High CAC Score and Current Status

Hello @mayoconnectuser1 and welcome to Mayo Clinic Connect. Your results simply don't seem to align with the way you are feeling, which is interesting!

I would like to bring in other members who have shared about high CAC scores in another discussion made up of women. Those members are @anniehall56 @degarden_girl @feelingthankful @crankyyankee and @joe22. Here is the discussion in case it is of interest to you to read through: https://connect.mayoclinic.org/discussion/andy-women-with-high-cac-scores/

What did your cardiologist recommend for follow up, if any?

Hi, Amanda,

Cardiologist said he would consider another stress test in a few years, but thought another CAC test unnecessary since they are so accurate. (sure, my results could have gotten mixed up with another, but this too, is very unlikely)

He did not believe angiography was appropriate given my health, stress test results and blood work.

Hi, I'm a 65 year old male and recently got a CAC score of 1595. I also passed a nuclear stress test with no indication of blockages over 70% or any other for that matter and I had a decent Echo. I have no symptoms and exercise daily with no pain or shortness of breath. My cardio said the only way to know for sure how bad any blockages may be is to do a catherization to go in and look. Here is my thinking. A nuclear stress test will supposedly show any blockage over 70%. You can't stent any blockages unless they are 70%. So why take the risk of a heart catherization? My cardio doubled my liptor to 40 MG and added a beta blocker to my blood pressure meds. I also started a plant based diet. He wants my LDL down to 50. Anyone else dealing with same issues? Hoping I'm going about this correctly.

@cedgar- My Calcium score is mildly elevated, but I do have calcification of the LAD artery. I don’t have symptoms- also taking statins and zetia and numbers are good.
I think you’ll do well on your medical treatment.
I would never do a cardiac cath unless it’s indicated.
My husband had a cardiac cath in his late 40s due to symptoms. During the procedure he went into cardiac arrest, but was brought back without problems. He did not need stenting then.
Cardiac arrest is something that can happen and is mentioned when you sign consent.
Have you had carotid artery ultrasound? Also tells of calcification.

Thanks for the advice on the carotid artery ultrasound. I'll ask the cardio about it. There should be other noninvasive ways to test arteries other then a cath. They told me they couldn't do a CT angiogram because the contrast and the calcium both show up white and I had too much calcium to do the test.

Hey @cedgar and welcome. Along with Ingegerd, I wanted you to be able to connect with other members like @mayoconnectuser1 so I move your post here:
High CAC Score and Current Status
https://connect.mayoclinic.org/discussion/high-cac-score-and-current-status/?pg=1#comment-727339
There is also a well established discussion here that you might like to check out: Extremely high calcium score at 42 - is there any positive here??: https://connect.mayoclinic.org/discussion/extremely-high-calcium-score-at-42-is-there-any-positive-here/

How long has this been going on?

I got a high CAC score 4 years ago at age 70. Got an exercise stress test with echocardiogram. Normal results. I had trouble finding a statin that didn't give me muscle pain, but finally settled on low-dose rosuvastatin. The cardiologist recommended that I follow the American Heart Association guidelines (The "Simple Seven"), which I have for the past 4 years. Doc said if I didn't have any symptoms, for example, shortness of breath or angina, I didn't need to see a cardiologist I've been doing fine and feel good due to healthy heart habits.

Greetings to all you Very High Calcium Score folks. I am 76 years old and still gainfully employed as a physician though not of course a Cardiologist. I recently had a scan that showed a CAC score of 1029 and have an appointment with a Cardiologist in a week to decide what to do. I am "asymptomatic" but a recent EKG showed a Left Bundle Branch Block. It had always been normal sinus rhythm before and led to the calcium scan. I was surprised when it was very high because I have been on statins for 20+ years (5mg of atorvastatin takes me from 240 to 90 with an LDL of 60 but an HDL of only 35 which is probably the problem) My blood pressure has been 120/70 or lower whenever tested at Doctors office. I don't smoke, don't drink but I have been obese ( recently went from 270 to 228)
What to do? Here is my analysis There is no value to repeating a high score CAC because it will only get worse over time. A younger person with a score of 0 but symptoms or a strong family history probably deserves a rescan but intermediate >100. maybe but probably not.
Now the question I ask my cardiologist is WTF do we do now? Will she say "lets do coronary angiography"? Should I add an ARB to my antihypertensives which are already working? Should I increase the intensity of lowering my LDL which is already below 70 and I am not Diabetic. There is no way to raise HDL Stay tuned for Chapter 2

I got a high CAC score this summer -- 397 at the age of 42, also "asymptomatic" and with nothing in my lipid profile or immediate family history to suggest this might be an issue. Fwiw, the next step for me was a CT-angiogram -- quick, non-invasive and gives a pretty clear picture of what you're dealing with. If you do that, I would also suggest looking into having the Cleerly test done; basically, you just have the CT-angiogram sent to them (your doc may need to sign off) and they run in through their AI system to literally create a picture of each coronary artery -- quantifying not just the volume of plaque in each, but the type (calcified/non-calcified/low density non-calcified), along with measuring remodeling and stenosis.

It might be valuable information for you, both as a baseline going forward and to see if -- hopefully -- a lot of what you have has been there a while and is calcified (and therefore more stable and less likely to rupture).

neirbookeik1, you say "there is no way to raise HDL", but my experience is to the contrary. I'm a long time statin user whose HDL was in the 40s for 25 years. In 2019, I adopted a low carb diet and my HDL has consistently been in the mid-to-high 70's. No added drugs, just lifestyle changes. My understanding is that HDL increases with fat consumption.
My CAC is 1100+, so I have some idea of what you might be feeling.
Good luck.