Living with high calcium score

Posted by pop77 @pop77, Oct 10, 2023

I am a 53 year old male. Just found out I have a CAC of 731. Most of it (699) is in the right coronary. I exercise 5 times a week , used to eat eggs every day (15-20 per week), cottage cheese and yogurt. Upon hearing this news, stopped eating eggs right away. Just trying to figure out what else to adjust. I don't have BP and am at a healthy weight of around 160 lbs for 5'8".
Doctor still has to reach out to me and I think most likely I will be put on Statins. I have high LDL and Apo(b), but triglycerides are under control.
The question I have is, how else should I adjust the lifestyle. I don't drink or smoke or eat meat. Should I reduce how hard I work out? I used to take my HR to 165 and whenever I did it I used to get a heartburn. I was thinking that the workout has triggered acid reflux but looks like something else is going on.
For those with high CAC , how hard do you work out? Should I stop hiking and running? Looking for some insights.

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questionofbalance,

You quote ... what is the quote from?

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High calcium score does not mean artery is blocked. More so it’s calcified plaque which is not prone to rupture. It’s unstable plaque which is problematic. I am 65 years and has 560score in LAD. AHA guide line says CAT is not required for asymptomatic and blockage of 70% can be well managed with medication and diet. So not to worry at all.

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@sharad

High calcium score does not mean artery is blocked. More so it’s calcified plaque which is not prone to rupture. It’s unstable plaque which is problematic. I am 65 years and has 560score in LAD. AHA guide line says CAT is not required for asymptomatic and blockage of 70% can be well managed with medication and diet. So not to worry at all.

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70 Year old male. Stress test-Echo was negative but EKG had a minor abnormality. I requested a CTA. CTA was stopped due to high CAC score of 1090. LM 68, LAD 474, CX 197, RCA 350. No symptoms. Cholesterol has always been 160 on statins. Recent diet change and Cholesterol is down to 124. Cardiologist is out 3 weeks for a phone conversation to review. Have always been active outdoors and 30 min daily workout. 3 weeks seems a bit long to address my concerns.
Any thoughts

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sw431c,

Cardiologist - IF he reviewed your numbers isn't prioritizing you because there isn't much he can do ...

Now, if he has not seen he information and used it to tailor your appointment? I would search for another cardiologist - and, ensure they are an interventional cardiologist, fellowship trained, good schools, preferably not too old, etc - it DOES matter.

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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.

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@bluesdoc

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.

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Thank you for such a clear, concise explanation- very helpful to me! Good luck! Best, Jim B

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@jimbehun

Thank you for such a clear, concise explanation- very helpful to me! Good luck! Best, Jim B

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You look fantastic and 15 years younger than your age. While I do not fully understand your numbers, my take away is that notwithstanding your negative deviations from the norms, one can do just fine with clean living and proper medical treatment. If there is more to it then that, please let us know. Thank you very much for sharing.

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@ike

You look fantastic and 15 years younger than your age. While I do not fully understand your numbers, my take away is that notwithstanding your negative deviations from the norms, one can do just fine with clean living and proper medical treatment. If there is more to it then that, please let us know. Thank you very much for sharing.

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Sadly and soberly, 'clean living' wasn't enough. I was a health freak all my life. But cardiac Lyme took a toll, I'm sure. And who knows what else. My chol was always borderline high, same # as everyone else in my family, none of whom had cardiac disease. So, it's down to 'proper medical treatment' and the rest of what I've always done. I had a 'life script' all my life that I'd live to a very old age pretty much maintenance free. Yeah, well...... then life happens, huh. And no dispensation for being a doc. Onward ~~~~>>>
jon

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@pop77

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.

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I totally agree. I’m a 54 F. Looking back, I wish I would’ve been more educated about my cholesterol. For the past 10-20 years my #s were high. I have a family history of heart disease and my cholesterol is now 240. In the past it was always 198-220. My primary dr said “don’t worry just watch certain things you eat, your active, not overweight etc & she also said my other #s balanced it all out. Gosh, I should’ve pushed more and went to see a cardiologist back then. So disappointed in not advocating nor taking it more serious at the time.

I recently had a ct calcium scan (recommended from my husband pcp as he said we’re getting older and it’s probably a good idea to look into the test) which came back high 444. I had my cholesterol checked immediately and that was elevated as well. I then went to a cardiologist and she started me in 40 mg Atorvastatin & did another lipid 3 months later. At that time all my #s went down but my ldl was still above 70 (80) so I was put on another 40mg. (My cardiologist wants it 70 or less) Currently I’m now on 80mg of Atorvastatin/aspirin daily. I wasn’t expecting that at all and was honestly scared about the whole situation. I asked to see if I could stay in the 40mg and watch everything I ate but she felt with my family history and knowing now it’s hereditary I should do the 80 mg. I asked for further testing but was told because I’m asymptomatic it’s not necessary. I told my cardiologist that I do have a pain on my left side that comes & goes but that was coughed up to muscular so idk. I considered myself somewhat active, I don’t eat red meats nor a lot of dairy. So all in all I’m just asking myself the same thing…..if I would’ve been put on meds 15-20, years ago especially with my family history (father heart disease, stents open heart surgery etc, along with a few of his brothers and both paternal grandparents dying from heart related issues & my mother and older sister have high cholesterol & bp with meds) could that have prevented the calcium buildup? I should’ve been more concerned way back then but I’ve just followed what my PCP Drs advice and she didn’t seem overly concerned.

Ugh…so frustrating that this is something I can’t control. I’ve never been on any meds like this so now I have daily statin/aspirin for preventative purposes. It’s hard to hear “heart disease” and it’s very scary.

I’m reaching out to get a second an opinion about my care moving forward. I have so many more questions that need answers and my first cardiologist seemed to just brush off what I’m dealing with. I need more guidance instead of being told don’t eat meat dairy (which I don’t) keep active (which I do) so at this point just getting another Drs perspective on my situation just to ease my mind.

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@leeds

I totally agree. I’m a 54 F. Looking back, I wish I would’ve been more educated about my cholesterol. For the past 10-20 years my #s were high. I have a family history of heart disease and my cholesterol is now 240. In the past it was always 198-220. My primary dr said “don’t worry just watch certain things you eat, your active, not overweight etc & she also said my other #s balanced it all out. Gosh, I should’ve pushed more and went to see a cardiologist back then. So disappointed in not advocating nor taking it more serious at the time.

I recently had a ct calcium scan (recommended from my husband pcp as he said we’re getting older and it’s probably a good idea to look into the test) which came back high 444. I had my cholesterol checked immediately and that was elevated as well. I then went to a cardiologist and she started me in 40 mg Atorvastatin & did another lipid 3 months later. At that time all my #s went down but my ldl was still above 70 (80) so I was put on another 40mg. (My cardiologist wants it 70 or less) Currently I’m now on 80mg of Atorvastatin/aspirin daily. I wasn’t expecting that at all and was honestly scared about the whole situation. I asked to see if I could stay in the 40mg and watch everything I ate but she felt with my family history and knowing now it’s hereditary I should do the 80 mg. I asked for further testing but was told because I’m asymptomatic it’s not necessary. I told my cardiologist that I do have a pain on my left side that comes & goes but that was coughed up to muscular so idk. I considered myself somewhat active, I don’t eat red meats nor a lot of dairy. So all in all I’m just asking myself the same thing…..if I would’ve been put on meds 15-20, years ago especially with my family history (father heart disease, stents open heart surgery etc, along with a few of his brothers and both paternal grandparents dying from heart related issues & my mother and older sister have high cholesterol & bp with meds) could that have prevented the calcium buildup? I should’ve been more concerned way back then but I’ve just followed what my PCP Drs advice and she didn’t seem overly concerned.

Ugh…so frustrating that this is something I can’t control. I’ve never been on any meds like this so now I have daily statin/aspirin for preventative purposes. It’s hard to hear “heart disease” and it’s very scary.

I’m reaching out to get a second an opinion about my care moving forward. I have so many more questions that need answers and my first cardiologist seemed to just brush off what I’m dealing with. I need more guidance instead of being told don’t eat meat dairy (which I don’t) keep active (which I do) so at this point just getting another Drs perspective on my situation just to ease my mind.

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I can relate totally. My CT score was 2012. Yes you read that correctly. I am 81 and my cholesterol has never been that high. Cardiologist was pretty lackadaisical about the situation. I plan to change docs. I guess if you’re a cynical person you might be tempted to say. “She’s old what is she complaining about. Ya gotta die of something “. Really?

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