Extremely high coronary artery calcium (CAC) score. Anyone else?

[LeeH]

Sigh... my cholesterol has been creeping up over the past few years. Discussed this with a new doctor who was on board with the idea of me getting a coronary artery calcium test done to show that, despite the elevated cholesterol numbers, my heart was healthy and I don't need a prescription for a statin drug.

That didn't work out so well. A very high score on this test is 400. Mine was 1441!

This means I have dangerous levels of plaque build up in the arteries around my heart. My dad had two heart attacks and bypass surgery in his mid-50s, and I had a brother pass away from a heart attack in his 40s, so I guess things could be worse.

Anyone here had this test done and score a crazy high number? I have an appointment with a cardiologist on Thursday. Wondering what to expect... besides a high dose statin.

[CarreraDan]

Don't panic yet. As someone who works in a cath lab and looks at coronary arteries all day the calcium CT scans can be highly inaccurate. If the plaque is in the wall of the artery and not concentric (all around the opening) blood flow isn't necessarily obstructed. I have seen many cases where the Calcium score is very high and the patient doesn't have blockages that we need to stent or bypass. On the other hand, I have seen low CT scores that we send straight to bypass surgery. Stress tests, MRI's, coronary CT's and Echocardiograms are all tools to help us look at overall heart health. A cardiac cath is the only truly accurate test that actually tells us how the blood is flowing in the coronary arteries. One of our doc's says "the dye doesn't lie".

I would expect to be scheduled for an outpatient cath with your family history. They will most likely go through your wrist and you will go home the same day. It truly isn't bad and we do 25-40 per day in our cath lab. Make sure the doc doing the cath can stent any blockages, not all cardiologist are interventionist, not all cath labs do stenting, some are just diagnostic. Any questions feel free to reach out, again don't panic yet.

[porsche tech]

I did not have that test but was having an occasional “tightness” feeling in the center of my chest that lasted a couple of minutes every so often. I kept thinking it might be indigestion but one of the guys I play golf with who is a cardiologist said, “no, get a stress test”. So my wife made an appointment with my dr for me to talk about a stress test. First thing he did was an EKG and came in the room and said, “you’re gonna hate me. According to this you’re having a heart attack right now.” He was consulting with a cardiologist at the hospital and they sent me by ambulance to the hospital.



First ambulance ride I ever had (I’m 76). This was back in January. Bear in mind I feel fine the entire time, I’m just at a routine dr appointment. Hospital did several other tests and the next morning put a catheter up my arm and installed 3 stents in one of my arteries. Walked out of there that afternoon, went to my buddy’s wife’s birthday party that night and played golf the following Saturday (the stent deal was Tuesday morning). Haven’t felt that “tightness” since.

Bottom line, get it checked out ASAP! I feel like my golf buddy and primary care guy headed off a catastrophic failure. I wish you good fortune with your situation.

[porsche tech]

CarreraDan posted while I was typing my story…what he said!

[masraum]

Originally Posted by porsche tech

I did not have that test but was having an occasional “tightness” feeling in the center of my chest that lasted a couple of minutes every so often. I kept thinking it might be indigestion but one of the guys I play golf with who is a cardiologist said, “no, get a stress test”. So my wife made an appointment with my dr for me to talk about a stress test. First thing he did was an EKG and came in the room and said, “you’re gonna hate me. According to this you’re having a heart attack right now.” He was consulting with a cardiologist at the hospital and they sent me by ambulance to the hospital.



First ambulance ride I ever had (I’m 76). This was back in January. Bear in mind I feel fine the entire time, I’m just at a routine dr appointment. Hospital did several other tests and the next morning put a catheter up my arm and installed 3 stents in one of my arteries. Walked out of there that afternoon, went to my buddy’s wife’s birthday party that night and played golf the following Saturday (the stent deal was Tuesday morning). Haven’t felt that “tightness” since.

Bottom line, get it checked out ASAP! I feel like my golf buddy and primary care guy headed off a catastrophic failure. I wish you good fortune with your situation.

Wow! Glad you've got a cardiac buddy and you took his advice!

Scary sheiße!

[MBAtarga]

After my annual physical - the Dr told me the imaging center next door does scans for $99. I had no symptoms - was mostly curious and decided to have it done as a precaution since it was so inexpensive. I walked over and 20 minutes was done. My score came back at 0.

[LeeH]

Originally Posted by MBAtarga

After my annual physical - the Dr told me the imaging center next door does scans for $99. I had no symptoms - was mostly curious and decided to have it done as a precaution since it was so inexpensive. I walked over and 20 minutes was done. My score came back at 0.

That's awesome! That's a really good sign you're not likely to have any heart issues any time soon. I really expected mine to be zero or close to it. I'm active, fit, hike a lot, have great blood pressure, etc. But apparently, high CAC in older athletic types is a thing. However, no studies have been done with that group as a focus. If I read the numbers correctly, my 10 year risk of a cardiovascular event is 1:4. If I take the statin and artificially lower my cholesterol, it becomes 1:5.

[LeeH]

Originally Posted by CarreraDan

I would expect to be scheduled for an outpatient cath with your family history. They will most likely go through your wrist and you will go home the same day. It truly isn't bad and we do 25-40 per day in our cath lab. Make sure the doc doing the cath can stent any blockages, not all cardiologist are interventionist, not all cath labs do stenting, some are just diagnostic. Any questions feel free to reach out, again don't panic yet.

The cardiologist I'm seeing is an interventional cardiologist and also the director of a cath lab at a local hospital. Per one of his online write ups, "...skills in cardiac catheterization, coronary angioplasty and stents, peripheral vascular treatments and pacemaker implantation."

[Bugsinrugs]

Anyone heard of the company Telestream? My friend and co founder dropped dead yesterday while jogging. He had a four way bypass 7-8 years ago and was trying to eat right and exercise. Quite a shock.

[Scott Douglas]

Wow, sorry to hear that Bugs.

[Bugsinrugs]

Originally Posted by Scott Douglas

Wow, sorry to hear that Bugs.

He was in his early sixties. Just a really nice guy.

[Mahler9th]

Some good perspective here.

Brings back memories, and the world is small...

I contributed to a new GE cath lab system in the late 70's as an engineering summer student. Also to GE's second whole body CT product.

On the biz side many moons later... I was in a parking lot at a PCA AX and asked a fellow member what type of engineering work he did. He said "systems engineering."

Very rare to hear that in the Silicon Valley area.

I asked "what kind of systems?" He said "a new type of digital x-ray system-- in a start-up."

I asked "what kind of digital x-ray system?"

He said "a new type of cath lab."

That was in 2004, and two weeks later I was working for his startup as a biz consultant.

The CEO drove a 3.2 car with a whale tail.

My PCA friend had two RSA's.

I had a 993 cab.

I had heard of this start up way back in the 90's as my CEO was on their board. They ran out of money and were reborn in 2000.

In 2004, flat panel tech had hit cath labs. GE's flat panel was developed in conjunction with Corporate R&D, and the head of CR&D had worked at GE's medical biz. An old friend/mentor that I carpooled with when I was a summer engineering student.

Anyway, the second iteration of that company ran out of money in 2005. They had tried for investment from GE and Siemens and failed. I knew members of the diligence teams from both of those companies.

After that company ran out of money, key engineers formed a high-end R&D consulting company. I helped a young friend get a job in that company about five years later. I also helped that young friend with his entry into the world of Porsches. I even found his second p-car on a PCA region web site.

He eventually co-founded a corporate VC subsidiary.

Anyway, the world is small and we are all connected. I hope the OP's medical care is top notch and prognosis is excellent.

Medical imaging has come a long way!

[Jolly Amaranto]

About 12 years ago I had an extensive "wellness" checkup paid for by my wife's company. It included a calcium scan. The results showed a calcium buildup in my heart. I had been seeing a cardiologist already for a few year, because of my family history, so asked him if it was something I should be concerned about. He said he was not worried about it but decided to run a nuclear stress test. That showed reduced oxygen uptake in my lower heart wall. He then scheduled a catheter scan. Major blockages in my aorta (widow maker) and other places. Him, "I believe you need bypass surgery." Me, "Okay, when?" Him, "We can do it at 7:00 am tomorrow." I had no symptoms and was riding my bike about 20 miles a day. I suppose I could have just keeled over at any time.

[stomachmonkey]

Was going back and forth with my GP on the Statins. Hated the damn things. Wrecked me.

He said if I do the Calcium score and get lower than 10 he'd stop breaking my balls, was like a 9.

Reminds me, need to get another, it's been 7 years.

[LWJ]

Mine is pretty darn awful.

I have the attention of a specialist. You never know.

[NY65912]

I asked my cardio doc just last week if he thought a CAC was in order. My current LDL is 142. On Crestor no side effects.

In June of '21 I had a stress test while in the hospital for Crohn's because they saw PVCs. I've had them all my life. But since I was in the hospital I said why not. They then wanted to do an angiogram to determine any blockages, tried to go thru the arm but the wire would not bend in my shoulder so in thru the thigh. Angio showed clean. Doc said 20 yo arteries for a 65 yo, not too shabby, but now they wanted to do an ablation for the PVS. I drew the line there. My regular cardio doc said no way.

I did an echo EKG and another stress test this past January. All was good beat my goal.

So when I asked the doc he said no reason for me to get a CAC, nothing note worthy.

He explained that it not a definitive test but can be useful for certain higher risk patients.

Best of Luck to all

[Chocaholic]

Not sure I understand the objection to taking a statin. Seems a lot of potential life threatening grief could be minimized. I’ve been on Crestor 10mg for years with no side effects at all. Lipid panels are consistently excellent. I’m not alone.

Some experience muscle aches as I did on Lipitor, but the switch to Crestor solved that problem. Seems far more convenient that catheterization and stent placements.

[stomachmonkey]

Originally Posted by Chocaholic

Not sure I understand the objection to taking a statin. Seems a lot of potential life threatening grief could be minimized. I’ve been on Crestor 10mg for years with no side effects at all. Lipid panels are consistently excellent. I’m not alone.

Some experience muscle aches as I did on Lipitor, but the switch to Crestor solved that problem. Seems far more convenient that catheterization and stent placements.

Some of us don't tolerate them well, at all.

I had the full monty, fatigue, muscle aches, tendons shrinking, bloating, gastro issues, not really headaches but constant pressure like my head was in a vice.

After the big pharma stuff I even tried Red Yeast Rice, figured maybe natural would be better.

Nope, same thing.

[LeeH]

I was just going through my old medical records to get ready for my appointment with the cardiologist tomorrow. I ran across something that has me really pissed off. 5 years ago I had an abdominal CT done because I was having an odd cramping that could not be explained. The CT report says there is atherosclerosis! The doc (PA) actually says, "... there is nothing that needs to be done about the plaque formation." Isn't it a bit odd that a CT in a 54 year old (at the time) shows plaque and the advice is to do nothing??? I didn't question this at the time, but I've spent the past few weeks learning about heart disease and can't believe that this was in his write up!

[bivenator]

Originally Posted by CarreraDan

Don't panic yet. As someone who works in a cath lab and looks at coronary arteries all day the calcium CT scans can be highly inaccurate. If the plaque is in the wall of the artery and not concentric (all around the opening) blood flow isn't necessarily obstructed. I have seen many cases where the Calcium score is very high and the patient doesn't have blockages that we need to stent or bypass. On the other hand, I have seen low CT scores that we send straight to bypass surgery. Stress tests, MRI's, coronary CT's and Echocardiograms are all tools to help us look at overall heart health. A cardiac cath is the only truly accurate test that actually tells us how the blood is flowing in the coronary arteries. One of our doc's says "the dye doesn't lie".

I would expect to be scheduled for an outpatient cath with your family history. They will most likely go through your wrist and you will go home the same day. It truly isn't bad and we do 25-40 per day in our cath lab. Make sure the doc doing the cath can stent any blockages, not all cardiologist are interventionist, not all cath labs do stenting, some are just diagnostic. Any questions feel free to reach out, again don't panic yet.

Excellent information. As stated the elevated Calcium score isn't the most reliable. When they first came out some of the cardiologists were hesitant to order because of the unreliability of the test to predict heart disease.