@allisonp I’m so sorry you are dealing with this. I’m also a woman in her 40s (I was 47 when I had my high CAC score, I’m 49 now). We are so rare, it seems, that it can be quite isolating. I’ve told my story here: https://connect.mayoclinic.org/discussion/any-people-in-their-40s-with-very-high-cac-scores/

I hope your new cardiologist is good! I had a bunch of testing at first, but my doctor has said I won’t get any follow up CCTAs or anything for another couple of years (unless I start having symptoms). But I dread getting news that all I have done isn’t working! I certainly empathize with what you are experiencing now.

Hopefully your new doctor will have you do a coronary CT angiogram. It might help put your mind at ease, since it shows where the plaque actually is. I realize my CAC score will continue to rise, but my hope is that my next CCTA will show that it is mostly just existing plaques becoming more dense rather than more of them forming…

I was very disappointed that the first trial for a drug that lowers Lp(a) failed, since I had really banked on that as something to reduce my risk longer term. I’m still waiting to see how the other trials unfold…

In any case, I wish you the very best as you sort through this. Hang in there!