I got involved in one of these high CAC score threads a few years ago. Mine is 2600, no symptoms, age 77, but history of Lyme carditis. History of bad reaction to IV contrast so no angio. I have high exercise tolerance, neg treadmill and perfusion tests. Then I got very symptomatic PVCs starting about 6 months ago. Not worse with exercise, but very uncomfortable. No benefit from beta blocker increase or flecainide. I'm not going to go to amiodarone or it's unaffordable milder form. I and my cardiologist decided to bite the bullet, take high dose prednisone to try to avoid the contrast reaction (delayed systemic hypersensitivity reaction - like total body poison oak unresponsive to meds once it starts 20-24hrs after dose), and we did the angio yesterday. As expected, the Ca++ is everywhere - intima, media, and adventia of vessels. There's a few small plaque lesions here and there but the star of the show is a 70% mid LAD lesion (in the 'widow maker' ) with OK pressure gradient. No procedure (ie stenting) indicated - just medical management - cholesterol and BP control, as I've been doing for at least 7 years. That plaque is probably stable and has likely been there a long time. Cardio says it shouldn't be exercise limiting. So, I'm OK for now, AND sobered as a life long health freak with some bad medical luck along the way. So it goes. As the saying is, 'I ain't dead yet'!! btw, I'm an MD with 50yrs of front line medical experience, ex ER doc (life long runner until the past few years when my back and knee said stop, no FH of heart disease, never smoker, etc). But we know that the overarching risk factor for all this stuff is AGE. Which sucks... Pic is part of my effort at keeping the reaper at bay.