High calcium score: I'm in shock

74 years old, received CAC score 6 months ago 1,328. Using web, I entered numbers and found my coronary arteries are equivalent to a 92-year-old, and 10-year risk of heart event or stroke is 39%. Immediately went on very strict raw vegetables diet. This diet is very hard to maintain. I had to back off, adding only fish, but as time goes by, it’s only been 6 months, I cheat. Sugar free chocolates, KETO cookies, but these put pounds back. I am 5’6” and my weight went down from 160 to 134. Was on a low dose statin for decades, but primary care physician (PCP) immediately put me on Rosuvastatin 40mg and ordered Stress Test with Echocardiogram. This stress test produced a Duke Score saying my risk was "only" 10%, walls and muscles are fine, injection great. So high CAC Score, low Duke score. PCP said I was doing everything I could, so don't worry, eat well, exercise, end enjoy remaining life. Few months later, I had to see a cardiologist. First meeting was perfunctory BUT HE DID order LIPOPROTEIN FRACTIONATION MOBILITY, and carotid arteries intima thickness MRI, because, “There is correlation between plaque in carotid arteries and plaque in coronary arteries” whatever that means. This test showed plaque blockage in lowest 10% risk category. So now, 95% risk based on CAC and 10% risk based on other two tests. My LDL went from 50’s to 19 on Rosuvastatin 40mg. Now it’s 27. I read over 100 scholarly papers and started to beg for PCSK-9. Cardiologist said no because diet plus Rosuvastatin 40mg tested at an LDL of 19. Great, yes? Well, wait. The fractionation mobility test came back, with small, medium and large particle sizes and risk panel B - not good at all. Since the particle labs are absolute measurements, not the LDL-C which is calculated, my cardiologist now says my REAL LDL is 110 and I will be on the PCSK9 Inhibitor immediately to get my “real” LDL-P (particle) lower than 40. I will soon go on Zetia in 6 weeks after I have another fractionation mobility test done. I am willing to share any numbers about my chemistry if you ask. I am still alive, happier that I have a much better hold on my numbers. Risk is still 39%. I begged for an invasive cardiology and doc doesn’t want to do it because risk of shedding a clot is 1 in 1,000. He WILL do it if I beg for it. There is so much knowledge I have now, would like to refresh this thread and get it going again. Ask me questions, there is supplements, for one thing, to talk about.

Yep - I recall a dual PET/CT system being used in pancreatic cancer diagnosis - but, using it to assess calcium?

Recently had my second coronary calcium scan. It was in the mid 2200’s. Five years ago it was in mid 1800’s. I had a nuclear stress test after each coronary calcium scan. It show no significant abnormalities both times. The doctor said calcium buildup outside arteries. Confused!

Relax. Mine at 55 was 2,845. Plus I have the beginning of an aortic aneurysm. Countless tests later and I’m popping 40 mg of statins and we are wait and watch. Once a year I’ll go in for a test. So relax. Get your MRI echo and stress test. The key is how well your body and your heart is pumping blood. You can have arteries that are 95% blocked, but still ample floods flow gets through the opening that exists.

Normally, a regular stress test is combined with a echocardiogram (not electrocardiogram or EKG) - you lay on your side for a echo prior to the stress test, then after exercising on the treadmill (walking or running) in order to elevate your heart rate sufficiently, you immediately lay on your side, again, for another echo. These two combined constitute a stress test with echo. An echo by itself is not as useful in diagnosis of asymptomatic patients. Again, I am not a medical professional.

Many cardiologists do not think a CT works well as the calcium causes blooming on the imagery which makes it difficult to assess arterial conditions.

@mayoconnectuser1

You are correct about PET utilized to detect, monitor a cancer diagnosis, but PET technology (usually PET/CT) is used beyond that....Neurology, Cardiac etc. and yes they are expensive. Cardiac MRI is also making strides as well, definitely expensive. I have worked in this field for 20 years. IMO--a bit of overkill, but everyone is different.
https://link.springer.com/article/10.1007/s11883-023-01107-0#:~:text=Results%20showed%20PET%20to%20have,PET%20as%20a%20confirmatory%20test.

I'm getting confused ...

PET scans are to detect cancers and are very expensive.

Echos are ultrasound assessments before a stress test and immediately afterward and provide very detailed video and imagery of your heart operating normally and following stress. The imagery is quite good.