I have a very high calcium score. What next?

I'm 54 and recently got a calcium score of 1525, which scared me (my dad died of a heart attack at 58). Cardiologist doubled my statin dose and scheduled a stress test. The stress test is normal with a Duke treadmill score of 10 and and the left ventricular ejection fraction is 74%. I'm told this is all great. But how do I reconcile the bad CTC score with the good stress test score? Thoughts?

I'm 62 and my father died at 55 (as well as grandfather, aunt, and uncle all in the 40's and 50's, plus 3 cousins with heart attacks and/or stents also at young ages). I'm asymptomatic and also have had a good stress test. I have maintained my ldl in the 50-70 range for years with 20mg Crestor and 10mg Zetia. After my high cac score (1014) my cardiologist call the very next day and was very alarmist due to the risk associated with the high cac (25% chance of a major CV event within a year, likely one within 3-5 years).. He immediately increased my statin to 40. Within a month my liver enzymes increased to 5-6 times the mormal upper limits, whereas in the past they never were outside normal limits. I then had to stop the statin completely for a month which got my AST back to normal and my ALT to 1.5 times normal (he said it's OK as long as it is not more than 2.5 times normal). I'm now back to 20mg and am being monitored every sis months.

As long as you are asymptomatic and living a healthy life style there is not much else you can do. As soon as you experience symptoms make sure you call your doctor or get to a hospital. Knowing you have a high cac score is a double edged sword. It is good to know you are at high risk so you can manage the risk factors that are within your control. However, that same knowledge can create stress and anxiety with the uncertainty of if/when you may have an event. If the latter is a major issue make sure you reach out and address it to avoid sure it doesn't lead to situational depression. You have to live your life as normally as possible!

Thanks, @keithl56, that's good information. My doc didn't mention the possibility of liver problems from the increased dosage (40 to 80). I wonder if I should inquire...

Ok yesterday, I had a massive gout attack. The only other one I had was in 2007 and by avoiding some foods, it was the only one. Now I'm on statins and I feel that they caused the gout. No gout in 11 years and I just lost 17 lbs. and I have been eating right. My heart doctor says no but I really think it's the statins.

I recently had a heart calcium ct scan which showed a high buildup of calcium and the lower arteries at the request of my primary physician. He then sent me to a cardiologist who had me go through a nuclear stress test which was completely normal. So two tests with opposite results which make me wonder about the value of either test. My primary physician told me his father went through the stress test with normal results and had a heart attack shortly thereafter. It would appear that some physicians that request the heart calcium ct scan do not know what the results mean. At this point I am not sure what to do further as I am being told to sit tight as everything appears OK for now. Has anyone gone through a similar situation and if so, what was the further action?

@real Sorry you didn't get anything positive 23 yrs ago my Dr sent me to a cardiologist after listening to my symptoms he sent me into hospital for a heart catheterization where this showed I had blockages in 3arteries so had a triple by pass this year will be 23 years I'm doing fine so if you feel something isnt right be proactive you are your best advocate

What was your calcium score (mine is over 1000)? The CT just quantifies the amount of calcified plaque in your arteries (usually only 20 is calcified so you probably have 5 times the amount of plaque). The stress test measure whether the plaque is causing stenosis (blockage) which if over 70% usually results in a stent. The fact that you had a good stress test means your heart is getting enough blood, but the fact that you have so much plaques means that if it ruptures you could have a piece break off and cause a heart attack or stroke. I'm in the same boat. As long as you are asymptomatic the treatment is really just healthy lifestyle changes and meds and cross your fingers! Now that you know you are at risk you know not to treat any symptoms lightly and head to the ER as soon as you feel anything unusual.

Hi @real

I see that this was your first post on Connect, welcome!

I am sorry to hear of your confusion between the two doctors. That is really frustrating isn't it?

If you are comfortable sharing more, what type of symptoms were you having prior to learning about the high calcium score?

As @lioness said in her post, it is important to be your own advocate, especially if you have a concern. Please remember that it is always your right to get a second opinion in order to put your mind at ease.

Have you considered another seeing another cardiologist for a second opinion?

I had no symptoms at all but my Dad died at age 60 from atherosclerosis so my primary doctor suggested I have the ct heart calcium scan which showed a result of 579 and said I was worse than 70% in my age group. He then sent me to a cardiologist who suggested taking a nuclear stress test and the results were very normal. Hence the confusion. I plan to pursue this a little further and will explore going to the Mayo Clinic. Other than that both of my doctors said to continue on my diet, take aspirin and the statin and I should be fine. Somehow that did not alleviate my anxiety.

That is very understandable, @real.

Having a family history where your dad died at age 60 is certainly a serious consideration for you. You are wise to continue to seek answers and be your own advocate. By the way, how old are you currently?