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super high coronary calcium score
I’m an active 79 yr old man with various heart ailments. Been feeling a shortness of breath for what feels like minor exertion, so I had a coronary CT scan done last week. My CAC number is 6195 which is freaking me out.
RCA is 3882 with less than 40% stenosis.
LAD is 2111 with less than 25% stenosis.
I’ve been on warfarin for past 20yrs due to aortic dissection surgery with aortic mechanical valve replacement. Read that warfarin can cause excessive aortic calcium but I’ve been told there is no alternative to warfarin.
Have pending follow-up with cardiologist. Looking for any suggestions or recommendations from anyone who has been through this.
Additionally, I had an echo a few months ago. EF is between 50-55%. Left atrium is severely dilated (6.07cm). Due to AV blocks, a pacemaker was installed about 3 yrs. ago. Also taking 200mg of amiodarone and started 5mg of rosuvastatin at beginning of year.
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Atrial enlargement is usually due to hypertension, often due to mitral valve prolapse or due to atrial fibrillation.
https://my.clevelandclinic.org/health/diseases/23967-left-atrial-enlargement One of the problems with pacemakers if they don't 'pace' properly is that they cause atrial enlargement, but can also cause ventricular enlargement.
Even so, your ejection fraction is decent enough for a man with your cardiac history. The calcium scores can be scary, but they're only part of the picture. You actually want some calcification of plaque because that tends to stabilize it and prevent it from getting dislodged and moving further down stream where it can get lodged and cause an embolic event/stroke. But the score is high, and you should probably be thinking seriously of some kind of therapy. Again, though, your assessed degree of occlusion or stenosis is moderate, and while it bears consideration and monitoring, your advanced age suggests that you are probably in the 'average' range of all calcification for your age (average meaning all people falling below a standard normal distribution curve inside of a standard deviation on either side of the mean). You should receive, or have received, all sorts of medical advice from a cardiologist or an internist.
gloaming:
thank you for this information. I do take blood pressure medication so pressure is ok and my pacemaker would report any afib event so i'm good with that so far.
Echo did show my right ventricular is moderately dilated and my mitral valve has mild regurgitation. Is that the same as prolapse?
Can you elaborate on kind of therapy i should be discussing with my dr.?
thanks again for your respose.
robmtk
https://www.mayoclinic.org/diseases-conditions/mitral-valve-regurgitation/symptoms-causes/syc-20350178
Prolapse can lead to regurgitation. Prolapse is basically a longitudinal displacement of the valve because of diseased supporting structure. https://www.webmd.com/heart/mitral-valve-prolapse-symptoms-causes-and-treatment.
I can't advise on therapy or treatment for high calcium score, although you may well have to take a statin, or more of it if you are already taking it. Oddly, statins increase calcification of plaque, and that's a good thing....you want that! It helps to stabilize it and to keep if from drifting further down the pipe where it can cause blockages. However, the statin, as you probably know, reduce the liver's production of low density lipids, meaning there's less stuff to calcify if it doesn't ever get deposited where you don't want it.