[bivenator]

A calcium score test will only indicate whether there is calcification of the arteries. Calcification is often a good indicator of heart disease, however soft plaque which builds up inside the artery is not detectable because it is not calcified. A calcium score test with a low number is not always a clean bill of health.

A heart cath is the gold standard for detecting blockages with a nuclear stress test being the second most accurate. Accuracy for the nuclear stress test is 90+% for blockages 65% and greater.

A treadmill stress test is helpful in a situation like vash's where the risk factors for heart disease are low. Peace of mind.

I work in the nuclear stress testing business operating labs for two different cardiology groups.

My own experience in the value of stress testing. My neighbor and I were working in our yards during the heat of the summer last July. I finished my work, waved at him as I went inside. He went inside shortly after, told his wife he wasn't feeling well. After showering he told his wife to drive him to the hospital and died before he made it through the ER doors. I think about him every day.
Fast forward 3 months and I tell the doc I work for that I haven't been feeling right. He puts me on the treadmill. Chest discomfort and EKG changes earn me a trip to the cath lab. I had two 99% blockages, 3 stents later I feel pretty good.
I have mostly eliminated red meat, fast foods and dropped 25lbs with an exercise regimen.

If you choose to forgo testing in order to assess heart disease then please be aware of what your body is telling you. One of the most common complaints by my patients is fatigue, "I used to be able to mow the yard without stopping but can't now." Short of breath with minimal exertion also is a clue. The most reliable predictor IMHO is family history. If your mother/father or siblings have heart disease then you are a candidate as well.

I miss David, he was a NASA engineer, father of 4. I drove his daughter to the 8th grade dance the other day. I must have gotten something in my eye when I dropped her off.

Listen to your body.