Coronary Calcium Score

Calcium is a chemical element that is essential for living organisms.

Most of the calcium within the human body is found in teeth and bone. A small amount, about one percent of total body calcium, is dissolved in the blood.

Undissolved calcium is metallic and hard and is difficult to break or cut with a knife.

Coronary Calcium Score

When we age, calcium deposits can be found in many parts of our bodies. Calcification of the walls of the arteries is common in people aged 65 and older. Calcification of the breasts is often seen in women after the age of 50.

So, to some degree calcification of arteries and internal organs can be regarded as a normal part of aging.

Due to their metallic nature and density, calcium deposits are easily detected by X-ray images. In the early days of cardiac imaging, doctors relied on detecting calcium, as it often was the only feature that stood out on radiographs of the heart.

If arterial calcification is abundant, the aorta and coronary arteries can be outlined on a plain radiographic image. Today these methods have been replaced by more sophisticated modern imaging techniques.


Coronary Artery Disease

The coronary arteries are important vessels that supply blood to the heart muscle. To be able to function normally, heart muscle cells need a continuous supply of blood, delivering vital nutrients of which oxygen is most valuable.

Atherosclerosis is a chronic inflammatory condition that may cause narrowing of arteries, and rupture of arterial plaques, resulting in blood clotting (thrombosis) and sudden disruption of blood flow. Due to several different reasons, the coronary arteries are very prone to atherosclerosis

If the supply of blood is disrupted, parts of the heart muscle may die and will be replaced by scar tissue. This can compromise the ability of the heart to pump blood to the organs of the body.

The term acute heart attack (myocardial infarction) refers to a situation where there is a sudden blockage (occlusion) of blood flow in a coronary artery.

In the early 1960’s several risk factors for atherosclerosis and coronary artery disease were defined. Since then it has repeatedly been documented that smoking, lipid disorders, and high blood pressure are associated with increased risk. Other conditions that predispose to coronary artery disease are family history, insulin resistance, physical inactivity, mental stress and depression.

Identifying individuals at risk is a major step to reduce the risk of coronary artery disease. Therefore, knowledge of risk factors and how to reduce their influence is of crucial importance. The declining death rate from coronary disease seen for the last 35 years can to a large extent be explained by reductions in major risk factors such as blood cholesterol, blood pressure, and smoking (1).

Atherosclerotic coronary heart disease is still the most common cause of death in the Western world. Thus far, our ability to screen for this disease has been limited.

Although the usefulness of screening is still debated, assessing the amount of calcium within the walls of the coronary arteries may provide valuable prognostic information.

advertisement

Coronary Artery Calcification

Although calcification of the coronary arteries can be regarded as an aging phenomenon, extensive calcification appears to reflect more severe atherosclerosis, higher risk of heart attack, and worse prognosis.

Coronary calcification can be seen in adolescents, although it usually starts later in life.

The calcification is composed of calcium phosphate, similar to that in bone.

For a long while, arterial calcification was thought to be the result of a degenerative process, but recent evidence suggests a that a more active process is involved, possibly arising from injury or inflammation of the vessel wall.

In June 2000, the American College of Cardiology (ACC) and American Heart Association (AHA) Consensus Panel wrote in the Journal of the American College of Cardiology: “Coronary calcium is part of the development of atherosclerosis; it occurs exclusively in atherosclerotic arteries and is absent in the normal vessel wall.”

Coronary Calcium Score

In the 1980’s US cardiologists lead by Dr. Arthur Agatston defined a method to assess the amount of coronary artery calcium by using electron beam computed tomography, otherwise known as ultrafast CT scan.

The density of calcium is determined by the so-called Hounsfield scale that measures density in Hounsfield units. The weighed score multiplied by the area of the coronary calcification provides the calcium score, commonly termed the Agatston score.

Angina Pectoris - What Is Angina and How Do We Deal With It?
The coronary arteries supply oxygen-rich blood to the muscle of the left ventricle of the heart.The amount of calcium in the walls of the coronary arteries, assessed by calculating the coronary calcium score, appears to be a better predictor of risk than standard risk factors

The amount of calcium in the walls of the coronary arteries, assessed by the Agatston score, appears to be a better predictor of risk than standard risk factors (2).

A recent study found that the progression of coronary calcification, assessed by two scans in 2.5 years, was associated with increased risk of cardiovascular events during a follow-up of more than seven years (3).

The presence and extent of coronary calcium are first and foremost markers of the extent of atherosclerosis within the coronary arteries. Nonetheless, it is important to understand that the coronary calcium score does not necessarily reflect the severity of narrowing (the degree of stenosis). Still, a patient with a high calcium score is more likely to have a significant narrowing of a coronary artery than a patient with a low calcium score.

An individual without coronary artery calcification is very unlikely to have a severe narrowing of a coronary artery (4).

Although cardiovascular events can occur in patients with very low calcium scores, the incidence is very low.

Coronary Calcium Score Interpretation

Based on a number of studies, the following definitions are used to relate the coronary artery calcium score to the extent of atherosclerotic coronary artery disease:

  • Coronary calcium score 0: No identifiable plaque. Risk of coronary artery disease very low (<5%)
  • Coronary calcium score 1-10: Mild identifiable plaque. Risk of coronary artery disease low (<10%)
  • Coronary calcium score 11-100: Definite, at least mild atherosclerotic plaque. Mild or minimal coronary narrowings likely.
  • Coronary calcium score 101-400: Definite, at least moderate atherosclerotic plaque. Mild coronary artery disease highly likely. Significant narrowings possible
  • Coronary calcium score > 400: Extensive atherosclerotic plaque. High likelihood of at least one significant coronary narrowing.

When interpreting coronary artery calcium score, it is very important to consider age and gender. For example, 50% of white males aged 70 have a calcium score higher than 14,5 and 50%  of white females aged 70 have a calcium score above 13. There is a calculator available here that provides coronary calcium score distribution based on age, gender, and ethnicity.

Coronary calcium score may contribute to risk assessment in people at risk for future cardiovascular events. A score of zero is associated with very low risk. Limiting primary prevention with statin drugs to those with a score above zero could spare 1 in 4 elderly from taking life-long medication that will benefit only a few (5).

How Is Coronary Calcium Assessment Performed?

Initially, coronary calcium assessment with CT was made possible with the development of the electron-beam CT scanner in the late 1980’s. The speed of this machine was much higher than that of existing scanners. The high speed made it possible to “freeze” heart motion to allow measurements of calcium in the coronary arteries.

Coronary Calcium ScoreLately, ultrafast spiral CT has been used to assess coronary calcium. This technique makes the scanning time very short. Often a scanning length of around 10 seconds is used.

The patient usually needs no specific preparation. Fasting is not necessary. As high heart rate may reduce imaging quality, patients are often asked to refrain from smoking and drinking coffee before the scan. Sometimes beta-blockers are administered to slow heart rate.

Many experts have expressed concerns about the radiation involved with the CT scan. It has been estimated that there may be an increase in radiation-induced cancer risk with repeated procedures (6).

Vitamin K and Coronary Calcium

Inadequate calcium intake can lead to decreased bone density, increasing the risk of osteoporosis and bone fractures. Supplemental calcium can increase bone mineral density and bone strength. However, recent data suggests that high consumption of calcium supplements may increase arterial stiffness (7).

Vitamin K2 is associated with decreased arterial calcification and arterial stiffening and may lower the risk of vascular damage according to recent data (8). Vitamin K2 is not very widespread in the modern western diet and almost non-existent in junk food. Increased intake of vitamin K2 might help to reduce the health risks associated with coronary calcium.

What to Do About Extensive Coronary Calcification?

There is no specific treatment available that lowers coronary calcium.

One randomized placebo-controlled trial (9) did not find any significant benefit with atorvastatin (cholesterol-lowering drug), vitamin C and vitamin E in patients with high coronary artery calcium score.

Although blood levels of cholesterol were reduced, there was no effect on the progression of coronary calcium score. Atherosclerotic cardiovascular events were fewer in the drug treatment group compared with placebo, but the difference was not statistically significant. However, there was a greater treatment effect in a subgroup with coronary calcium scores above 400.

Treatment of individuals with high calcium scores should aim at reducing risk. This involves treating lipid disorders, high blood pressure, and diabetes if present. Refraining from smoking is essential. Regular, moderate exercise is advised. Due to the overwhelming evidence of benefit in individuals with atherosclerotic heart disease, treatment with aspirin and statins is often advised.

If extensive calcification is present, further evaluation may be needed. Stress test associated with nuclear and echocardiographic imaging techniques is often performed. Coronary catheterization with angiography of the coronary arteries may be indicated to assess the severity and extent of coronary narrowing.

advertisement




383
Leave a Reply

avatar
145 Comment threads
238 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
129 Comment authors
Dan S KuhnKatiesfsfsfDenise HribarSteve Recent comment authors

This site uses Akismet to reduce spam. Learn how your comment data is processed.

  Subscribe  
newest oldest most voted
Notify of
Bill
Guest

I had one of these done last year, 49 years old, score was 37, so I guess that’s pretty good. I had it done for my own personal interest.

Greg
Guest
Greg

Yes. 37 is great you fool. Stop eating sugar and processed foods.

Jay Santos
Guest
Jay Santos

Stop giving ridiculous advice.

Ron Poirier
Guest
Ron Poirier

Don’t knock a 37 at age 49. I sure wish I could have that.

Jay Santos
Guest
Jay Santos

A score of 37 indicates you will have a massive heart attack within 3 years so it looks like you have about one year left. Good luck!

icanhandletruthcanyou
Guest
icanhandletruthcanyou

Don’t listen to anything Jay Santos says… he is a troll.

joanne martin
Guest
joanne martin

Not good. It should be no calcium present at 49. See dr

Edith Nir
Guest
Edith Nir

So which is it – should we use statins to lower risk (with score under 400) or will it not have an effect on the calcification progression???

Axel F Sigurdsson
Admin
Axel F Sigurdsson

@ Edith Nir

There is no evidence thus far that statins will reduce the progression of coronary calcium.

The rationale for their use is based on the assumption that individuals with high calcium scores have extensive atherosclerosis, and the fact that statins have been shown to improve outcome in patients with established atherosclerotic cardiovascular disease.

Don C
Guest
Don C

I am being advised to commence “statin therapy”…strongly! using phrases like ‘The risk of death is greater than any other side-effects’, but I am far from convinced. I am 64; my CT Coronary Calcium Score was 3; my Carotid IMT Score was “1.1-1.3”; I am a non-smoker for the past ~30-40years; I am quite fit (swimming ~1km every day) to the point where the cardiologist was unable to stress my heart during a Stress Echocardiagram; and my diet is good, high in veg, fibres and fish with only token (perhaps once a week) red meat. Admittedly my Father died of… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the comment Don.

Although statins don’t appear to reduce coronary calcium, they may reduce the risk of future cardiovascular events. However, a coronary calcium score of 3 is fairly low and clearly below medium for your age. You can use the calculator here.

In order to see the whole picture it would be interesting to have some information on your lipid profile. Do you have high blood pressure?

Peter T Capozzoli
Guest
Peter T Capozzoli

Isn’t a score of 3 at age 64 VERY low? Top 25%?

Marilyn Z
Guest
Marilyn Z

Your health sounds fabulous. My doctor pushes a lot of tests and pills, too, and I keep telling him there is no heart disease in my family yet he acts like I might drop dead any moment. I am now taking statins which I resisted for years but I am diabetic and they think it has a correlation there to keep the blood sugar low.

What I am trying to do is find if there is a way to reduce these scores because mine was 61 and I am 72 but with low blood pressure and I exercise regularly.

bob_johnston
Guest
bob_johnston

Marilyn – you might want to remind your doctor that’s there’s no documented benefit for women to take statins and that people with higher cholesterol live longer on average than people with lower cholesterol after you reach the age of 50.

I’d send him this video and ask him why he’s never taken the time to understand the difference between relative risk ad absolute risk, why he’s never learned the difference between observational and randomized controlled trials.

https://www.youtube.com/watch?v=UCk_vTkS6bU

Marilyn Z
Guest
Marilyn Z

VERY INTERESTING!

I will tell him about this. Wish I could go back to my old heart doctor who gave me the stress test.

Thanks for taking the time to answer! I am very appreciative.

bob_johnston
Guest
bob_johnston

Any time. I get so frustrated by doctors whose first action is to reach for the prescription pad when the numbers don’t bear that course of action as prudent. The video is really good, not only does it explain the difference between relative risk and absolute risk but it tells you the true numbers on statins.

Marilyn Z
Guest
Marilyn Z

Long ago, when we went to a DO, we did not have that problem with the pills, but, gradually, they seem to have changed their thinking and are just as bad as an MD. My 93 year old uncle was just put in the hospital for a very bad fall in a lot of pain but nothing broken. My 91 yo aunt kept telling them not to give him much in the way of pain pills because of his bad reactions to some of them. They wouldn’t listen and he was going absolutely insane with them. After about a week… Read more »

bob_johnston
Guest
bob_johnston

I actually almost didn’t post that video simply because of his endorsement of the Mediterranean diet – not because it’s much better than what a typical American eats but because there are many types of Mediterranean Diet (just look at all the countries in this area, all eating different foods) and it’s very confusing to try and pinpoint it. This doctor’s version is fine – meat, cheese, veggies and fruit – what he didn’t include in his description is whole grains, and I think that’s the key. I am an unabashed advocate of a low carb diet. I believe the… Read more »

Peter T Capozzoli
Guest
Peter T Capozzoli

Actually, the “Mediterranean Diet” uses little meat. Wikipedia has the standard definition: “The Mediterranean diet is a modern nutritional recommendation originally inspired by the traditional dietary patterns of Greece, Southern Italy, and Spain.The principal aspects of this diet include proportionally high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yogurt), moderate wine consumption, and low consumption of non-fish meat and non-fish meat products.” My family came from Southern Italy and that is what they eat and what I eat (and have all my… Read more »

bob_johnston
Guest
bob_johnston

This is the problem, Peter, few agree on what a Mediterranean Diet is. The French have one of the lowest heart attack rates in the world yet they eat a lot of saturated fat and nI’m pretty sure France is on the Mediterranean. Turks and Greeks don’t eat a lot of grains, mainland Italians eat a decent amount of pasta but also aren’t noted for a low rate of heart disease like the French. It’s confusing to say “Mediterranean Diet” as a catch-all phrase when it could mean a number of different things. The doctor in the video I posted… Read more »

Peter T Capozzoli
Guest
Peter T Capozzoli

I eat few grains these days. A little pasta. Italians don’t gorge on pasta in Italy. I have found the most important thing to keep blood sugar stable and low is eating 5 small meals that include protein. Carbs without protein make blood sugar fluctuate wildly.

cthetruth
Guest
cthetruth

I believe our problem stems from our food that is filled with hormones, antibiotics that ruin the flora in our digestive system, GMO’s ,foods that are modified with roundup to resist pests along with msg that is in every packaged product , fillers, colorings, artificial sweeteners, corn syrup which our digestive system cannot metabolize and the list goes on and on.The difference in Europe is they don’t allow these toxins in their food supply. This is where our inflammation comes from. It is about time we demand that our food is free from these poisons and we will see our… Read more »

Karen M.
Guest
Karen M.

Most of the elderly in France who don’t have as many heart attacks went through the war with very simple foods. They didn’t get cream, butter, etc. They didn’t get the rich pastries that the French eat today. You’ll need to see how he newer generations fare.

mo Ab
Guest
mo Ab

Actually the French consume the highest amounts of fats from a variety of sources of any nation. AND, they have the lowest rates of cardiovascular disease.
Therefore the “French Paradox”. The Swiss are right behind them with regard to both dietary fats and low risk of CV disease.

Federalista
Guest
Federalista

This is incorrect advice. There is a fair amount of data that women without coronary disease may benefit from taking statin therapy. The data is not as robust as it is with men but thousands of women have been enrolled in statin trials and there is significant evidence that women may benefit.
https://www.medscape.com/viewarticle/814526#vp_2

bob_johnston
Guest
bob_johnston

JUPITER was a terrible study – it weeded out everyone except for those with high C-reactive protein scores AND normal LDL-C scores. Just by this the results from JUPITER can only be applied to people who fit both those conditions, which is quite rare. I’ll repeat this because it’s pertinent – you cannot apply the JUPITER study results to people who didn’t have levated C-reactive protein and noral LDL-C. And just look at the name, it stands for “Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin” – do you think with a name like that… Read more »

Federalista
Guest
Federalista

Here is a good review for you about statins in women that contains multiple meta-analyses of the many trials with statins having women in the trial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709236/ Their conclusion: “For primary prevention, statin therapy reduces major CVD events in men and women, but we can debate whether it reduces all-cause death, especially in women.” That is where the debate is, whether statins reduce all cause death in women, not whether statins work at ALL in women. As far as the Jupiter study, it was a rigorous, randomized control trial. The data were clear, there was a mortality benefit for those… Read more »

bob_johnston
Guest
bob_johnston

I hate being dismissive and rude to people but your lack of critical thinking is pissing me off. You’re not even trying. Let’s look at JUPITER again. This was a trial that only included people with normal LDL-C. Statins are supposed to be effective because they lower LDL-C, why would anyone take a statin when they have normal LDL-C? Why would this study even be done unless the group financing it knew that LDL-C wasn’t the problem? And you’re saying that elevated CRP is a risk factor for heart disease – that’s a new one on me. Doctors don’t even… Read more »

Federalista
Guest
Federalista

Here is some info on CRP and heart disease. https://www.webmd.com/heart-disease/guide/heart-disease-c-reactive-protein-crp-testing The Jupiter study was set up the way it was because many other previous trials had shown benefits of statins in patients with high LDL. If they had set up the trial in patients with high LDL and high CRP and shown a benefit it may have been just because the LDL was lowered. But the designers of the trial wanted to show that there could be a benefit of statins even in patients with normal LDL, which was an ambitious goal. And they achieved that goal. This expanded the… Read more »

bob_johnston
Guest
bob_johnston

Should I take statins for a hangnail too? I have a toothache, perhaps some Crestor will take care of it This is pathetic. You’re making claims that statins are providing these great benefits (they’re not) and you completely discount the possible side effects. This had me rolling – “But it is hard for most people to stick to a healthy diet”. You make it sound as if eating poorly can be counteracted by taking drugs. It doesn’t work that way. You get on those drugs and you never get off them because they don’t provide a cure, they simply lower… Read more »

Federalista
Guest
Federalista

No, statins will not help with a hangnail. But they may help with a toothache. Periodontal disease can cause inflammation which may increase CRP levels — leading to an increased risk of heart disease. Why are you on a low carb diet, are you trying to lose weight? Low carb Atkins or Atkins like diets can be good for weight loss but for reducing the risk of heart disease, -which was the point of this article on coronary artery calcium, they may not be great. Mediterranean diets or Ornish diets have more data showing benefits in preventing heart disease and… Read more »

bob_johnston
Guest
bob_johnston

Dude – you have no idea what you’re talking about, please stop (actually please continue, you amuse me with this stuff). I’m on a low carb diet because I want to be as healthy as possible and as you can see from my lab results that’s exactly what I am. And while I have no need to lose weight I did lose 35 pounds once I ditched the carbs. I suppose that was all water weight? Your Harvard link is a joke – not only does Harvard put out some of the most questionable observational studies on nutrition out there… Read more »

Federalista
Guest
Federalista

You like being contrarian. And that is ok, even good every now and then. But if you are obstinately contrarian on every issue you will find that you are on the wrong side of the facts more often that not in life.

Your views on statins and diet are very fringe and radical. With the evidence known about heart disease up to this time, I would strongly recommend that anyone with heart disease not follow your ideas.

bob_johnston
Guest
bob_johnston

I am a contrarian when the available data indicates that the best course of action. I couldn’t care less how many and who believes it to be true if the data doesn’t agree. There are countless things where I agree with the conventional wisdom because that’s what our best information indicates. Nutrition and drug therapies for chronic disease are simply areas where the conventional wisdom aren’t backed up by the data and I’ve adjusted my beliefs accordingly. My own pesonal experience has shown me this to be correct. Just look at your arguments on this thread – you started out… Read more »

Nigel Kinbrum
Guest

“I am a contrarian when the available data indicates that the best course
of action. I couldn’t care less how many and who believes it to be true
if the data doesn’t agree.”
Any fool can cherry-pick studies from the millions available on PubMed, to prove their point. Gary Taubes is a classic example of this.

Doing science properly means looking at all of the evidence, not just the evidence that reinforces your confirmation bias.

Ted63
Guest
Ted63

Bob, you are a rock star. We LCHF people are certainly the current outcasts in this era of ADA and AHA guidelines and behind the scenes big pharma. Hey if you’re A1C/ LDL is too high here are expensive drugs to take/ inject- (never mind (good) diet). #bigpharmawantsyoufat
I’m with you brother.

bob_johnston
Guest
bob_johnston

Thanks Ted – Not only am I a big fan of LCHF to regain your health but I’m also beginning to think that a combo of LCHF and intermittent fasting is about as healthy an approach as you can get. We will see what kind of research comes out as time goes by.

Nigel Kinbrum
Guest

“I’m on a low carb diet because I want to be as healthy as possible and
as you can see from my lab results that’s exactly what I am.”
You’re on a low-carb diet ‘cos you’re too stubborn or stupid to reverse your insulin resistance. Your surrogate markers are meaningless on a high-fat diet.

Nigel Kinbrum
Guest

You ditched over-refined nutrient-poor, calorie-rich food products for nutrient-rich, calorie-poor produce. That’s what improved your health, not the carb reduction. You’ve fallen for the “cum hoc ergo propter hoc” fallacy.

mo Ab
Guest
mo Ab

So I am sure you also agree with Bob that statins suck…right?

mo Ab
Guest
mo Ab

Generally agree with your view that A. statins not terribly good therapy, and B. the studies re: statins are poor to terrible (not to mention the data is juggled and manipulated with by the Drug Company hacks).

Re: anonymity…proud tradition of several of our Founding Fathers.

MrSativa
Guest
MrSativa

The link you provided is to be taken with a grain of salt. It’s a WEBMD site and they pretty much tow the line with big pharma. That’s who funds them.

Greg
Guest
Greg

Bravo.

Andrés
Guest

@Marilyn Z: If you are diabetic you should try to keep your blood sugar in check, that is lower than 140mg/dl (120mg/dl) at 1 hour (2 hours) after meals.

I would read the two other most relevant links to Jenny Ruhl’s work too.
Misdiagnosis By Design – The Story Behind the ADA Diagnostic Criteria and How Blood Sugar Control Works–And How It Stops Working.

Under an unhealthy diet normal can be unhealthy. Everyone should check his/her postprandial blood glucose after most usual meals and act accordingly.

Finally, if you decide to stop statins (they cause diabetes) then do it slowly.

Marilyn Z
Guest
Marilyn Z

Thank you for that reminder. I remember reading that statins cause diabetes and had forgotten that. How do you stop slowly? Space the pills farther and farther apart? I am new to this diabetes thing and my AVERAGE is 130 per wk. I have no idea what I am doing with it. I made some pretty bad tortillas to use as wraps and those got me thru until I found some wraps that are 7 gram net carbs and really love those. I heard that COLD dishes with potatoes or pasta do not work as starch in the body, but… Read more »

Marilyn Z
Guest
Marilyn Z

The first article was a lot to digest and not encouraging,but helpful. I understand blood glucose a bit more and am even more determined to keep down.

bob_johnston
Guest
bob_johnston

I completely agree that keeping blood sugar in check is a very desirable goal, I differ from Andrés on the numbers though. I think the clinical blood sugar targets are high by quite a bit – I would avoid all foods that raised them over 100 mg/dl (fully understand that this is my own belief and not supported by most). Something else to consider is that Type II diabetes is a disease brought about by the body producing too much insulin and not necessarily due to high blood sugar – groups like the ADA say to eat a carb-filled meal… Read more »

Ron Haugland
Guest
Ron Haugland

I am 74 and had open heart surgery at 68. Fully recovered now. Diet is a personalized nutrition plan from Metabolic Balance (loricassidy.com) and all my lipid numbers are below the goal numbers my Lipid Doctor set for me when he said we were going to treat me aggressively. I am on Crestor 10mg, zetia, and berberine. My C-Reactive Protein is .02 which is very low (this measures inflammation). My ejection fraction is 59 up from 25 at the time of my surgery. I am living at my ideal weight and feeling better than ever and active in sports I… Read more »

Rita Karakul
Guest
Rita Karakul

Don’t take their statins , Don. Run, don’t walk from that doctor. You are perfect not only at your age, but at ANY age!!!

Don C
Guest
Don C

Thanks Rita. Some further reading and (of course!) this forum lead to rejecting the statins and giving that doctor ‘the flick’, but it’s funny how that sort of experience leaves lingering doubts. We (or at least I!) tend to view the medical profession on a pedestal and it’s unsettling, in many ways. when evidence appears that pedestal can be very tarnished.

John Mahoney
Guest
John Mahoney

Because the pharm. companies make lots of money off of these drugs.

Greg
Guest
Greg

Because BigPharma like to profit off you. 50% of heart attack victims have “normal” cholesterol numbers. What a joke. Watch the ABC Australian documentary Heart of the Matter.

Jay Santos
Guest
Jay Santos

Last time I checked there weren’t any cardiologists roaming the internet answering health questions. In other words, quit typing and make an appt. with your doctor NOW.

Edward Hutchinson
Guest

This review may be useful to some readers of this article.
Vitamin K Dependent Proteins and the Role of Vitamin K2 in the Modulation of Vascular Calcification
I think it’s also worth considering the synergistic roles of magnesium and Vitamin d working together with the actions of Vitamin k. Vitamins D and K as pleiotropic nutrients

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the links Ted.

I really enjoyed reading the review on K2. Its promising role for preventing or modulating vascular calcification is of great interest.

The question whether the anti-inflammatory effects of vitamin K and vitamin D may be important when it comes to preventing vascular calcification is also of great interest. Both these nutrients appear relatively safe and they’re certainly not expensive.

LyndaF
Guest
LyndaF

For an easier read about the connection between vitamin K2 and calcium in the body, try “Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life” by Kate Rheume-Bleue. I found it very interesting and informative.
https://www.amazon.ca/Vitamin-K2-Calcium-Paradox-Little-Known/dp/1118065727

Richard Dupont
Guest
Richard Dupont

did it work

Jkart
Guest
Jkart

It’s not clear what CT measuring of arterial calcification really means. Is it the measurement of the length of arterial vessel affected by calcification? Or is the measurement of arterial narrowing from calcification?

If one has a score that puts them at the 50th percentile for their age/sex, then how frequent should CT technology be used to monitor the progression? Every year? Every 3 years? ???

Axel F Sigurdsson
Admin
Axel F Sigurdsson

@ Jkart Coronary calcium score reflects the total amount of calcium within the walls of the coronary arteries, taken together to provide a single number. It’s based on density and area. Coronary calcium score tells you nothing about arterial narrowing. One can have a high calcium score without any narrowing or blockages being present. However, a patient with high calcium score is more likely to have a significant narrowing affecting blood flow than a patient with low calcium score. Regarding your last question the only thing I can tell you is that nobody really knows how to use coronary calcium… Read more »

Jkart
Guest
Jkart

Thanks for the clarifications. For whatever reason, it was in my mind that the calcium score was directly related to the level of vessel blockage.

Marilyn Z
Guest
Marilyn Z

Then why in the world has my doctor been after me to get one for the past three years? There is no heart disease in my family, at least within a generation or two. I think he means well, but I get so tired of being sent for tests when my blood work is great other than my cholesterol scores.

Marilyn Z
Guest
Marilyn Z

I have since submitted to going to a heart specialist and really loved this guy. He put me through all the tests and I passed quite easily…the stress test was a breeze. Anyway, to what you were saying about high calcium scores, this doctor told me he has patients with scores as high as 5000 (yes 5 with FOUR zeroes) and their hearts and arteries are perfectly fine. I am beginning to wonder if my doctor gets a kickback for sending me for unnecessary tests. As it is, I quit that doctor and found a young female osteopath, but the… Read more »

JeffryGerberMD
Guest

Thanks for the post Axel. In our reports Volume130 is also reported an it is suggested that it be used to measure progression from year to year rather than AJ scores.

There has been some debate regarding the essence of calcium scores and its ability to predict risk.

Glad you posted because I wanted to discuss with you. Comments?

Jeff

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Jeff I think there are several things to discuss and many unresolved issues when it come to coronary artery calcium score (CACS). One thing worth mentioning is that CACS is probably not very useful as a diagnostic tool. By that I mean that if you have a patient with chest pain, breathlessness or other symptoms, you’ll have to use other methods such as exercise testing with or without nuclear or echocardiographic images and then, if positive,coronary angiography. I don’t think CACS is a useful screening tool for large parts of the population. In that respect, it’s probably not cost-effective.… Read more »

JeffryGerberMD
Guest

Axel,

In the US insurance is not paying for CACS, this usually means that insurance concludes that it does not provide useful information. However, many pay out of pocket for the screen and I agree as you stated above there may be some usefulness.

We do CIMT’s with limited doppler in our office as a competing technology. I am not sure itima thickness correlates with risk but I like to visualize plaque. I suppose that using these tools in the right context can be useful.

Jeff

Greg
Guest
Greg

Insurance companies care about your health? LMAO

Marilyn Z
Guest
Marilyn Z

I truly think mine does. They give me *rebates* for getting mammos, colonoscopies, annual checkups and a few others. This year I should get $70 from them plus they call and make sure I am refilling my prescriptions and getting my flu shots, etc. If I stay healthy, it is less outlay for them. Makes perfect sense to me.

They will not pay for the CACS though….stupid me, I paid for it myself.

John wagner
Guest
John wagner

I suspect a calcium score will turn out to have a practice value other than measuring it like the length of a fuse on a time bomb, and having no treatment to stop this progression. If a person has a high score and angina/significant block, then surgical treatment might be more indicated, as compared to same person except low calcium score. This person might respond better to medical treatment, ie statins, etc. bottom line, use it to help decide surgical versus medical treatment of coronary disease.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

John.

That’s a hypothesis that is still to be tested.

I don’t now of any evidence so far suggesting that calcium score is useful when deciding whether to go for surgery or medical therapy. Usually these decision are based on the number of arteries with significant narrowing (stenosis) assessed by coronary angiography, the localization of the narrowings and the extent of myocardial ischemia.

Don A
Guest
Don A

I would appreciate any comments/advice from the experts on this blog. I am a 62y.o. male at 5’11’ and weigh 213 lbs after losing 20 lbs since Feb 2014 and have started exercising and cycling regularly since March of this year. I plan to lose another 20 lbs. I have mild asthma and take asmanex 220mcg 2 puffs daily. BP is well within normal limits. In Sept. 2000 I had aCAC of 11. LMA: 0, LAD: 9,CFX: 0, RCA: 2. IN 2007 I had an angiogram due to a thallium stress showing a possible problem but cardiologist thought was false… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Don A. Some studies have suggested that there is an association between statin use and coronary artery calcification. Furthermore, there is no evidence that statin treatment halts the progression of coronary calcification. However, this does not mean that statins accelerate the progression of atherosclerosis. In fact, as your cardiologist suggested, calcification of plaques may indicate healing. In theory, a calcified plaque may be more stable and less likely to rupture than a non-calcified plaque. It is possible that there are different mechanisms behind coronary calcification and coronary artery narrowing. In one meta-analysis, coronary calcification was not affected by statin therapy… Read more »

Don C
Guest
Don C

Thanks very much for your reply (22 Oct at 08:22) Axel. I am answering here because there was no “REPLY” link in your reply. I should admit I am feeling way ‘out of my depth’ here. My understanding of all this feels incredibly superficial. My instincts tell me I am in good health and I should seek another opinion before I embrace statin drug therapies, but I live in a country area where specialists are few and far between. So your blog (and, even more so, your input re my circumstances) is hugely appreciated…and I will do my best to… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Don.

Although your LDL-C is rather high there are positives. Triglycerides are low and so is TG/HDL-C ratio. This is an indirect sign of LDL-particles being large rather than small which is positive.

Generally speaking statins lower the risk of cardiovascular risk. When the risk is low, like it appears to be in your case (coronary calcium score of only 3, not smoking, no hypertension and regular exercise) the likelihood of benefit from statin treatment is probably very small.

Don C
Guest
Don C

Thanks Axel Your comments are reassuring, not only because they appear to confirm my instincts, but also and especially because they give me another independent and very expert source that is looking at (at least some of!) my particulars. My current cardiologist appears to be relying heavily on the Carotid IMT results. He suggests that those results effectively forecast a deterioration in my coronary calcium — His words were along the lines of ‘There is now a sludge, rather than hard calcium in my heart, but soon (as in the next couple years) the thickness in my carotid will be… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Don
Unfortunately I have very limited experience with Carotid IMT.
I’m also reluctant to go into much detail regarding your health. That would be irresponsible of me. The only thing I can do is discuss these issues in general terms as I did in my previous comment.
Of course I think you should listen to your doctor. I have no doubt he wants what’s best for you. However, the question when to use statins is often difficult to answer and experts don’t always agree.

Rich Frontera
Guest
Rich Frontera

I am a 60 year old male. My cholesterol is and has been low for 30 years (with statin). I exercise regularly. My blood pressure is normal and I am in excellent physical condition-low body fat- no lipid issues Went for a Calcium score which was 426. Which falls under extensive cardiovascular disease. Any comment or suggestions

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Rich.
A calcium score above 400 implies that your risk for having a cardiovascular event is elevated. However, it doesn’t imply that you have any significant narrowings/blockages in your coronary arteries. Sometimes other tests are performed to check for that.
I think you should focus on limiting your risk by not smoking, eating healthy and exercise regularly (which you already appear to be doing). In my opinion there’s no reason to stop the statin treatment. Although statins don’t appear to affect the calcifications per se they may help lowering your cardiovascular risk.
Discuss with your doctor whether he believes further testing is needed.

Rich Frontera
Guest
Rich Frontera

Thank You for your response. As a follow up to the calcium score I had a nuclear stress test and was told the result is “normal”.

I don’t know what that means. Since a score of 426 means “severe cardiac artery disease” (where I was)……does a “normal” nuclear stress test mean I don’t have “severe cardiac artery disease”. Just feel like I have no idea where that leaves me.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Rich
I presume the nuclear stress test shows that blood flow to the heart muscle is normal which indirectly suggests that there are no blockages/narrowing in the arteries affecting blood flow.
But, keep in mind, this is only my presumption based on the limited amount of inormation.
Your doctor should be able to explain it all to you.

andy
Guest
andy

I just received the results of my calcium scoring test. I am 44 years old, 100 pounds overweight. My cholesterol is “borderline”. My calcium score is zero. Does this mean that cholesterol isnt a problem for me, or just that it hasn’t effected my coronary arteries yet? Considering my weight, high blood pressure and eating habits, I was surprised to have such good results.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Andy
That’s good news. However, remember that you’re quite young. A calcium score of zero is fairly common at your age. I think you should do what you can to improve your lifestyle and try lo lose weight.

Scott
Guest
Scott

Hi, Quick question….I just had a Calcium screening test done last week. Im 42 years old. All my vitals are good BP 110/60, cholesterol in normal range. My HDL has always been a little borderline low (42). Anyway, my Calcium score was 7. Id never even heard of Calcium scoring before this so im a little nervous and unsure what this all means. From what I know 7 is low, but perhaps not so low for my age. Im confused. Any light you can shed would be great. My Doctor and I are supposed to talk about beginning statins, but… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Scott.
No I don’t believe your code red and as I see it you’re probably overreacting. I just wonder why you had a calcium score performed. In fact I think there’s limited data available for your age group. Anyway, a score of 7 is low. The sensible thing is to discuss the findings with your doctor.

Scott
Guest
Scott

Thanks Axel for the reply. That makes me feel better. To answer your question about why I had the test done…..Last weekend I had a very uncomfortable feeling in my chest, so after no relief for 12 hours I went to the Emergency Room where they did every test under the sun….EKG, Echocardiogram, x-rays, blood panel etc. It turns out that I have Pericarditis which im finishing up my treatment for with Colcrys. Feeling much better. So in running all those tests the calcium score was something they picked up in passing. I went to my primary care physician this… Read more »

Sara Pasquini
Guest
Sara Pasquini

7 is not a low score for someone your age. I’m 42 and mine is 14. At our age it should be 0. The key is to do anything you can re; diet , exercise, etc. to keep it from progressing. We are too young to have this score. So whatever we are doing needs to change. Inflammation, eating processed and fatty foods, lack of exercise, etc. will do this. So yes, a score of 7 may seem low but if you continue doing whatever you are doing then it will increase and will be very bad. Be careful and… Read more »

Scott
Guest
Scott

I guess my main worry wasn’t so much in the current score of 7. It was more because my understanding is that if you have a positive calcium score, even if its low at the moment, will continually increase to a significant # as time progresses. Thats what my confusion and sort of worry is.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

I understand Scott. However, it’s very hard to tell how and if arterial calcifications will progress. You may still have a score of 7 after ten years although it’s likely to be higher just because you’ve aged.
Take this as a positive thing and tune your lifestyle so you may be able to reduce the likelihood of future disease.

Scott
Guest
Scott

Thanks Axel, thats comforting. Are there any lifestyle tips you can give me. I plan to up my cardio vascular exercise. I’ve mainly mostly done only weight training with a little cardio mixed in. As far as dietary are there things that are most desirable to eat aside from the obvious, staying away from bad fats and simple carbs.

Scott
Guest
Scott

Im also very confused about the statin thing. My Dr wants me to start it. But ive read so many conflicting things about the side effects and being only 42 years old, i feel that if I were to be on them now, that it would be a lot of years ahead of me for those side effects to happen as opposed to if i was 70 years old now. I kinda would like to know if lifestyle changes and habits at my age and score would be something to seriously consider as opposed to a life commitment to statins

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Scott
Your reasoning is sensible and rational. When prescribing statins it’s important to be sure that the benefits outweigh the risks. Most people tolerate these drugs very well, even for long periods.
Of course you should focus on lifestyle issues. The question is whether statins will bring additional benefits. Your blood lipids, family history and other risk factors will have to be taken into account. Discuss the pros and cons of statins with your doctor. This is where shared decision making (between you and your doctor) is important.

Terry Stahly
Guest
Terry Stahly

I am 62 and my score just came back and is 912 and it was 800 three years ago. My cholesterol is 106 and labs are excellent, my stress test is wonderful I exercise 35 min on treadmill daily at 4.0 mph look and feel great for my age and am very active, I quit smoking 17 years ago do not drink anymore but eat sub sandwiches, bacon eggs butter and double cheeseburgers fries etc. I take Vytorin for cholesterol my doc says not to worry but the web says my chances for a heart attack are one in four… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Terry
The calcifications are not necessarily the problem by them selves although they may predict risk. Your target should be to lower your risk of cardiovascular events. Of course it’s mostly about lifestyle issues and like in your case, statins are frequently prescribed to lower risk. From your description it looks like you could do a bit better with your diet. Great you quit smoking because that’s a huge issue. I also believe regular exercise is often underrated as a preventive measure.

Leigh
Guest
Leigh

My 53 husband was originally given a calcium score of 960, which was then taken down to 640 following an angiogram. He is on statins, angina medicine, aspirin and carries a spray in case he has a heart attack. He has osteoporosis in his knee and I suspect in other places too. Thinking of putting him on Vit K2 as my other fear is a link between calcification and dementia if the plague starts to build up on the brain. This is one condition where there are multiple organs that you really need look at in treatment options, as treating… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

That’s a a difficult question Leigh. I suppose statin treatment may reduce his risk of cardiovascular events. However, more information is needed in order to have a say on that, for example his lipid numbers, information on smoking, blood pressure and family history.

christian
Guest
christian

Hello, I had a heart scan performed about three weeks ago.I am 48 about 15 lbs over weight but, I’m working on that . My calcium score came back at a 59. To be honest it has me shaking in my boots. The lower left descending artery has 58 and I have 1 in another.. Does this mean 58% of my artery is closed ? This has my children very upset.. Any and all advice would be appreciated…thanks and God bless you..Chris

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Christian
No this doesn’t mean that there is 58% narrowing or blockage. Coronary calcium score only reflects the amount of calcium within the walls of the coronary arteries. If I understand it correctly, in your case the calcifications are mainly found in the left anterior descending artery which is quite common. Although calcium score is a marker of risk it doesn’t really tell you anything about the degree of blockage or narrowing.
Speak with your doctor about whether further work-up is indicated and if any treatment is necessary. Focus on reducing your risk by working on lifestyle issues.

Joe
Guest
Joe

Hello. I have a calicum score of 450 at age 40. No significant blockages. normal weight and blood pressure. Suffer from PVC s. Curious to know if that is a cause or effect of the high calicum number. All I can get from my Doctor is this puts me at a high risk for a cardiac event and can’t predict if the plague will rupture. He said keep an eye on your risk factors. But no real advice on how to prevent a future event. I feel doomed. What can I do. Again not overweight. Excercise and blood pressure normal.… Read more »

Joe
Guest

Correction to my previous Email. Typo. My age is 60 not 40.
I am looking forward to any advice you can give me based on the above information. Seems to me that with the knowledge that I am at a high risk. Something could be done. Removal of plaque etc. There must be a reason why it forms in the first place. Inflamation but what causes the inflamation. Etc. Thanks so much.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Joe This is not something that can easily fixed. We don’t really know what causes arterial calcifications. Genetic factors play a role and probably inflammation as well. Why some people have low calcium score and some high is still not entirely known. Having calcium in the arterial wall is not the same as having narrowing of the vessel or a blockage. Calcified plaques are not more prone to rupture than softer plaques. However, studies show that high score is associated with higher risk of vascular events but it doesn’t mean you’re bound to have one. Discuss with your doctor whether… Read more »

Phil
Guest
Phil

Like many of the men in this blog, I was found to have a positive calcium score. The test was done as part of eval for atypical chest pain. I had no cardiac risk factors and was found to have a score of 330. I was started on aspirin and high dose lipitor. I had neg nuclear stress test. Not sure where to go from here as I run regularly, have normal baseline chol and BP and don’t smoke. Do I need to make a big change in diet ie The Dean Ornish low fat vegetarian diet? Are there false… Read more »

Denise
Guest
Denise

Oh boy! After reading about calcium scores in the single and double digits, and people are concerned, now I am really concerned. I have severe rheumatoid arthritis and fibromylagia, along with a few other issues that don’t really bother me. Sept 14, I passed out in the shower, cold. i woke up on the floor of the bathroom. I ended up seeing a neurologist and then a cardiologist. The neurologist said my brain was fine. The cardiologist I saw was not my regular cardiologist because mine was out on disability. The temp cardiologist ran a number of tests – echocardiogram,… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Denise.
Although high calcium score is associate with increased risk, removing or reducing the amount of calcium isn’t necessarily a good thing. For example it’s possible that calcium deposits may result from healing of inflammation within atherosclerotic plaques. High calcium scores should be approached by general risk modulation which includes healthy diet, regular exercise, not smoking, taking care of high blood pressure, avoiding obesity and treat lipid disorders.

Denise
Guest
Denise

Please correct me if I am wrong. The calcium could be a result of the inflammation? from my RA? I have had RA for about 12 years.I am just so physically and mentally tired from all of this.

Andrea
Guest
Andrea

High cholesterol runs in my family and I have had it all my life. I am 29 years old and it has finally hit me what great risk I have. I have been on statins for 10 years but cholesterol levels are still high. I am scheduled for a calcium score test tomorrow morning, hoping to find out I’m not too late to make life long life style changes. Would you think this is a good idea to get this procedure done?

Bob Johnston
Guest

Hi Axel, I actually had a bit of an issue with this portion of the article. Treatment of individuals with high calcium scores should aim at reducing risk. This involves treating lipid disorders, high blood pressure and diabetes if present. Refraining from smoking is essential. Regular, moderate exercise is advised. Due to the overwhelming evidence of benefit in individuals with atherocslerotic heart disease, treatment with aspirin and statins is generally advised. Before getting started I should begin by saying I’m extremely skeptical of the lipid hypothesis and that saturated fat is bad for you and that taking statins is beneficial… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Hi Bob. That’s a vey good question. In fact you’re right that I have written a lot on statins on my blog and probably share some of your skepticism. “Due to the overwhelming evidence of benefit in individuals with atherocslerotic heart disease, treatment with aspirin and statins is generally advised.” Firstly, this is not about my personal opinion. This is the view of most cardiologists and experts on the issue. In fact there is strong evidence for the efficacy of statins in secondary prevention. This is why clinical guidelines are very clear on the issue; statin treatment is recommended for… Read more »

Gary Storms
Guest
Gary Storms

Bob: thank you for your cogent contribution to this thread. I’ve recently received a high calcium score and learned a lot from your posts. You’ve convinced me that finally I really do need to change my diet. Thanks again

Bob Johnston
Guest

Axel – thanks for the response and it certainly wasn’t my intention to draw attention away from coronary calcium scans, a test I think has strong benefits and is a much better indicator or coronary health than a treadmill stress test. I think you make an important distiction between primary and secondary care which most people tend to gloss over. If a person has never had a heart attack the course of action for prevention should be very different than the course people who have had heart attacks should take. But the difference oftentimes seems to be blurred and people… Read more »

gspappaPhil
Guest

Again I was hoping that you could shed light on what type of diet is most beneficial for someone with a positive calcium score (330) at age 50 and no other CAD risk factors. I have read Dean Ornish’s books and would like an opinion regarding the need to severely restrict fat from the diet. Thanks

Bob Johnston
Guest

Hi gspappaPhil, Here’s my $.02 on the topic of diet: Before I start I should warn you that my ideas go against the mainstream but I believe I have an exceptional amount of evidence to back them up. I believe most doctors and nutritionists who promote a low fat, high carbohydrate diet don’t have a clue what they’re talking about. Most people are skeptical of what I tell them but if you have an open mind I think I can persuade you to go against the grain. To me it seems quite apparent that heart disease is caused by chronic,… Read more »

R.Hindenburg
Guest
R.Hindenburg

Most intelligent comment made

Bob Johnston
Guest

One more thing – I should have posted this last night but forgot. I like this study by Stanford researcher Chris Gardner called the A to Z Diet Study. He put a group of participants on the various diets to see which is most effective for weight loss and improvement of the markers for heart health. What makes this study special is that Gardner is a vegetarian and was fully expecting to see his diet win out. It’s to his credit that he didn’t try to fudge the results when they didn’t turn out as expected. Here’s a video recap… Read more »

GetItRight2016
Guest
GetItRight2016

Excellent video!

Denise
Guest
Denise

Back toy original question and please correct me if I am wrong. I am completely new to this. From what I have read and what my dr has told me, could my calcium be a result of my body trying to repair itself from inflammation caused by my RA, I have had high blood pressure in the past. I have had chest pains but no heart attack. All of my heart tests and lab work came back good. My dr put me on a statin to lower my risk dr a heart attack. I understand that that is what is… Read more »

Kyle H
Guest
Kyle H

I am a 40 year old male that spent my 20’s to mid 30’s around 210 pounds (I’m 5’11”). Ate the wrong foods, etc. In the past 2 years I have lost 60 pounds and have been feeling fine. My dad just had a 4 way bypass 2 weeks ago and his calcium score was through the roof. They started to stent, but had to go the bypass route. I took it upon myself to have my GP order a calcium score for me. The result was 25 in RCA and 9 in LDA, 23 overall. With nothing more than… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Kyle H. I assume your doctor has ordered coronary angiography. This procedure provides pictures of your coronary arteries in order to check there are any narrowings or blockages. If there are, angioplasty may be performed. Angioplasty is performed with a balloon and most often a stent is inserted in order to restore normal blood flow in the artery. In fact, a coronary calcium score of 23 isn’t very high and does not by itself call for an angiography. However if there are symptoms such as chest pain or if exercise testing or other tests have suggested that blood flow is… Read more »

Kyle H
Guest
Kyle H

I sincerely appreciate your response. He’s basing this on an EKG and family history along with the calcium score. I’m apprehensive about anything this invasive (and expensive being self-pay). We have an imaging center that provides relatively affordable CTA scans (around $1,100). **Could that be an alternative until there is more reason for concern? The cost of angiography might as well be $1M to me right now. The chest pains I’ve described to him are more muscular, i.e. on top of the ribs than a deep pain. Again, I feel he’s pulling the trigger too quickly. Adding to my concern… Read more »

Deborah
Guest
Deborah

I am a 61 year old female. Post menopausal, not taking estrogen (a family history of uterine cancer prevents that) with a severe anxiety disorder and fibromyalgia. The last few years have been very stress filled – things i have no control over, unfortunately – and this has led (in addition to the constant stress) to my eating poorly, not moving enough, some weight gain, etc. I just had my calcium score taken, and it is 74, all in my left anterior descending artery. My dr. is VERY concerned that it is all in that area, and wants me to… Read more »

Bill
Guest

Hi Deborah, I’m no Doctor so I’ll leave that aspect to Dr. Axel but you mentioned that you have a history of anxiety and feel you have no control over that. I’m also a pretty anxious individual and I think that deep breathing exercises and meditation, if done consistently, can help you lessen your anxiety. Just a thought.

Good luck

Deborah
Guest
Deborah

Thanks so much. I do both, and they do help, but the disorder is something I’ve had since a child, and sometimes leads to terrible panic attacks and as you know, just not fun. I’m one of those people who have to take meds daily. All that said, I appreciate your input – I have a feeling I’ll need to practice more meditation from here on out. It can only help. 🙂

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Hi Deborah A calcium score of 74 puts you at the 85th percentile. This means that 85 percent of women your age have lower calcium score and 15 percent have higher score. It is quite common to have most of the calcium in the left anterior descending artery. I don’t know of any studies suggesting that the localization of coronary calcium is an issue in terms of risk. Of course lifestyle is important. Not smoking, healthy and regular exercise are key issues when it comes to lowering risk. Your doctor obviously believes you may lower your risk further by taking… Read more »

Deborah
Guest
Deborah

Will do. Thanks so much for the information.

L
Guest
L

Hi. This is a query about whether I am ready for some surgical procedures, , angioplasty? Last week, at the recommendation of the same physician I’ve been seeing, I had a coronary calcium scan. This past year, I have had a carotid scan (ultrasound) which showed moderate plaque in one artery but still good blood flow, and a stress echocardiogram which showed also showed good flow with some plaque buildup. The latest Ca CT scan was pretty high, Coronary Artery Calcium Score (i.e. Agatston Score with Threshold 130 HU) Left Main = 0 Left Anterior Descending = 284 Left Circumflex… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Hi L

I’m reluctant to give any personal advise, that would be irresponsible of me. But I’ll try to respond to you in general terms.

Angioplasty or surgery is not a treatment for calcifications or high calcium score per se. It is only performed if there is a significant narrowing (or blockage) in a coronary artery. A normal stress echocardiogram usually implies that there are no significant narrowings.

Sm
Guest
Sm

Hi Dr Axel, I’m a 57 yr old woman, oopherectomy three years ago, (ER+ bc), strong FH heart disease, I had a calcium scan done 6 months ago at the urging of my endo ( hyperthyroid now under control). Score was 1100. Prompted a cardiology consult….stress echo normal, 48 hour holter showed occasional runs of svt, 24 hr BP monitor had some high #s but my normal is rather low. Started Lipitor 40 mg, aspirin 81 mg, and toprol XL 25 mg. I walk 2-4 miles per day, eat ( mostly) a healthy diet, and am 5’9″, 132lbs. Would you… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Hi Sm
We’re all ticking time bombs and more so as we get older.
However, a negative experience may have positive consequences. Look at it positively and use this knowledge to motivate you to improve your lifestyle. There’s so much we can do ourselves; not smoking, regular exercise and healthy diet. it all counts. And of course, follow the protocol your doctor has suggested.

Pamela
Guest
Pamela

Hello, I had a chest CT Scan about four years ago and mild aorta calcification was found and I was told by my doctor that it was nothing to worry about, but I was only 42 at the time, now I’m 46. It has been bothering me for years that any calcification was found. I am thin , no family history of anything , parents are healthy and in their late 70s and I have 7 healthy siblings in their 50’s. My blood pressure is 106/64 . Just had lipid panel done Total Cholesterol 144 Trig 47 HDL 48 LDL… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Pamela
Mild aortic calcification is a little bit different from coronary artery calcification. Your lipid profile looks good. So hopefully there’s nothing to worry about.

Bob Johnston
Guest

Hi Pamela – I’m curious about the dramatic change in your HDL levels. The 25 level is concerning but it seems to have improved dramatically since then. Your trigs are quite low (which is good), I’m wondering if you changed up your diet at some point.

Tweet
Pin22
Share360
Share1