High CAC Score and Current Status

Posted by mayoconnectuser1 @mayoconnectuser1, May 21 1:30pm

Hi All,

I am now 68, have slightly elevated BP that has been controlled with Telemisartan/irbesartan (20mg/d) for 20+ years. I am 10-15 pounds overweight and am very active, but do not “work out” – lots of walking and maintenance on rental houses. I have had both hips replaced. Father died from lung cancer at 50 yo (3 pack a day and risky work – boat paint, propellor grinding), mother died from infection at 87 yo. Sibling early diagnosis of pancreatic cancer at 64 yo – good chance of long life due to early diagnosis and quick action.

In Sep 2019, given the low cost (no health related reason), I had a CAC (coronary calcium) test – a few days later I left on a two week vacation to Europe. Got back home to find a letter from my doctor, indicating the CAC test was “abnormal” – like 1340! At this time: Triglycerides 120-140, total Cholesterol 120-150, HDL 40-46, LDL 60-110. Never any medical issues other than hips and somewhat elevated BP.

I immediately reviewed options, met with cardiologist and started atorvastatin and Vascepa (have also taken 81 mg aspirin for the last 20 years). Did walking treadmill stress test within a couple of weeks. "Bruce protocol, normal sinus rhythm at rest, 9 minutes, no shortness of breath (legs got tired on the elevated portion), METS 10.3, peak heart rate 159, peak blood pressure 195/90, no ST-not T changes diagnostic for ischemia, occasional PVC. Conclusions: 1. Negative treadmill stress for inducible ischemia to achieve workload, 2. Achieved 10.3 METS. Placing patient good for functional capacity for age, 3. Duke treadmill score of 9. Placing patient at a low 5-year cardiovascular mortality risk."

No one recommended a re-test for CAC. Cardiologist indicated they are rarely inaccurate.

Next series of blood work – note massive decrease in triglycerides
Jun 2020 – Triglycerides 56, total Cholesterol 115, HDL 48, LDL 47
Feb 2021 – Triglycerides 60, total Cholesterol 121, HDL 46, LDL 53
Aug 2021 – Triglycerides 27, total Cholesterol 99, HDL 46, LDL 39
Mar 2022 – Triglycerides 49, total Cholesterol 106, HDL 46, LDL 47

Fast forward to today – very active, just returned from a month long tour of Portugal and Germany where we averaged 8-10 miles a day walking, rolling luggage in and out of airports, trains, and cars. Walk and work on something daily – do not watch sports – ie not a couch potato. I still feel great – and have felt great for decades.

Thoughts? Another CAC test? Another stress test?

Thanks to All!

Interested in more discussions like this? Go to the Heart & Blood Health group.

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?

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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.

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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.

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@cedgar

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.

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@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.

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@cedgar

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.

Jump to this post

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.

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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?

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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.

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