CCTA after 1,000+ CAC score - warranted?

My understanding is the CT-A is an angiogram - but non-invasive (except for the injection of the contrast dye). Otherwise I'd need two of the invasive types of angiograms (one for the LAD artery and another for the RCA artery). Also, apparently, carotid arteries can also calcify, and the CT CAC test doesn't measure them. They are the two that carry blood to your brain (e.g. if obstructed then you get a stroke). The CT Angiogram with dye might be able to observe narrowing spots of all of the above. Then I'd get the catheter to pinpoint areas for widening. I hope that makes some sense.

I definitely concur that anyone with high CAC should have their carotids checked. I did and there is stenosis but not enough to worry about yet. Also, the same mechanism that is clogging your coronary arteries can impact the arteries in your brain. I've had a couple of brain MRI's that show that I have chronic microvascular ischemia. You can visibly see areas where there has been ischemia and white matter disease, and lacunar strokes. If you have high CAC be on the lookout for neurological symptoms. The problems is that there is no treatment since they can't stent your brain like they can your coronary arteries. But the same things you do to manage your CAC can slow progression there as well.

No, don't think I would take one of those MIBI tests (also all those various pop-up clinics in Alberta are a bit suspect, IMO - best to stick with hospital procedures - in any case I'm not in Canada at present). Were you referring to the 2-part MIBI tests equating to the 500 chest x-rays?

I will, however, enquire about the CT Angio test with my Cardio Doctor. I know it uses contrast dye which scares some people off, but I have had a contrast dye CT scan 5 years ago when a hospital was checking for possibility of an embolism. The dye didn't cause me any problems. I will also ask about getting the carotid artery ultrasound.

MIBI stress test does come with two rounds in the CT scanner. You go into the scanner first thing, they do a baseline, then you are asked to go on the treadmill, with CO2 mask and an IV in place, they start the treadmill, and with an attending physician in the facility monitoring your vitals in real time, they take you up to your VO2 Max. They stop the treadmill, you go sit in a room after a debrief by the attending who should provide you with immediate feedback about what he/she saw, you're asked to eat and to drink, wait about an hour, then another round in the scanner.

You can get a copy of your disc of your CCTA and have your dr. send it to the folks at Cleerly (https://cleerlyhealth.com/) it's a few hundred dollars but you will get a clear picture of what's going on inside - the exact type of plaque and amount of plaque. It uses AI technology.

I found out i had 80 percent blockage in LAD and 72 on right side. I'm on a very strict whole food plant based diet very low fat --- so am able to avoid anything invasive. Made lifestyle changes and got my LDL under 55 where you can start reversing or halting the progression of heart disease.

Coming back to this issue again..

Has anyone with a very high CAC score tried a different non-invasive procedure to investigate if there is any blockage in the arteries attached to the heart? Something like an ultrasound or similar? I had the corotid arteries checked, and there was stenosis in both - but not too bad (L34%; R19%). Is there anything similar for checking the LAD and RCA? My regular doctor said I shouldn't do the CT-A with contrast dye as it can cause significant damage to the kidneys.

Also a bit worried that the higher Lipitor (went from 20 to 40 mg) might be affecting muscle mass but not sure, I worked hard to lose weight and it could be from the exercise (lost 25 pounds in 4 months and of course you lose it everywhere). Now my butt is so soft that it hurts to sit for a long time and leg muscles seem really soft and flabby.

My nurse daughter encouraged me to get a CAC screening last year. It was a shocking 534. This was does without dye which I believe is most common. Last year I started a statin which resulted in a significant reduction in my lipid panel, especially triglycerides. Towards the end of 2024 I Noticed a slight discoloration in urine. At my annual checkup in January I asked for a urinalysis test to be performed and it was ignored. I even left a sample and it was tossed out. Around March I noticed increasing pain in both fore arms. It progressed to my shoulders. Two weeks ago, I asked for a urinalysis. I have a history of trace urine in the blood. There was no blood and I told them I thought it could be the statin. My doctor set up an urology appointment. I declined. I stopped taking the statin two weeks ago today. Pain in both arms is significantly diminished. I will probably give myself a month break and see how I feel, and then start back at a reduced rate. Maybe 20 mg twice a week. Hope this info helps.

maryselfe,

I am confused - it sounds like you and your doctors are not in agreement, and so you have chosen a different self treatment path?

Do you have a cardiologist?

No, we’re not in agreement. My primary doctor is a real no show. I do have a cardiologist and she does not seem alarmed. Everything else, blood pressure is good. But for you, a cardiac scan of the heart can be done without contrast, or dye.