I have a very high calcium score. What next?

Hello hikerguy62...I wish someone would study my case. I feel great(for an almost 79 year old male). I walk 7 days a week sometimes twice per day. My apartment is second floor with 14 steps which I traverse 10-12 times per day. I do have plaque presumably throughout my system but it has been there long enough to be dispersed and hard. Also time has allowed for "angiogenesis" of my heart. Look it up . It's a very well known phenomenon where the body develops alternate circulation. Sometimes good, sometimes troublesome.
I will save stents and other procedures for the day(s) when angina interferes with my life or when fatigue sets in.
That's my story and I'm sticking' with it.

Exercise stimulates angiogenesis while no exercise causes capillary regression. No one needs stents for a high CAC score unless there is significant blockage (I think over 70% or something) and symptoms including shortness of breath and chest pain with exertion.

Obviously you are doing good. You are an inspiration.
Best wishes!

Dear drrawat,

In America we are often over tested , over diagnosed and over treated IMHO.

When it comes to vascular disease, the angiogram can definitely lead down a slippery slope. Do you agree that angiogenesis often keeps individuals with narrowed, and even blocked, arteries strong and active ?

We almost hear nothing about the body's ability to compensate through redundancy( eg the Circle of Willis feeding the brain through "work around"
circuits.)

Please tell us more about your experience and views.

I understand your concern for your calcium score. Mine is 2235. Last fall I was having some left arm pain with minimal exercise. An MRI showed narrowing in two heart arteries and I received two stents. I saw the MRI results and it looked like stalactites and stalagmites reaching toward each other.

As I understand it, stents are more likely to gather calcification as time goes by. I will be taking Plavix for the rest of my life to keep platelets from settling around the stents and causing a blockage. If the stents get blockages (more likely after 10 years) , I will need by-pass surgery. So, bottom line is to work with your cardiologist to determine if further diagnostic testing is recommended. I personally think it is best to wait as long as possible before getting a stent. And a stent isn't recommended for everyone with high calcium scores. Some people never develop the localized narrowing of the arteries so a stent would not be helpful.

I know it is horrible having heart disease and never knowing when a blockage may develop. For me the left arm pain was pretty distinctive -- was definitely not a sore muscle. It came on with even mild exertion; no question in my mind that it was THE left arm pain associated with heart blockage. I did not have chest pain but others may experience things differently.

I wish you good health and peace of mind.

Donna

pumaguy79,

I completely disagree with your broad statement re being over tested/treated ... sure, it might seem that way while medical professionals are searching for causes, and perhaps informed and aggressive testing hasn't yet saved your life, but the processes have certainly saved hundreds of thousands, maybe millions of other lives.

Now, less broadly, some testing and treatment may be "over," but the question is, as always with large populations of circumstances - where is the line?

There isn't a reputable doctor in America that would rush a patient in for an angiogram, stents etc after getting a CAC score if the patient is otherwise healthy and asymptomatic. I voluntarily took a stress test but my doctor recommended I didn't need it. When symptoms arise (whether you have a CAC score or not) including shortness of breath, chest pain (or pain in shoulders, arms, neck, jaw, back or stomach), weakness/fatigue, etc then it's time for invasive testing.

I'm 64 and thought in decent shape, a bit overweight, and scored 700. I was shocked as many and there isn't guidance except seeing cardiologist, who are booked for two months. Epidemic?
I eat well and make most meals, mostly plant based with seafood and chicken.
Hurt my knee last year and after 45 years of running had to back down to walking 4 miles.
I'd like to do some light jogging/walking for four miles and I'm doing knee exercises. I got heart rate up to 168 jogging but worried should I not push myself more? Most info says diet and exercise but limits according to score aren't mentioned.
My goal was to back down to 10mg of Lipitor after being on 20 for 20 years. Doc said yes, but first do calcium score. After score he advised going up to 40mg and take aspirin. Aspirin bothers my system so i stopped taking it.
Reading more about K2 helping with heart but it clots blood. Also, seems I should have been taking CoQ10, which I'm doing now. I backed off of K2 because I think more research needed and trying to get it from pasture raised eggs, some cheeses (which is saturated fat) high in K2, and other prepped foods high in K2.
Off for a light run/walk - thinking I go light until I see cardiologist. May last run I felt fine.

question,

You don't mention your BP ... is it high?

And, yeah, that's a long time running/jogging - hard to stop, but sounds like it's time.

Does a single 81 mg coated aspirin really bother you? It's different for all of us, but I never noticed it.

Did you have stress test with echo?
Peripheral artery disease ultrasound?
Advanced lipids panel (CardioIQ)?

Cardiologists… BTDT, been there done that. If you are otherwise a healthy individual with no symptoms the most a reputable cardiologist will do is put you on a statin and perhaps give a stress echocardiogram or nuclear scan. If the stress echo results are normal the doctor will advocate for aggressive lifestyle changes: regular exercise, balanced mostly plant based diet, abstaining from smoking and excessive alcohol and keep BP in check. Regular check-ups/blood work with your GP are important.

Also keep in mind if you have an elevated calcium score it has been high for a VERY long time. And how are you doing now? Fine and probably asymptomatic.

CAC score isn’t a death sentence; it’s a wake-up call.

If no symptoms don’t get tricked into an invasive coronary angiogram without any functional testing like stress echocardiogram or nuclear testing. And resist the unnecessary angioplasty.

Get on a statin. I resisted like an dummy for 20 years, my father started taking them when they first came out in the 1980s I believe it was, and when he recently turned 85 years old I realized he was just doing fine on them and my fears were irrational. The statin will stabilize the soft plaque and prevent it from breaking off and forming clots.

Calcium is just one piece of the puzzle, while this illustration isn't scientific it gives a good overall picture.