High calcium score: I'm in shock

Posted by sjy70 @sjy70, Jun 14, 2021

Hi everyone... just wanted to share my last few days - I'm scared and lost and was just hoping to hear from some people who have been in my place. Long story short - I went in for a "routine" checkup at age 50 to make sure my heart was okay. I had a stress test two years ago that was fine. But I do have a family history, and somewhat high LDL and blood pressure so the doctor sent me for a cardiac calcium score. It came back at 407 at age 50!!! That's like the 98th percentile for my age, which is shocking. I do Crossfit and have done half marathons so it was totally unexpected. Now I'm going for another stress test in two weeks to make sure no blockages are over 70%, and I'm not sure of the steps after that.... I'm terrified of needing open heart surgery - I've gotten myself into a place of being okay with a stent if needed. I know it's better to know than not know, but I just feel like my life was suddenly ripped out from under me and to be honest I'm spinning right now... every waking second I feel like I'm going to drop over..

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

I have found that the "discovery portion" of our disease state tends to lead to further discovery-ie, the newest info seems to downplay calcified plaque as being (in context!) much more benign than soft vulnerable plaque which seems to be the main culprit in heart attacks etc.
So, although shocking and scary, that is where your attention should be pointed. And blockage, of course.
Two companies out there, Cleerly and another one whose name I forget that do CCTA with advanced AI imaging which will give you a much clearer picture of your disease. Both are new, FDA approved and legit.
Neither is presently covered by insurance (afaik) and will cost you $1500-2300 depending on whether you can get your team on board to order it.
Best of luck, I would sleep a little easier, at least until you get the vulnerable plaque picture

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@ams016741

Hi All, I found all these posts to be very informative and valuable. So thanks for all the posts. My situation ... 62 y/o very active male (hiking, cycling, high intensity interval training at least 4x per week). Feel great after each workout and am asymptomatic. Last physical LDL was 147, HDL 56, and Triglycerides 59. Since the LDL was at the same level for the last 3 years my primary recommended a statin. Asked that he do a CT calcium score first. Results came back with a total score of 1326. Breakdown as follows: LAD was 410, left circumflex was 256, and right coronary artery was 660. So I started freaking out!

Met with cardiologist and he immediately put me on 80 mg Lipitor, 81 mg aspirin, and told me to stop the high intensity training for the time being. Because I was asymptomatic he wanted to a nuclear stress test and a cardiac hw echcardiogram. If I was symptomatic he would have done a cardiac catheterization. The results of each test were perfect! The nuclear stress showed good blood flow. I thought it would show the blood flow in each artery but apparently it doesn't.

Spoke to cardiologist this morning and he said its ok to resume the high intensity interval training and to keep taking the statin and aspiring. I told him I was still freaking out and was afraid of just dropping over one day soon. He wants to do Coronary CTA scan next but apparently the results of the coronary CTA scan tend to be higher than what's actually there. So if the scan shows there is a 90% blockage it may only be a 60% blockage. Scheduling out the scan is 6 weeks out.

Asked about doing a catheterization instead but he said because I am asymptomatic that the insurance companies may not cover it. So I don't if I should tell him that I am symptomatic now.

Is there anymore that I can do or I have I been handed a death sentence?

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Your LDL should come down.

Did you get an advanced blood panel/Cardio IQ?

An cardio echo should indicate flow rates, and ejection fractions, etc.

The issue with CTAs is the calcium causes a form of blooming on the scan image, obscuring some/much of the ability to assess blockages.

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There are risks involved with a catheterization. And in my experience, before doing the cath, the doc would require a CT scan to determine the location of blockages. So if you trust your cardiologist, I would follow his recommendations. If you don't trust your cardio, seek a second opinion.

I had similar numbers in my calcium score done in 2006. I finally became symptomatic in August 2022 and needed the catheterization and two stents in September. Your CT scan will tell you and your doc what you need. In the meantime and until you become symptomatic, it is important to keep cholesterol low and the aspirin will keep your blood from easily clotting. You may wish to see a dietician for guidance on your diet.

I wish you good health and a long life.

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@degarden_girl

There are risks involved with a catheterization. And in my experience, before doing the cath, the doc would require a CT scan to determine the location of blockages. So if you trust your cardiologist, I would follow his recommendations. If you don't trust your cardio, seek a second opinion.

I had similar numbers in my calcium score done in 2006. I finally became symptomatic in August 2022 and needed the catheterization and two stents in September. Your CT scan will tell you and your doc what you need. In the meantime and until you become symptomatic, it is important to keep cholesterol low and the aspirin will keep your blood from easily clotting. You may wish to see a dietician for guidance on your diet.

I wish you good health and a long life.

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degarden,

Two cardiologists, and many other studies, indicate the less than useful nature of CTAs in the presence of significant calcium - due to the way the the scan responds to the very calcium one is seeking to assess.

Would like to hear more about this, though.

How was your blood work, and other lifestyle factors prior to 2006, and in the intervening years before you became symptomatic?

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My diet before 2006 was probably like many people's diets -- too heavy in red meat and various dairy. After 2006, I was prescribed various statins but could not tolerate any of them. I totally changed my diet to one free of red meat, dairy products, eggs, shellfish, etc and full of high fiber foods, small portions of chicken and fish. Even with this change, I could not get my cholesterol down to desired levels and then, Praluent came on the market and I was one of the early users. It brought my cholesterol numbers way down to desirable levels. I can't remember when I started with Praluent but it must have been at least 7 years ago.

I have always had an active lifestyle with hiking, biking, time at the gym and that has not changed.

Over the last year or two I had noticed some left arm pain when walking up hills but attributed it to a bulging disk in my neck. Just before the stents I developed unstable angina and consider myself fortunate to have gotten to the hospital before I had a heart attack. Afterwards my cardio showed me imaging of my heart that showed stalagmite/stalactite looking areas in the LAD and RCA arteries which are the ones that were stented.

The stents come with their own concerns as platelets can build up on them and if the artery closes off at those sites, the next step is by-pass surgery. I am now taking Plavix which is an anti-platelet medication and I will likely be taking that for the rest of my life.

So, there is my history and I am grateful for my excellent cardiologist's care and am happy that I am still here. Several years ago I asked my cardio about having stents before a heart attack and she said that stents before symptoms hadn't proven to extend life. Not sure why that would be but your cardio or own research might shed light on that.

Your situation seems similar to mine and as much as the whole "heart disease" diagnosis is frightening, maybe it is just a part of aging for some of us. I figure these stents will be good for another 10 to 12 years and maybe by then I will be ready to leave this earth. Maybe!

I wish you well.

Donna

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I just got my results the other day, my CAC score is not as high as what I've been seeing online but the results are freaking me out. I'm 51 woman and my score was 46, in the 95th-100th percentile. So I guess that means I have the worse score out of all woman my age? I'm guessing my number is great if I were 90 years old? Seeing the words severe is just freaking me out. I see the cardiologist in 4 weeks, my Dr. want me to take baby aspirin now. I'm already on statin and blood pressure meds. Here are the written results summary:
"Coronary artery calcification is present reflecting coronary atherosclerosis. The Agatston score is 46, which places the patient between the 95th and 100th percentile adjusted for age and gender. Note that Agatston scores above the 75th percentile are considered severe."
We will see what's next.... 🙁

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So here is the upside-
Your score is "great for a 90 yr old" so now your goal must be to live to 90 without adding to your score.
So how do you do that?
stop smoking. lose weight. eat correctly. increase your statin to maximun crestor to insure maximum lowering your ldl-c (without adding meds). Drive your ldl-c to <50, adding meds until you go down to goal. Manipulate your bp meds to drive it to 110-115/70-75.
Thats alot of work. Real work. Hard work.
Good luck.

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Two days ago I got the results from a CT calcium test. Over 2000. I am healthy and 73 and I’m in shock. I don’t read about any kind of treatments except to just get your things in order. I can’t get in anywhere for two months to see a cardiologist. I’m scared

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@nany123

Two days ago I got the results from a CT calcium test. Over 2000. I am healthy and 73 and I’m in shock. I don’t read about any kind of treatments except to just get your things in order. I can’t get in anywhere for two months to see a cardiologist. I’m scared

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That's a big number. Didn't your ct test have comments regarding stenosis etc? Mine did. I wouldn't wait 2 months, find a workaround to get into a cardiologist sooner. If you can't find a workaround, come out of pocket and get in to an out of network cardiologist. After all, what is money for?

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@nany123

Two days ago I got the results from a CT calcium test. Over 2000. I am healthy and 73 and I’m in shock. I don’t read about any kind of treatments except to just get your things in order. I can’t get in anywhere for two months to see a cardiologist. I’m scared

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nany123,

First - calm down. There are many folks with know numbers that high who are in good health, otherwise - and asymptomatic

But, it is time to assess your health more formally - you need advanced lipids panel to determine meds, stress test and echo with the stress test. A CTA (different from CAC - unless you and cleerlyseeker mean you have already had one, then what he said.

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