Extremely high calcium score at 42 - is there any positive here??

Posted by steveny @steveny, Jul 8, 2022

I'm a 42-year-old male. Exercise regularly, not overweight, non-smoker. While not overweight, I will say that my diet is crap -- way too much fast food, pizza etc. I guess I still eat like a high schooler.

Anyway, I saw a cardiologist figuring after age 40 this would be wise. He took bloodwork which was basically all fine. The cholesterol was *slightly* elevated and he recommended getting a heart calcium score. Told me he expected it would show nothing but that he just wanted to be thorough. Turns out the score came back at 397.

Obviously, this caught me totally flat-footed. I figured with my diet there might be some plaque, but this number places me in the 99.999th percentile for my age. And everything I have read online sound pretty dire about my long-term prognosis now -- that significant damage has been done, that it can't be reversed and can only get worse and that the statistical linkage between a number like this and heart attack-stroke is profound.

Weirdly, the cardiologist did not seem to be conveying any alarm when he told me the score, though. He was extremely matter of fact about it. Just said it was "very, very high" and that he would put me on a statin (which I've already started) and that I should take daily baby aspirin (doing that too). He said I should focus on improving diet and continue exercising (I already run 4-5x a week) but he was also pretty emphatic that "this must be genetic." (There is a history of heart problems on my father's side of the family -- though he is 76 and has yet to have any heart trouble himself.)

This was all a lot to get hit with at once. From the doctor's casual, matter of fact tone, I left the office a little confused, wondering if maybe this score wasn't that big of a deal and was a very manageable thing. Why else would the doctor not seem that disturbed by it? But then I started reading everything I could find on the subject and it's been pretty devastating.

Obviously, I'm ready, willing and able to implement the dietary changes, but for the score to be this bad at this young of an age (and with no smoking history, not being overweight, and doing regular exercise), it seems like I'm in serious trouble here. So upsetting to read that I can't bring this number down.

I guess I'm just posting this in the hopes that others here might have some experience and insight and be able to offer something, anything that is encouraging? When I read all of the medical material online about high CAC scores, am I missing something? This has all been playing out over the last 24 hours and I feel like I've basically just found out that I could drop dead of a heart attack at any moment and that my life expectancy has been drastically reduced with this news -- and that there's no way to get it back to normal. I now have a million questions for the cardiologist, but when I called his office today I was told he's just started his vacation and won't be back until August.

Any encouragement or practical advice would be greatly appreciated. Thanks.

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

Please reach out to any heart research studies in your area. Many pharmaceutical companies sponsor them and everything is done at no charge to you. I recently joined one in my area and my results have been staggering in a good way.

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You can look up my old posts on these boards to see my previous comments but, in short, I also felt my cardiologist was taking everything way too casual. I asked around and found a highly-rated person who didn’t take insurance but I went anyway. He put me through a series of tests like a nuclear stress test, sonograms of my heart etc and said the blood flow was just fine. That put my mind at ease. He also prescribed an injectable drug twice a month that brought my LDL way down. Upping the statin dose hurt my stomach and from what I read online, it is not that successful in bringing down your LDL past a certain point. I also could not tolerate a baby aspirin. For some people, like me, it causes incredible heart burn. One night, I even thought I was having a heart attack but I stopped and that intense pain stopped. Any doctor who takes your heart health casually is not good IMO. I’d move on but know also that it’s not a death sentence. It’s all about blood flow. If it’s flowing, you’re generally okay. If not, it indicates a blockage but hey, I am NOT a doctor. Good luck to you.

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@maryecox

Please reach out to any heart research studies in your area. Many pharmaceutical companies sponsor them and everything is done at no charge to you. I recently joined one in my area and my results have been staggering in a good way.

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What results were staggering and what are you doing to get these results please.

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@poppy07

What results were staggering and what are you doing to get these results please.

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I enrolled in an LP(a) study and have been very happy with the results.

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@maryecox

I enrolled in an LP(a) study and have been very happy with the results.

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mary,

Your comments sound like a teaser ... what are the specifics?

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@degarden_girl

I am 78 YO female. Because my cholesterol was in the high normal range, in 2007 my cardio sent me for a CAC just to assure there was no calcified plaque. We were both shocked when it came back in the mid 500 range. I immediately went on a statin and removed all eggs, red meat, butter from my diet. I wasn't able to tolerate statins so was without them for several years until Pralulent was approved for reducing cholesterol and heart attacks. Fast forward maybe 5 years and I developed left arm pain with minimal exercise. Into the hospital and received two stents. I am back at the gym, doing vigorous exercise. I must continue to watch my diet and use the Pralulent but I'm doing fine. My father died of his one and only heart attack at age 50 (in 1962 before all these advanced cardio testings were available) so I feel fortunate to have made it to this age. My Mom had by-pass surgery when she was 79 so I am glad I didn't have to go that route.

I am one of 7 children and two of us have calcium scores above zero. I guess we got the problematic cardio genes. And we can't beat ourselves up about this. Only 25% of cholesterol is from diet. The remainder is made by the liver. And cholesterol is different in different people. One sister has cholesterol of over 300 and a zero CAC score. I have an abundance of LPa (L P little a) which is a low density lipoprotein with a little tail on it which burrows into the artery wall. She has light and fluffy LDL which just floats through her blood stream. It is indeed genetic.

Steveny, I understand that you are feeling heartsick and betrayed by your body. If you hadn't already been taking such good care of your body I think you would be in a far worse situation. I suggest you see a nutritionist to discuss healthy eating choices and then just know you are doing everything you can to keep your heart healthy.

Do you know where your calcified plaque is located? Some arteries are of less concern than others.

I wish you peace and good health.

Donna

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Yes, I know all three. Here are the results:

LEFT ANTERIOR DESCENDING:
Type: I
Proximal, Mid: few mixed plaques in the proximal - mid segment of LAD causing mild stenosis (25-29% luminal narrowing)
Distal: normal
Diagonals: small D1 normal, D2 normal
D3: small calcific plaque in the proximal segment of D3 without significant stenosis
LEFT CIRCUMFLEX:
Proximal: few calcific plaques in the proximal segment of LCx causing minimal stenosis (1-24% luminal narrowing) Distal: normal
Obtuse marginals: OM1 normal
RIGHT CORONARY:
Proximal: calcific plaque in the proximal segment of RCA causing minimal stenosis (1-24% luminal narrowing) Mid: mixed plaque in the mid segment of RCA causing minimal stenosis (1-24% luminal narrowing)
Distal: normal
Posterior descending: normal
Posterolateral ventricular branch: normal

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@mayoconnectuser1

mary,

Your comments sound like a teaser ... what are the specifics?

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I am currently enrolled in the study and unable to comment on what I perceive to be the results. The study is to determine whether a drug will lower LP(a) numbers. The drug is in its infancy, not yet approved by the FDA. It is "double blind" which means that no one, including the lead doctor knows the study results. I highly recommend that you research medical studies being conducted in your area. They can be a very valuable health tool.

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@steveny9

Yes, I know all three. Here are the results:

LEFT ANTERIOR DESCENDING:
Type: I
Proximal, Mid: few mixed plaques in the proximal - mid segment of LAD causing mild stenosis (25-29% luminal narrowing)
Distal: normal
Diagonals: small D1 normal, D2 normal
D3: small calcific plaque in the proximal segment of D3 without significant stenosis
LEFT CIRCUMFLEX:
Proximal: few calcific plaques in the proximal segment of LCx causing minimal stenosis (1-24% luminal narrowing) Distal: normal
Obtuse marginals: OM1 normal
RIGHT CORONARY:
Proximal: calcific plaque in the proximal segment of RCA causing minimal stenosis (1-24% luminal narrowing) Mid: mixed plaque in the mid segment of RCA causing minimal stenosis (1-24% luminal narrowing)
Distal: normal
Posterior descending: normal
Posterolateral ventricular branch: normal

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This is a lot of specific info and your plaque is exactly in the same arteries where my plaque was found. From the percentages of blockage, it looks like you caught this early and now your cardio will be following you closely.

I wasn't able to tolerate statins but to tell the truth, for the time that I was on them, they didn't do all that much good. It wasn't until I went on Praluent that my cholesterol numbers dropped significantly. It is an expensive drug if not covered by insurance. Some patients have been prescribed a statin plus Praluent if the statins just didn't help much. If your doc feels the statins are getting your numbers where they need to be, Praluent likely won't be prescribed as your insurance won't cover it. I don't know when Praluent will come off patent and generics will be on the market but that might be worth looking into with the idea that you might want to pay for it yourself if insurance doesn't cover. Praluent dropped my LDL like a stone.

The CAC score above zero is always horrifying but in my case, it stirred me to action on diet and more exercise and eventually I stopped being horrified but did continue to "follow the rules" to do my best to keep the CAC score as low as possible but as my doc said "it always gets worse".

I wish you good health and peace.

Donna

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@poppy07

What results were staggering and what are you doing to get these results please.

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I am enrolled in a research study for a drug that is being tested on humans. Hopefully it will be FDA approved in the future so that all can benefit. See if you can find a heart research study in your area.

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@macj007

I am a very active ( 60 yrs) , run and play hockey. NO cardiac symptoms but High cholesterol and calcium score motivated me to get an CT angiography. I was wise to push for this test as it showed a 75% LAD blockage which required statins and a stent. That was six months ago in which time my cholesterol has dropped from to 240 to 150, and the LDL from 147 to 55, HDL steady at 65. Hope this helps.

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What was your Calcium score?

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