Living with high calcium score

@ pop77
Welcome to Mayo Clinic Connect!
Being able to have the scan to get our calcium score is a great advantage but will also frighten us.
You probably will start on statins and you will also get advice on a diet.
If I were you I would want to see a cardiologist. You probably need a stress test to evaluate what you feel when you exercise.
It’s a good thing that you had the calcium score test. Now you and your doctors know what you are dealing with and you can get appropriate treatment.

Cardiologist appointment immediately.

Stress test ASAP.

Can you post your HDL, LDL, and Triglyceride numbers?

There is little reason to go crazy with stressing workouts.

I have stopped high stress work outs after I found out about the High CAC score (which was Monday afternoon). I am going to see my PCP today , hopefully cardiologist and stress test very soon.
My HDL is 48, LDL is 139 , Triglycerides 87, non HDL chol -158, Total Chol -206, HS CRP 0.7 and Apo b 116. When I punched these into the risk score test I got only around 6% as risk. However the high CAC score tells another story.
Though I have heart burn/gas/pain around chest, they are not severe and I do not have shortness of breath or anything. That is why I thought this could be acid reflux and gas. Lot of burping and passing gas, which made me feel better afterwards. I will ask my doctor to go to cardiologist immediately. Now I am reading more I am getting more concerned. Before the CAC test I was not even aware of all the examples.

My example - at 65 high CAC, then adjusted LDL down to 45-50, HDL stayed the same at 45-50, Triglycerides adjust down to 45-50.

Atovastatin and icosapent ethyl.

Took about 30 days for the changes to occur.

Stress with echo fine, peripheral ultrasounds fine, CT inconclusive due to image blooming from the calcium, cardiologist not recommending anything else at this, UNLESS pain of any sort, then would cath me.

I just looked at all my past records, first detected total chol above 200, 20 years ago! I was younger and more confident that I can reduce chol below 200, which I did. The cholesterol has been fluctuating between 180 and 22 over the past 20 years. For all the younger folks here, if you find total chol above 200 think about take statins sooner than delaying like I did.

Be aware of high CAC scores and ensure follow up testing is done with cardiologist. 6 years ago, I had a CAC score of 1350 and cholesterol of 180. Stress test showed no issues, but went on Crestor, Repatha to lower cholesterol. I continued healthy life style with regards to eating and exercise. I am 5' 10 and 175 lbs. After a year of continued borderline high cholesterol, I went on Ezetimbe which lowered my hereditary high cholesterol immediately. Took another stress test with no issues. This week, my latest CAC was 2214 which led me to have a CT angiogram which shoes 70-90% blockage in the LAD section of the heart. My advice is that CAC score and stress test are not enough to know for sure what is really going on inside.

Lou,

It is said that CT angiograms are significantly blinded by high calcium deposit reflections... in a manner that prevents assessment of blockages, or thus was my understanding.

Did you have an echo with the stress test? With that much blockage EF would have been affected - or should have been?

what lifestyle changes did you have to make? thanks.

What food lifestyle changes are cardiologists recommending besides the obvious. I've read that eggs, cheese, and beef are out. But pasture raised organic eggs have high omega-3. Some low-processed high end cheeses are high in vitamin K2, which is good (see below). I no longer eat red meat but used to eat mainly grass-fed beef which is also high in omega-3. Most studies generalize our foods which removes potential benefits from non-traditional foods. Do we need an update?

"Optimal Vitamin K2 intake is crucial to avoid the calcium plaque buildup of atherosclerosis, thus keeping the risk and rate of calcification as low as possible. Matrix GLA protein (MGP)—found in the tissues of the heart, kidneys, and lungs—plays a dominant role in vascular calcium metabolism."

Anyone taking K2 supplements? How do you measure progress?

Interesting Danish study:
https://bmjopen.bmj.com/content/13/7/e073233
The effect of supplementation with high-dose vitamin K2 (720 µg/day) and vitamin D (25 µg/day) over 2 years was examined in the very recent Danish AVADEC (Aortic Valve DECalcification) Trial.21 Aortic valve calcification progression was non-significantly decreased.22 However, the supplementation appeared to slow down the progression of CAC, especially in patients with severe CAC (score>400). It also reduced progression of the non-calcified coronary plaque volume. Very importantly, the total number of cardiac events and all-cause death was significantly lower (unpublished data). As these findings were secondary outcomes, the results are only hypothesis generating and a confirmatory trial is requested.

Hypothesis
In a randomised setup, we test the hypothesis that supplementation with vitamin K2 (720 µg/day) and vitamin D3 (25 µg/day) in comparison to placebo will reduce the progression of CAC in patients with severe CAC.