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Cardiologist disregarded my CAC score of 595
I'm 53, I am about 30 lbs overweight, I've lost 30 lbs this year. I eat extremely healthy due to the fact that as soon as I hit puberty, the weight was just a battle to keep off. My cholesterol has always been in the normal, but the last few years my tri and LDL have went up. After losing a friend to unexpected heart attack, I decided to get all the preventive testing I could. My primary recommended the CAC to help put me at ease, I had some chest tightness with stress. Also during this visit, labs came back normal cholesterol but 126 LDL up from 90ish. So when I got a 595 CAC score I nearly lost it!! ok, since then I've done some research and found it's just part of a puzzle, but apparently it is an indicator that I have plaque build up- even with healthy diet. As I started some research, I knew my uncle died of unexpected heart attack at 51 (was healthy), my grandma smoked heavy, but had a stroke at 59, my other uncle stroke and blockage 62 - drinker and previous smoker, my super healthy uncle (my dad was 1 of 6 boys) had a heart attack at 66 and they said it was hereditary - bc no other real indicators. So I get and stress test, it's abnormal. My cardiologist (just assigned) says abnormal just means between normal heart beat and heart attack - grey area. The CAC score is not an indicator and shouldn't be used, "he's seen much higher numbers" - if my parents didn't have early heart attack, my uncles don't matter, when I said what about 126 LDL, he says "everyone has cholesterol in their blood" he then went on to let me know, I wasn't just gonna get a stent, he literally said this like 5-6 times, and I never mentioned it. Is this Dr as crazy as I feel. btw, I stated due to the many factors, a CT scan was called for - he ordered, and due to LDL and high CAC a statin would be called for - he prescribed. He seemed mad about the whole thing. YES I'm definitely seeing a new Cardiologist once CT scan is done. Why did this Dr. act to defensive about CAC info?
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should be best too do without...edited@kobe2026
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1 Reaction@kallettla 0 is great. Wow! You can’t do better than that. Congrats.
@cher51 except that it means nothing. I likely have the more dangerous unstable soft plaque like I have in my carotids.
@kallettla That is what I want to find out. My problem is the LAD 486. Soft can cause blood clots. Yikes!
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1 ReactionYes it does seem like you need a new cardiologist. A CT with contrast will show exactly how much blockage you have and where. Since you are symptomatic and had an abnormal stress test, I would expect it to be warranted. I would do some searching for a new cardiologist, and you can also lean some on your primary care doc in the meantime to assist. Good luck!
For what it's worth, I just had one, and it really wasn't much of an issue. It's a very fast test. The dye makes you feel a little funny, but it was a breeze through it.
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3 Reactions@pizi I am so glad that you posted this because my situation at age 57 is similar to yours with a cac score of 1146. Just like you I was active throughout my life and while I did it necessarily watch everything I ate for the most part I was reasonable. My angiogram also showed no blockages more than 30% but it appears my right coronary artery was dilated or I guess the exact word they use is ectasia . I continue exercising but just lowered the intensity but increase the frequency and certainly watch my saturated fat intake much closer and cut out most simple carbs. Just like in your case my father had bypass when he was 74 - 75 and even though he was not very active and did not necessarily watch his diet and certainly enjoyed some alcohol he had a long life until he passed about a year ago at almost 89.
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1 Reaction@ssmfltr that sounds genetic. I was tested and turns out I had an elevated LP(@) same as my father. It doesn't matter how much excersise i do I can't prevent it from happening
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1 ReactionI am 59 have had genetically high cholesterol but with a good ratio since my 30s (and the good ratio has improved over the years. I had a postpartum stroke at 42 with no residual effects and no history or explanation other than the stress of pregnancy on my body. I've never been overweight except maybe 5 pounds or so due to a bad birth control med in my 20s whch I stopped -and it took me 5 months to lose the baby weight. I did the CAC scan 3 years ago and got a zero score.
I too would have had some concern with a score in the hundreds and it never hurts to get a second opinion.
Congratulations on your weight loss! Most of my normal weight is genetic too - mom and sister have always been thin or underweight. Part of it is me - I do well with portion control and reasonable choices and I've been exercising daily since 1982 except less so just during pregnancy.
I'd also look into the link between the extra weight and any heart issues but I'm not a medical provider. Again congrats on the weight loss -that's awesome!!
Unfortunately doctors (most ) are angry and tired of over work and under pay too many people, not enough doctors. We have to be our own advocates now . doctor's will not take the time to know you or even take an interest. Most don't even remember you on your second visit. we have to know what we need done as they're not going to tell you anything anymore. They simply don't care . healthcare is not what we used to have years ago. also people don't work anymore, there is a shortage of health care providers. In Oregon doctors offices often have signs posted, help wanted , no experience, no schooling needed. Medical Assistants no longer need schooling either (in Oregon) probably
everywhere by now.