High CAC score

Posted by cedgar @cedgar, Aug 4, 2022

Hello all. I’m a new member and unfortunately my CAC score is 1560. A had a nuclear stress test and echo with no problems. I exercise everyday with no issues. I’m 65 and never smoked. BMI 27. Cardio told me only way to know about blockages is to do a catherization. For now I decided to hold off on the cath since I’m not convinced any benefit would offset the risk of the procedure. It’s hard to believe there is not another non-invasive test for blood flow in the coronary arteries. So Cardio increased my liptor from 10 to 40 and I decided to try a plant based diet based on Dr Esselstyn book on CAD. The good news is within 4 weeks my LDL dropped from 99 to 49 and my total cholesterol went from 165 to 100. Unfortunately my HDL fell to 37. So I’m going to tweak my diet to add some salmon and other HDL enhancing foods. I’m also going to see another Cardio for another opinion. I did start taking K2 with my D3. From material I’ve read online some Dr’s believe you can reduce plaque if you keep your LDL level below 70. Others suggest that by reducing plaque some of it may come from under the calcium which could shrink the calcium and enhance the blood flow. I haven’t seen any medical studies that show you can reduce calcium but I believe you can at least halt it. Has anyone else approached their CAC this way? Any thoughts on my plan? Am I right on holding of on a catherization? Thanks

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Hello @cedgar

I see that you have already been introduced to some Connect members with a high calcium score. I hope you are gaining some good information from reading their posts. I'm sure that this diagnosis was a surprise to you.
I can understand that you are concerned about having a heart catheterization. I've had one and I know the anxiety I experienced as well. This is a fairly routine procedure and is generally quite safe when done by an experienced cardiologist at a good hospital.

You asked if there were any other non-invasive tests to check on this. Here is a link to some information about a CT scan of the heart,

https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686

Have you had a CT scan of the heart?

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My former cardiologist created the Agosten aka
Calcium Score. Dr. Agosten stressed two things with me that apply here; cholesterol molecule size and stickiness (large, fluffy, non-sticky won't clump and adsorbs and sweeps up some of the little sticky stuff) and one can increase HDL with exercise.

Since so much of this is genetic, there are likely limits to how much one can increase HDL or large-molecule size but small changes can yield large results. Kind of analogous to compounding interest over time.

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@hopeful33250

Hello @cedgar

I see that you have already been introduced to some Connect members with a high calcium score. I hope you are gaining some good information from reading their posts. I'm sure that this diagnosis was a surprise to you.
I can understand that you are concerned about having a heart catheterization. I've had one and I know the anxiety I experienced as well. This is a fairly routine procedure and is generally quite safe when done by an experienced cardiologist at a good hospital.

You asked if there were any other non-invasive tests to check on this. Here is a link to some information about a CT scan of the heart,

https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686

Have you had a CT scan of the heart?

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Thanks for the reply. The cardio said they couldn't do a CT angiogram because my calcium level was too high and the radiologist wouldn't be able to tell the difference between the contrast and the calcium because they both show up white on the scan. I would be more agreeable to a catherization if I knew what it would accomplish. He more or less said it was to know about any blockages but not necessarily to fix blockages. I've read is it is difficult at best to stent calcium. I had a cath in 2008 and it was no big deal but there is a small risk of serious consequences. My thinking is I'm going to treat the problem through med's and diet first. But I'm hopeful the new cardio I'm going to see will offer another way to check blood flow......maybe ultra sound or the Cleerly test.

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Calcium deposits are the reaction of one's body to endothelium damage. For most people statins will increase one's calcium score. High LDL cholesterol may not always be the problem. A vegetarian diet may not be the best approach for everyone. The causes of Endothelium damage are extremely varied. The rupture of soft plaque is what causes heart attacks.

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@pcspetpro

Calcium deposits are the reaction of one's body to endothelium damage. For most people statins will increase one's calcium score. High LDL cholesterol may not always be the problem. A vegetarian diet may not be the best approach for everyone. The causes of Endothelium damage are extremely varied. The rupture of soft plaque is what causes heart attacks.

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All news to me ("endothelial damage"?)
Interested in the part about rupture of soft plaque being "what causes heart attacks".

Surely, not the only cause, though, right?

I would be happy if someone more knowledgable than me, could provide information about calcium scores - for instance, how they're measured, and whether there aren't other heart attack precipitators and if so, what? What are considered the most reliable calcium score? Also, overall, more about plaque - inflammation, hard vs soft, and whether it can be reduced,>

and More.

I'm presently trying to decide what cardiac sub-speciality most pertains to my issues and this would help (interventional cardiologist vs electrophysiologist, general cardiologist and/or other)?

I have heart rhythm problems (AFIB, tachycardia, ways of evaluating these problems),. I also have an inherited lipid disorder (one sibling died suddenly in his sleep of some heart issue - was about to have another stent implanted, so his plaque deposits must have factored).

I feel I need more testing (so far only lipid panels, routine EKGs, a few echocardiograms, chest Xrays, a dobutamine stress test 7 years ago (can't have treadmill test because of orthopedic problem). I've also had a few periods monitoring hb prompted by unprovoked tachycardia - the last monitoring was a week, the tachycardia lasted three weeks,. (Other?)

I'd like to have more tests done, feeling heart has not been adequately evaluated , especially because I'm looking at a possible Watchman procedure. Thinking of: calcium test of heart and aortic valves, C+reactive protein high sensitivity blood test, another stress test (as sensitive as possible), and an HbAic test. Whatever other ways there are to check out regurgitating valves (mitral valve, tricuspid, aortic - especially, the latter). Would like to check for blockages considering the decades of very high lipid tests even though they are presently (just barely) within norms. Prefer if possible to avoid an angiogram. because of the risks, but bearing in mind that one sib died two years ago. (He had had decades of very high lipids and a heart attack before he was even forty,ent and was at the time of his death, awaiting placement of another stent).

Wondering if there's a way to check why I have the arrhythmias (paroxysmal Afib, lasts many hours but asymptomatic and a recent unprovoked period of constant tachycardia, lasting three weeks.)

My present cardiologist prescribes me daily Xarelto
and PRN Metoprolol (12.5 - 25 mg.) The first time I took it (the full 25 mcg) almost knocked me out. He seems too casual about my arrhythmias - about everything.

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I also question my cardiologist judgement. So I took the CT scan which showed a aortic aneurysm on my heart which was pretty large but the cardiologist said we will watch it. I took it to my Vascular surgeon specialist and he said go back to the cardiologist and tell him of your concern and that you want to be proactive . If he doesn’t listen to you call and tell us and we will change his mind it’s to big and could go anytime. I also just read that Low Magnesium levels can increase the calcification in your arteries? I am now looking to get confirmation of that. I need to lower that level my blood is saturated with calcium.

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I don’t know if this information will be of any use but I have a procedure that may help and is non invasive. I had a Triple A , meaning Abdominal Aortic Aneurysm or a bulge in my Aortic artery. It was repaired in a delicate procedure that took a long time to do. Since it was successful, I must have the repair stent checked every year. I must be examined thru my body, to check the blood flow. The machine is set to record the information and I believe it uses a special ultrasound technology that can be set to see how much blood is going thru the artery inside the stent. Maybe your cardiologist could use this machine to check the flow inside your heart. Unfortunately, I don’t know the name of the machine or the procedure. @becky1024

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That machine is what the Vascular surgeon uses when I go in for 6 mo evaluations on the stents in my legs.

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Hi
Similar situation for me, healthy ( 60), very active but a 400 calcium score and 240 cholesterol persuaded me to take a preemptive path and get the CAT despite doing well on stress tests. Found a 75% LAD blockage which I had stented. Also took statins and changed diet …. Cholesterol now 145, LDL 50, HDL 65. Hope this helps

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@callalloo

My former cardiologist created the Agosten aka
Calcium Score. Dr. Agosten stressed two things with me that apply here; cholesterol molecule size and stickiness (large, fluffy, non-sticky won't clump and adsorbs and sweeps up some of the little sticky stuff) and one can increase HDL with exercise.

Since so much of this is genetic, there are likely limits to how much one can increase HDL or large-molecule size but small changes can yield large results. Kind of analogous to compounding interest over time.

Jump to this post

Did Dr Agosten talk about how small changes yield large results? Just curious...

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