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Any people in their 40s with very high CAC scores?
I’m a 47 year old woman, and in January I had a calcium scan with a score of 538.
I had started a statin last year and somewhat randomly asked for the CAC scan at my 6 month follow up visit just to see what my score was, since I had learned of CAC scoring just a few weeks before.
Needless to say, the score was shocking to me and my PCP. I do have some risk factors, so I didn’t necessarily expect a 0. Most of my adult life I have been fit and healthy, but I gave birth at age 40 and struggled after that to lose the weight. In that time, my cholesterol crept up and so did my blood pressure. I have been active in that time, since I have a young kid, but the extra weight and some other postpartum issues made exercise more difficult for much of that time. I have returned to exercise and getting more fit in the last couple of years, but my body is not even close to the shape it was in before I got pregnant. But this score is nearly unheard of for a woman my age, which of course worries me a lot.
I have seen a cardiologist (a physician assistant) and I have a CCTA, nuclear stress test, and echocardiogram scheduled over the next month or so. I also started Wegovy. I will meet with the MD after those tests are complete and then they will discuss any medication changes, procedures, etc. Their take is that the CAC is a screening test, and I have been flagged by the test for follow-up. Once they have a better idea of what is going on, then they can address it. This makes me feel better in some ways, but I also worry that more tests will bring more bad news.
In terms of my question: I’m less interested in suggestions of what to do medically, since I feel like my cardiologist’s office is taking the right steps. But I guess I wanted to know if there are others out there in their 40s who are dealing with this. As a parent of a young child, this is especially stressful. I would love to hear from others about how to cope with this news. I feel like I’m the only person this young to have this kind of score, which is scary and lonely.
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I wanted to go ahead and update this post in case it helps any others out there in a similar situation. I had a CCTA with contrast, a nuclear stress test, and an echo. I then saw my cardiologist (MD) to go over the results. The additional testing proved very reassuring. I do have mild CAD. I have 3 small plaques in the areas identified by the calcium scoring scan. Two of the plaques are minimal (0-25% blockage), one is mild (26-49%), so I had a CCTA score of CAD-RADS 2/P1. But my heart otherwise is perfectly healthy - everything is getting enough blood, no damage anywhere, etc.
So basically the main thing going forward is to make sure the CAD doesn't get worse over time. I've started taking a higher statin dose and I started Wegovy. When I go back in for the blood test to make sure I am tolerating the statin dose ok, they will also test my LP(a), since heart disease runs in my mother's family and some promising treatments for that number seem to be heading down the pike. That way I'll know that number and can advocate to start treatment down the road.
It's been a very stressful few months, but now that I have a better sense of my heart health, I am glad I got the CAC test. Since I'm otherwise so low risk (premenopausal women are not supposed to be prescribed statins even), I probably would not have had aggressive treatment until I was post-menopausal without this happening, I'm glad this condition was flagged early, well before it became more dangerous. So there is hope out there! I would just urge younger folks with high CACs to get aggressive follow up so that you learn what is actually going on in there, rather than just worrying over the CAC score.
I am on 10mg rosuvastatin which has lowered my LDL to 74. The doctor would like it to be even lower, but instead of increasing the statin dose, we've added 10mg ezetimibe. Studies show that the additional benefit of that is better than increasing the statin dose.
Thanks! I'll keep that in mind. My numbers were nearly ok on 5 mg of rosuvastatin, so just increasing to the standard 10 mg dose seemed the best first step to be more aggressive about getting the numbers even lower. But I'll see how things go from there and see if adding something else makes sense!