49 yo male 1900 calcium score normal stress test and echocardiogram

This week my PCP recommended increasing my baby aspirin to 2 a day due to plaque building up in my brain causing blockages there. He said to only used coated aspirin and take with food to minimize GI bleeding risk. Now, in addition to the CAD and brain issues (chronic microvascular ischemia and lacunar strokes) he suspects some carotid blockage so I have an ultrasound in 10 days. The tendency to plaque build ups is insidious.

Began seeing Cardiologist for first time in my 71 years 6 weeks ago. Earlier this Summer I was having a leg Vein Ablation procedure and the anesthesiologist said I had PVCs during surgery. Over the years my Internist reported some mile irregular heartbeats, had me on a low dose of Ramipril for slightly high BP & Atorvastatin “just to keep any plague on my veins in place”. Internist for years saying “not a good candidate for plaque because cholesterol is near perfect. Back to the Cardi, I’ve had 21 day monitor test, Heart Echo Cardi, Abdominal Echo Cardi, and everything looks okay, the “Irregular HB is very mild case” per Cardiologist. Prescribed BisoProlol to slow things down. Before leaving him today, he suggested I have a Calcium CT Test, insurance won’t pay but it’ll tell us if you have any issues with that even though your cholesterol #s have always been good. I got the call on the way home from the office that my #s were surprisingly high at 2000, compared to 0 being ideal. I almost wrecked the car. Like many on here. I wasn’t having any indication of heart issues, feeling great and very very active 71 year old. One good thing was my Internal Med Doc has had me on the statin for over 10 years so what’s stuck on the walls of my veins may stay there. I go back next week for a Nuclear Stress test and will determine from there the next course.

@pkoutou

Hello,

After having a calcium CT scan done (March of this year) and getting my results (2534 @ 61 years of age), I did a LOT of reading on heart disease and CAC scores. Every article I've read says the CAC scores are very accurate.

Has your cardiologist mentioned doing a nuclear stress test? I had both a nuclear stress test and echo done a few months ago and both came back normal. Give your age and high score, I would think your insurance would approve the nuclear stress test (make sure you ask, as I had to get a approval for both tests).

Has he put you on a statin yet? I was immediately put on 10mg of Crestor/Rosuvastatin by my primary doc, but when I saw my cardiologist, he upped it to 20mg. It did a phenomenal job of knocking down all my cholesterol readings (first column shows the levels from March 2023 and the second column is 7 weeks later while on 20mg of Crestor):

Tot. cholesterol 221 137
Trig. 69 48
HDL 83 78
VLDL 12 11
LDL Chol Calc 126 48

Best of luck to you.

Andy

Update. After echo cardio, nuclear stress test my Cardiologist found abnormalities in my Circumflex Artery at left bottom side of heart. I’m scheduled for first Heart Cath to take a closer look and hopefully correct any issues.

Hopefully the blockage is not too high. I had 60-70% blockage in the LAD and decided not for a stent. I am at 64 yrs. old with almost 1600 CAC. Make sure to ask questions. Be well.

alaskat,

Could you share your rationale for refusing a stent? Please be as technical as possible.

Did your interventional cardiologist advise you to stent?

Cardiac Cath two days ago. 40% blockage at beginning of D1 artery off of LAD. Cardiologist said he would not stint unless >70%. Sent me home with Heart Healthy diet, lose weight and exercise 3 times per week. Changed statin from Atoravastatin to Rosuvastatin (Crestor). Said he’d see me in 3 months.

4aces,

Do you know why the statin change?