Hi Dash man - first of all, don't panic. This is not a death sentence, nor a guarantee that you're headed for a bypass or a heart attack, but your risk is higher than most your age, so it definitely deserves attention. Panicing will cause other reactions in your body that will make this worse, not better. In my opinion, ignorance is not bliss, and therefore I feel it is GOOD that you found out about your elevated score, because now you have an opportunity to change things because you know about them. Your first goal here is to reduce the rate of growth of your plaque. From there, we try to stabilize it - stable plaque is much less prone to rupture than soft, pliable, "dynamic" plaque. Completely stabilized plaque is almost as good as no plaque, but some (not many) are actually able to regress that plaque and lower their score that way.
First, what I've learned not to do, and let me preface that I am not a doctor and am not giving medical advice - just sharing my experience. If you're asymptomatic, i.e., no chest pain, shortness of breath, etc., I would NOT get any invasive test like a coronary catheterization - the risk is not warranted. I would NOT get a Thallium or any other kind of nuclear stress test - the huge radiation dose is not warranted. These are tests a doctor or cardiologist might recommend for you and you could end up with an unnecessary stent - don't get me wrong, stents can be life-saving, but are not indicated if you have no symptoms. Again, my (and many "preventive" cardiologists') opinion. The only stress test I might agree to is a non-invasive, echocardiogram.
What TO DO: You need to figure out the cause of your plaque so that a strategy can be devised (and there are many) to attack it. This involves some advanced bloodwork - specifically advanced lipoprotein analysis. Your doctor may or may not be willing to order these tests. The good news is there are plenty of doctors out there who will, and better news is you can order them by yourself without a doctor at all. When I started my journey in this area six years ago, I had to find a new doctor. The guy I had seen for 20 years, and who I personally liked very much, did not know what to do with my elevated CAC score, and his answer was "statin and monitor". That is not necessarily a good strategy and for me would have yielded disastrous results.
So Dash man, the choice is yours - you can be proactive and self-empowered, and begin to focus on a lot of things yourself, but I will tell you that it takes some work and takes some time. Some folks just don't want to invest that way and prefer to relegate their healthcare to their local doctor. It's all a choice man - and I totally respect everyone's right to choose!
I can help point you to names of specific tests, etc. that you could ask your doctor about. Could also point you to many other resources - just kinda trying to gauge your interest in how you want to tackle this.
But please, don't panic!
Pete
