Add my thanks to the ones you've already gotten. I didn't pay much attention to what my heart was doing till a couple of years ago, other than watching diet and exercise and monitoring cholesterol levels (including the various deltas and ratios among components).
Then I started having shortness of breath on mild exertion, like bicycling uphill. Passed the treadmill stress test with flying colors, calcium score was 1, but the echocardiogram showed backflow in the valves- ejection fraction was 65-70%. Not much they do at this point but monitor it and it was stable over 6 months between tests and the next one is in 12 months. My cardiologist is very positive about my continued exercise- he said, "Live your life but don't overdo it". I'm finally starting to calm down and I have a FitBit so I can look for changes in patterns, which have not occurred so far. I can see from your story that it's important to notice "quantum" changes and not chalk them up to old age.
And it's good to know that the calcium score does not mean my arteries are squeaky-clean.
By the way, my sister the doctor tells me that the LAD artery is known as The Widowmaker.
The good thing about this discussion is that people have shared stories from both ends of the scale. I had a very low CCT score and ended up having a big problem. Another person had a CCT over 1,000 and is alive and well. This doesn't mean a CCT is a waste of time. It just means it's not a definitive way to know whether you or I or someone else have a serious problem. If your results show a very low score can you go home and relax? No. If your score is sky high does this mean you should be making arrangements for your funeral? No. Do some people benefit from a CCT in some way? Hopefully yes. I can't imagine a zillion cardiac docs are having their patients pay out of their own pockets to have this test done and it's a total waste of time.
It's probably a good idea to pay attention to how you are doing when you're bike riding and how long it takes you to recover. This is the insight that I failed to take advantage of because I wasn't looking for it. If you're looking for it and you see your recovery time taking longer on a more frequent basis you might want to talk to your cardiac doc.
My experience is that cardiac docs don't tend to tell their patients how bad things could be. They seem to take the more middle ground approach, probably because most people don't want to hear the full range of possibile paths their future could take. For the most part this works out okay but for those who fall at the end of the bell curve they aren't aware of the range of possible outcomes and aren't looking for hints that could make a difference in their survival. I think this is where hearing about other people's experiences is a plus. Real world data is sometimes at the extreme but there's nothing that says your outcome won't be equally extreme.
Calling an obstructed LAD the "Widowmaker" has a nice cheerful ring to it. Since I never got married I guess I didn't qualify. Things worked out for the best!
One benefit of my situation is that I've looked at all the angiogram pictures and can confirm the doctor's conclusions that all the other arteries in my heart are perfectly clear. And since there are stents where the obstructions were located those regions won't cause any problems in the future. Newer stents are very good, much better than earlier stents. Better expansion design, better materials, better fatigue properties. With the addition of cholesterol lowering drugs chances are pretty good that I won't have another problem like this. I'll eventually die of something but obstructed heart arteries are pretty low on the list. (Hopefully.) How many people in my age group can say that and have solid data to back it up?
About a month ago I got a Fitbit Inspire 2 through Silver & Fit, which is a program my Medicare supplement insurance company includes as part of their insurance package. It was free so I figured "Why not?" I ordered one and 3 days later it was in my mailbox. I've been using it to track my heart rate throughout the day, especially on my hiking days. It's pretty neat. One limitation is that Fitbit doesn't give you a way to download the data so you can read it into Excel and look at it in more detail. I dug around and found a website that will do this. It works fine. One of the pluses in this is that you can collect this info over time and see how your heart rate is doing over months and years. If you take the same bike ride over a long period of time and monitor your heart rate every so often it would be easy to overlay them in Excel and see how you are doing. You could compare recovery times and things like that. If you see your recovery time increasing you have solid data to show your cardiac doc.
In the longer term a person could do this over a period of years and see how their cardiovascular system is holding up. Every so often you do the exact same exercise (bike, run, hike, swim, etc) and see how your heart is doing. Performance varies with ambient conditions so keep this in mind. This seems like something worth doing.
There are a lot of fitness trackers on the market. I don't take advantage of the social media support that Fitbit has but others probably get a lot of value from it. Polar is supposed to make really good heart rate trackers and they're not stupidly expensive. Apple watches are very good too. There's a lot of info on YouTube about this. Almost anyone can monitor their heart rate 24/7 if they want to.
I looked into the CT angiogram situation and found some good info about it. It looks like it's pretty good. Medicare has guidelines for the type of CT machine settings needed to get usable results so they are certainly aware of it. I imagine interpreting the results is where the uncertainty comes into play. These things aren't always obvious. I know an MD who interprets x-ray images (a radiologist?) and she said a lot of what she does involves intuition and experience to make the call on whether a problem is there or not. There was an earlier posting to a company that has software that does CT angiogram interpretation so this could help with things and get the cost down too. Unfortunately Medicare won't pay for a CT angiogram if you don't have any symptoms to justify it. I imagine a family history of heart attacks and premature deaths might be enough justification for your cardiac doc to authorize it, but that's just a guess. The benefit of a conventional angiogram is that it's pretty obvious if you have obstructed arteries or not. Unfortunately, any time they start poking around inside your heart with a long hollow wire there's a chance something bad could happen.
This is not easy stuff for most of us to wrap our brains around because it's still part art and part science. We'd like a clear and unambiguous answer of whether we have plaque in our arteries or not. In a lot of cases this is difficult to know until a problem arises and sometimes there isn't a happy end to the story. Three months after I had my cardiac episode on the hiking trail a woman was hiking the same trail with a friend and had cardiac arrest and died right then and there. She was 43 years old. Her friend came back a few weeks later and put some roses on the location where she died. I happened to see her and talked with her a while and heard more about what happened. The rose petals are long gone but the stems are still there. I pass them every time I hike that trail. It's a good reminder that bad things can happen when we least expect it.
Sometimes we're lucky, sometimes we're not.
