I have a very high calcium score. What next?

Hi, I just stumbled across this post from you and am curious if you’ve learned anything more about your situation/gained any new perspective or insight since? I am in a very similar situation - age 42, just found out I have a 397 calcium score, non-smoker, not overweight, exercise and a blood panel that according to a cardiologist actually looks basically fine. He is shocked by my high calcium score.

Anyway, not sure if you will see this, but very curios if you have any updates and hope you are well.

My Christmas present this year was receiving the news that my calcium score was 1444 on a routine screen at age 63.

I am actually MAD about getting the score. I was a consulting bio-electrical engineer to NASA a million years ago, and my first gig there was in instrumenting the cardiovascular lab. A lot of the instrumentation that is used for telemetry in hospitals today we built up from parts. I mention this because often times parts lie.

Here is an interesting paper done on calcium scores back in 2017 demonstrating a 50% error rate on some CT systems caused by a heart rate of 75bpm.

Sorry---they will not let me post the URL yet, so I will amend when I get permission, but the title is: Influence of heart rate on coronary calcium scores: a multi-manufacturer phantom study. And it was in the International Journal of Cardiology, 28 Dec 2017.

I dont know about you, but my heart rate was well over 110bpm going into the CT scanner tube. Yet the doctors keep telling me that the machine is 100% accurate with the score. When I provide them with the paper, they look confused, then angry at my mention.

So now I have to do the complete stupid human trick to prove to my doctors that I am 100%. Like many of you, I can imagine when we get to the end of this that the calcium score will have been caused by a secondary occurrence, not inter vascular. In the interim, I am left with the upset of thinking I have a time-bomb in my chest, instead of a heart. Since the news, I am throwing PVCs like crazy, and getting anxiety attacks that should be laughable.

I should mention that I gave up red meat five years ago, am not obese, exercise regularly, and have no family history of heart disease at all.

I am not angry that there is a CT calcium scan test. I am angry that doctors believe these high values like a religion, when to me it seems like an anomaly with the technology as many of you have found out the hard way. When will some one do a meaningful study to show that these super high scores should be viewed with suspicion?

And I remember when gastroenterologists would not accept that H-pylori caused stomach ulcers---complete nonsense! So now, I guess it is cardiology's turn. I think the CT makers are way over stepping what is feasible.

Pete

@santafepete, welcome. I noticed that you wished to post a URL to a research paper with your post. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Clearly the link you wanted to post is not spam. Please allow me to post it for you.

- Influence of heart rate on coronary calcium scores: a multi-manufacturer phantom study (2017) https://link.springer.com/article/10.1007/s10554-017-1293-x

Grateful to you for the assist on the URL, Colleen---thanks so much!

Pete

Hey thanks! Pretty interesting read, @50% error introduction due to increased hr quite disappointing considering no one effing mentions this when taking the test. Looking to see if the Cleerly test backs up my @900 calcium score, although it seems the calcium wont kill you before the vulnerable plaque will lol.

As the owner of a CAC score >2600 with normal treadmill and perfusion studies (no angio because of horrid reaction to IV contrast), and fwiw, a practicing doc for ~49 years (ie, I'm old, but still in the game), I should remind the group that 1. very high CAC scores are not understood by the cardio community 2. A few patients I know in my age cohort with high scores who have gotten an angio have not showed calcified intima plaque but rather Ca++ at the outer portions of the coronary vessels (ymmv) 3. with normal treadmill and perfusion studies we probably do NOT have a time bomb in our chest any more than age-predicted 4. Consider carotid US as carotid and coronary lesions often parallel one another. In my case with my very high CAC score, my carotids are completely clear of atheroma. Just another piece of the puzzle. The most direct way of addressing our anxieties about coronary Ca++ is to get functional studies - treadmill/perfusion testing. And, this is NOT medical advice as that is not appropriate here, but consider statins (or other LDL lowering approaches) to stabilize whatever plaque you might have, esp if lipids are high.

For me, a very helpful post bluesdoc. I am literally breathing easier and see a diagnostic path forward for me. I did not want to risk contrast, so you have helped with the suggestion of perfusion testing. I was a bit dubious about it, but will take it on.

And bio-electrical engineer, turned professional blues player here myself (Hacksaw Harry). 2022 NMMA nominee. It is a small world! Keep it down low amigo.

I'm more of a hack player, but I've been at it a long time, since 1959. There's a clip of my sloppy playing on YouTube under my name, Jon Sterngold. My band's website is http://www.terrainband.com and I have a bunch of noodling up at http://www.soundcloud.com/bluesdoc. Enjoy. Also, I have a book of true stories from my ER career up at https://lifepathguide.com/my-stories.htm

jon

hey there, would love to chat. I'm basically in full freak out mode at moment. Just received score and it's 430. I am 46. Non-smoker, not overweight, exercise and total lipid profile as seen attached. He suggested a 5 mg statin to start out. Didn't think a nuclear stress test was needed but I demanded it, so going in 10 days but have to pay out of pocket over $3k for it. According to the charts I'm in the 99th percentile and have the arteries of a 90 year old. Something isn't right. I've completely overhauled my lifestyle in the last week and plan on continuing. Cut out alcohol, and eating like a rabbit basically with some protein. Have lost 8 lbs. In any event, would love to hear how you are doing and any information you could provide.

Ok.
So you must begin the "healing" of your soft plaque. This is the most dangerous, far more dangerous than the stable calcified plaque you just got bitch slapped with.
To do this you must go to Rosuvastatin 20mg or 40mg(max dosage). This should drive your ldl-c down to mid 60s-preferably lower.
Here's whats up-the soft plaque not shown (but implied) by your calcium test needs to develop a fibrous cap or a thicker fibrous cap to protect from rupture.
After 8 weeks of Rosuvastatin another lipid test to see where you are at. If not