping on...
58yr male (I am a little older) asked for a CAC score Dec 2024. No smoke, LDL in 120’s, No hypertension, BMI 32 (yes, need to loose some weight. Score was 716..stress EKG and Echo came back good. 20mg Crestor, LDL now 58. It’s very stressful, worried about ticking time-bomb.
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1 ReactionHusband only knew his was high accident by checking for something else. He’s 67 and score is 5,185. Has no symptoms. Atorvastatin was increased from 10mg to 80mg and LDL is now 35 which cardiologist likes and wants him to stay on that dose. He takes Aspirin 81mg daily also now. He’s has drastically changed his diet to much healthier eating. No more red meat and high fat content. All test came back fine…EKG, Cat scan, angiogram . Asked forStress test which is upcoming and to have carotid artery checked and that was fine. It was all a shock to both of us, but that was July and now it’s December so we are adjusting. I’m going to see a cardiologist in January to see if I can get a Ca score as well. I feel like there’s probably many people walking around with a high CAC , but don’t know it. I wonder when my husband’s score first started to climb.
@star123 @star123 My PCP seems reluctant to escalate it to a cardiologist, but he prescribed me atorvastatin.
I went for a run on an isolated trail today and kept thinking that if I had a heart attack out there, no one would find me for a while. That’s true for anyone, I guess, but knowing I’m suddenly in a high-risk category hit hard. It’s a lot to process—going from feeling healthy to having a chronic disease that’s the world’s top killer. The stress of it probably isn’t helping either, so maybe I also need therapy, meditation, or some kind of radical acceptance to keep my head straight.
Anyway, I wish you the best managing this and hope you have many pleasant years ahead with your family. Thank you for sharing and helping me see this reaction is normal.