No discussion of the cath lab at all, at least not yet. The cardiologist who set this up (and who initially recommended the CT scan) has been emphatic this entire situation is nothing for me to be worrying about -- that "you don't have a problem right now. You have the potential to have a problem. And we know what to do to stop it from becoming a problem, and that's what we're doing." He has told me that he doesn't think the CT-angiogram is necessary "but I would like to have it anyway, so that we have something to compare to in the years ahead." And he's told me that he expects the results from tomorrow's CT-A will be reassuring to me.

I've mentioned this in other posts, but I have found his seemingly casual and not-too-worried response to my 397 score to be very confusing. I want to be reassured by it -- he's very well-credentialed, it was *his* idea to even have the CAC scan in the first place, and he's talking about this is an entirely and easily manageable situation that I shouldn't be losing sleep over. But I am having enormous difficult squaring that with all of the available literature on CAC scores and their meaning -- especially at levels this high in people as young as me. I did see a second cardiologist for a second opinion. He looked at the scan, confirmed its accuracy, and advised the same approach -- statin and diet/lifestyle modification -- and he also didn't communicate alarm/urgency in how he talked about the situation.

I would really like to believe that there is more nuance and complexity to these CAC scores -- room for them to be benign and only truly alarming under specific conditions. The way my cardiologist has handled this gives the impression that that's how he views them. But again, the data just seems so overwhelming here. There have been major studies with very large sample sizes, and they uniformly point to my situation being...very bad. I don't know if I am permitted to post links on this forum yet, but I just keep staring at this particular study in shear terror: Among my age group -- 32 to 46 years old -- those with CAC scores over 100 had an incidence of death of 22.4 per 100 people over a 12.5 year follow-up period. Almost 1 in 4. And then I remind myself that my score isn't just "over 100" -- it's basically 400.

STUDY:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397328/