Cardiac CT Scan for Calcium

I had an appointment with my cardiologist yesterday. I'm scheduled for a nuclear stress test next Friday and a deep ultrasound look into my carotid artery the following week. He prescribed me 40mg of the generic for Lipitor to see how I do with that and will reevaluate in three months. I've lost 12 pounds since receiving my 1056 calcium score and hop to lose some more. I'm 47 pounds lighter than my all time high two years ago. I've dropped dairy, breads and pasta from my diet. I only eat lean means and veggies, preferably green, and some nuts and fruits. I feel pretty good so I think I can control this thing without anything invasive. My cardiologist told me one thing very interesting, the calcium scores, while highly accurate, show the cumulative build up in an artery and does not indicate any particular blockage. The plaque can be spread evenly through an artery or built up in one location, which is obviously more dangerous. Hopefully the nuclear stress test will reveal more. The carotid test is important since my father had two strokes by the time he was my age.
I'm glad I have all my affairs in orders, but hope they won't be needed any time soon.


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I heard Dr. Steven Nissen, head of the Cleveland Clinic's cardiology program on the radio yesterday. A caller asked him about a calcium scan and he suggested that a test for C-Reactive protein was a much better and less expensive test for the potential for heart attack or stroke. He said the test costs about $25 or less and was done with a simple blood draw. Next time I have a physical I think I'll ask the doc to try this.
 
I had the calcium scan five years ago and it was somewhat high. My doc didn't seem terribly worried, and he explained to me that the calcification is an cumulative lifetime thing. So my score could have shown something old, and I might be doing fine lately.

I had the C-RP test last year and it was right in the middle of the "average risk" range.
 
rdy2go said:
I heard Dr. Steven Nissen, head of the Cleveland Clinic's cardiology program on the radio yesterday. A caller asked him about a calcium scan and he suggested that a test for C-Reactive protein was a much better and less expensive test for the potential for heart attack or stroke. He said the test costs about $25 or less and was done with a simple blood draw. Next time I have a physical I think I'll ask the doc to try this.
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He's always been an opponent of the calcium score. Even after all these years of proving its effectiveness as a predictor of heart attack risk. I had the C-Reactive protein test a couple of months before my cardiac scan and was shown to be normal risk. I'm high risk with the calcium score 1056. I'm getting a nuclear stress test next week and a carotid test the following week. I've also change my diet significantly and lost a lot of weight. I'm not taking any chances.


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So today I had a nuclear stress test and just got a call from my cardiologist to tell me good news. Though I have a high calcium score, the calcium is apparently spread out thinly throughout the coronary arteries and I don't have anything other than mild plaque buildup. Diet and exercise should keep me going with a follow up calcium score next year to make sure growth is under control. Next week a carotid artery test.


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Dash man said:
So today I had a nuclear stress test and just got a call from my cardiologist to tell me good news. Though I have a high calcium score, the calcium is apparently spread out thinly throughout the coronary arteries and I don't have anything other than mild blockages. Diet and exercise should keep me going with a follow up calcium score next year to make sure growth is under control. Next week a carotid artery test.


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Congratulations to you - It is great news. I bet you are quite relieved. (I would be.)
 
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tmm99 said:
Congratulations to you - It is great news. I bet you are quite relieved. (I would be.)
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Thanks! I was very relieved as is my DW. I'm still going to continue to eat healthier and lose a few more pounds.


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Dash Man, please consider getting a non-invasive Coronary CT Angiogram (CTA). I am 48, in excellent shape, and have had yearly treadmill stress tests since 2012. Only issue was a high LDL of 170-190 that I spent a few years unsuccessfully trying to lower with diet, etc, even though I was already at an ideal athletic weight (6' 1", 180lbs). It's a genetic issue. On a whim, i had the same calcium heart scan performed in Dec 2014 and was shocked to recieve a score of 202, with 8 lesions in 3 coronary arteries. After my meltdown, my doctor put me on 10mg of Lipitor and throughout 2015 my LDL dropped to 80. In February 2016, I visited one of the top cardiologists on the West Coast, he reviewed the heart scan and strongly suggested I get a CTA so we can see the exact plaque buildup in each artery. I took the CTA at the end of Feb 2016 and was shocked yet again to find my calcium score went up to 303, but even worse was that one of the LAD artery lesions is a 50-69% blockage (the other 6 are scattered 1-24% blockages in the LAD, LCX and RCA). With that info, he put me on Crestor 40mg (the highest dose of the strongest statin) to get my LDL to below 50 as that rate has shown to halt the rapid increase in plaque in those with existing plaque burdens. I'm right around LDL 50 now and just had a stress test which was fine. So, your plaque may be scattered, but with your high calcium score I would want to know if I have any blockages of more than 50-70% that are not showing up on a stress test. My 50-69%'er would probably not have been discovered until it was too late.

The CTA was 2 hours of my time start to finish with the dye being the only uncomfortable part. This is not anywhere near the invasiveness of the standard angiogram.


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forza said:
Dash Man, please consider getting a non-invasive Coronary CT Angiogram (CTA). I am 48, in excellent shape, and have had yearly treadmill stress tests since 2012. Only issue was a high LDL of 170-190 that I spent a few years unsuccessfully trying to lower with diet, etc, even though I was already at an ideal athletic weight (6' 1", 180lbs). It's a genetic issue. On a whim, i had the same calcium heart scan performed in Dec 2014 and was shocked to recieve a score of 202, with 8 lesions in 3 coronary arteries. After my meltdown, my doctor put me on 10mg of Lipitor and throughout 2015 my LDL dropped to 80. In February 2016, I visited one of the top cardiologists on the West Coast, he reviewed the heart scan and strongly suggested I get a CTA so we can see the exact plaque buildup in each artery. I took the CTA at the end of Feb 2016 and was shocked yet again to find my calcium score went up to 303, but even worse was that one of the LAD artery lesions is a 50-69% blockage (the other 6 are scattered 1-24% blockages in the LAD, LCX and RCA). With that info, he put me on Crestor 40mg (the highest dose of the strongest statin) to get my LDL to below 50 as that rate has shown to halt the rapid increase in plaque in those with existing plaque burdens. I'm right around LDL 50 now and just had a stress test which was fine. So, your plaque may be scattered, but with your high calcium score I would want to know if I have any blockages of more than 50-70% that are not showing up on a stress test. My 50-69%'er would probably not have been discovered until it was too late.

The CTA was 2 hours of my time start to finish with the dye being the only uncomfortable part. This is not anywhere near the invasiveness of the standard angiogram.


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Thanks!
I see my cardiologist for a follow up in August and will bring this up. Was this covered by your insurance or did you pay out of pocket? Do you know the cost?



Enjoying life!
 
I had to pay $800 out of pocket as insurance did not cover the test...it was performed at Cedars Sinai hospital in Los Angeles.


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The best thing about the test is that I no longer have to guess about which arteries are clogged and the amount of plaque. I know exactly where the trouble spots are and my cardiologist can retest in a couple of years to see if those spots got worse or stabilized. I'm obviously concerned about the bad 50-69% lesion, but I'm glad I know it exists and can plan treatment and lifestyle choices in light of this info. Maybe I don't need to run firecalc out until I'm 100 years old given the genetic issues...


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forza said:
The best thing about the test is that I no longer have to guess about which arteries are clogged and the amount of plaque. I know exactly where the trouble spots are and my cardiologist can retest in a couple of years to see if those spots got worse or stabilized. I'm obviously concerned about the bad 50-69% lesion, but I'm glad I know it exists and can plan treatment and lifestyle choices in light of this info. Maybe I don't need to run firecalc out until I'm 100 years old given the genetic issues...


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Click to expand...


I've already made significant lifestyle changes based on my calcium score. Haven't eaten any processed or fatty food since the test and have lost 25 lbs, and 50 lbs from what I was a few years ago. I miss sweets and pasta, but have adjusted. I get more exercise too. My primary care doctor doesn't want me to lose more than 5 more pounds.
The $800 isn't bad, so I'll have to investigate the cost here in PA. My calcium CT was only $129.


Enjoying life!
 
So four months since my lifestyle change I now weigh 163, down from 195 in March, and my recent blood work shows a big improvement. My LDL is 38, HDL 65 and triglycerides 60. Those numbers have never been so good!


Enjoying life!
 
Dash man said:
So four months since my lifestyle change I now weigh 163, down from 195 in March, and my recent blood work shows a big improvement. My LDL is 38, HDL 65 and triglycerides 60. Those numbers have never been so good!
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Congratulations! What do you eat now that you didn't eat before?
 
It's more about what I don't eat anymore. I avoid processed foods, pasta, breads, sugar (except in fruits), any sweets or fatty meats (except certain fish like salmon). I do eat lean meats, lots of fruits, nuts, beans and veggies. I also control the portions of the meat limiting it to 4-6 ounces maximum. I only drink water, wine and scotch 😊 (got to have one bad thing on my list).


Enjoying life!
 
Moemg said:
I would definetely get one . My Brother died of heart disease in his early 50's and my sister who is thin,exercises daily & eats right just had a heart attack.
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Sorry about your brother. Too young.

I had a stress echo for similar screening (my brother died of sudden death, had massive coronary disease). You may wish to compare the two (Calcium scan v. Stress echo). I think the latter gives better quality information (odds ratios) than the CT calcium.

My stress echo was normal and gave additional information about valve anatomy and chamber functions. Either would provide useful information, assuming that risk factors are otherwise normal (i.e. no other known heart disease, diabetes, coronary symptoms, etc.)
 
Dash man,

Those are extremely good lipid #'s for having the best shot at stopping the plaque from escalating (LDL 38!). I've been on the highest dose 40mg of Crestor for a few months without side effects and I'm at LDL 59, HDL 63, Trig 40. 6' - 175lbs right now. My cardiologist is satisfied that these #'s may slow down my plaque progression...we'll see.



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audreyh1 said:
LDL 38 - lord almighty, are you on statins?!?

Cholesterol: Can It Be Too Low?
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Since I am T2, my PCP insists that my LDL be below 70. At my last blood test it was 64, triglycerides 73, but unfortunately the statin I am on also drives my HDL down to 33, although I have always struggled with low HDL despite exercising a lot.

This very low LDL bogey always concerned me, as it was my understanding your body needs cholesterol to maintain good hormone levels.
 
DFW_M5 said:
Since I am T2, my PCP insists that my LDL be below 70. At my last blood test it was 64, triglycerides 73, but unfortunately the statin I am on also drives my HDL down to 33, although I have always struggled with low HDL despite exercising a lot.



This very low LDL bogey always concerned me, as it was my understanding your body needs cholesterol to maintain good hormone levels.
Click to expand...


I've always suffered with low HDL. I have no idea why it is 65 now. My previous lifetime high was 45 while in the military. I do some exercise now, but not that much. My triglycerides at 60 are the best they've ever been. I believe dietary change helped that, but I do miss pasta, cheese, bread and ice cream.


Enjoying life!
 
forza said:
My cardiologist is satisfied that these #'s may slow down my plaque progression...we'll see.

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I'm hoping the same. The typical cardiac calcium score increases 30% per year without treatment. I'll get another calcium score next spring to see if my changes make a difference. In slowing things down.


Enjoying life!
 
Dash man said:
I've always suffered with low HDL. I have no idea why it is 65 now. My previous lifetime high was 45 while in the military. I do some exercise now, but not that much. My triglycerides at 60 are the best they've ever been. I believe dietary change helped that, but I do miss pasta, cheese, bread and ice cream.


Enjoying life!
Click to expand...

You've done a remarkable job with your dietary changes. I need to do much better in that area, but I still love cheese, snacking on popcorn and an occasional couple of DWs oatmeal cookies.

My last calcium score was about as good as it gets and the stress echo was also very good. As Rich pointed out, I also thought the stress echo may be more more revealing of cardio vascular health than the calcium score.
 
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