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PSA: CT HEART CALCIUM SCORING


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100% agree. Did it last fall. Mine was only$50 and our company gives us $1000 a year for non covered expenses, so didn't cost me anything. 3 arteries totally clear, 1 in the mild range... of course it's the one that causes the widow maker heart attacks. I have horrible family genetics, so not surprising, but scared me a bit. My grandfather was dead by my age, and my father had had at least one or two stints put in, and at least one heart attack. Prompted me to switch to a mediterranean diet and be more faithful to cardio. Down 10+ lbs, and my sleep tracker measures my resting heart rate in the low 60s and sometimes in the 50s at night. 

Edited by Mo Horn
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Good for OP in getting this going. Go to the AHH if you can. It does a great job on this (called the HeartSaver CT scan). Easy, quick and painless procedure.  

The ARC even has coupons occasionally for 1/2 off on this. Even without one the thing is dirt cheap and pays off infinitely with the peace of mind you get from a clean result, or the followup needed to address an issue. Either way, it's a win. 

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I did the HeartSaver scan at Austin Heart Hospital maybe 20 years ago.  They gave me the results and told me to hand them off to my doctor.  I looked them over, it appeared that I had 0% blockage, so I just never did the handoff.

That might have been a tactical error.  #warrenzevon

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I'd resisted getting on a statin in my early 40s.  A few years ago when I changed docs, my new doc mentioned my "a bit high" cholesterol numbers and when I still was resistant to getting on a statin, he suggested the CT-Calcium scan.  Scored a zero, which is good.  Then I got on a minimal statin dose 3x per week.

 

How often are you guys (pushing 50) getting these?  Every 5 years?  10 years?

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I got one.  It was high.  Basically, if you get a bad one, you never need one again, because the next time you'll need a coronary angiogram to check for blockage.    
If you scored well, I assume its up to you as to how often you get one. 
This was my experience.

Got one when I was 42. I consider myself healthy-ish. Normal body weight, exercise regularly. I don't eat great though.

I scored over 90th percentile on the calcium test. That's not a good score at all. Like really shitty. I was even training for my second marathon at the time of the test. So I don't know where the correlations are. I think it's genetic because I told my dad and he said his was bad too. And he's in better shape than I am today

My cardiologist said there's no need to do another calcium test. He said it's a good data point, but doesn't mean anything definite by itself.

However, I did do a stress test also and he said that should be repeated every couple of years because of my poor calcium score
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13 hours ago, dcbc said:

How often are you guys (pushing 50) getting these?  Every 5 years?  10 years?

My doc said every five years, and that was after scoring a zero. I don’t know if that’s standard, or because I told him I have some heart issues in my family and my cholesterol was creeping up, but not in a concerning range yet.  I’m a bit overdue.

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My doc said every five years, and that was after scoring a zero. I don’t know if that’s standard, or because I told him I have some heart issues in my family and my cholesterol was creeping up, but not in a concerning range yet.  I’m a bit overdue.

My cholesterol has always been comically low. Like 70. My “good” cholesterol is even lower at around 40 which is a problem by itself.

I had 90% blockage on two vessels including the LDS.

There’s a blood work panel done by Boston Heart Diagnostics that you can have done which is way more detailed than a normal panel. Most doctors don’t even know it exists. You can get it at Any Lab Test Now, IIRC. That panel showed that while I wasn’t diabetic, my blood sugar would spike really high after meals. During those spikes sugar is converted to bad cholesterol and those proteins are sticky. That was building up causing the blockage. As a result, I take metformin to prevent those blood sugar spikes from happening. Dunno if that would’ve been discovered without that special blood panel.
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1 hour ago, South Austin said:

My doc said every five years, and that was after scoring a zero. I don’t know if that’s standard, or because I told him I have some heart issues in my family and my cholesterol was creeping up, but not in a concerning range yet.  I’m a bit overdue.

I scored a zero at age 40.  Recently had another (late 40s) that showed some blockage.  My doc adjusted my BP meds (healthy weight, exercise regularly, eat too many burgers), and I've been told that when we have our 3-mos reevaluation soon, he'll likely send me to a cardio who will run a stress test and likely put me on a statin, as I have borderline cholesterol.

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I had one of those tests at Austin Heart. The scoring was something like 0 to 9 with 0 being best. My score was a 1. I was reasonably fit, worked out, ate healthy, didn't smoke, didn't eat processed foods, etc. My blood cholesterol levels were above normal (low to mid 200s), which I've come to find out was genetic in my case. I was young. I figured I was fine. However I had a myocardial infarction approximately a year after taking the calcium scoring test. A piece of cholesterol broke off and had blocked my LAD artery. They call this heart attack the Widow Maker.

Esp if you're still young, focus on getting your cholesterol and blood sugars to within the recommended range. Everyone needs to take those tests annually.

If your blood sugar is higher than you want it to be, in addition to increasing exercise and paying better attention to your diet, try this pill for 90 days. https://pendulumlife.com/products/pendulum-metabolic-daily

Apologies for sounding like a commercial for a specific product, but what that pill has done for my metabolism over the past 3 months is nothing short of amazing.

If you have a family history of cardiology problems see a cardiologist.

If you're a woman, or if your wife, sister or mother needs to see a cardiologist, help them find a female cardiologist. A study published a couple years ago concluded that female patients get better results from female cardiologists.

Quote

Female physicians have better patient outcomes compared with their male peers, while female patients are less likely to receive guideline-recommended care when treated by a male physician, according to a systematic review from the American College of Cardiology’s Cardiovascular Disease in Women section published today in the Journal of the American College of Cardiology.

 

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2 hours ago, FirstTimeCaller said:

I did some bloodwork about a year ago and my cholesterol was slightly high. Surprised me because I don't eat a ton of red meat.

Y'all know that cookies/cakes has that shit? I inhale that stuff. 

Carbs are the cholesterol generator, not meat.

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Yeah, from a dietary standpoint, the biggest issue I have, now that I've gone from thinking all I have to do is not be stupid is now to be proactively smart, is going to be the baked goods.  I've always been a bread guy, and now I'm trying to limit myself to some whole grain stuff as a treat now and then. Yay avocado toast.

I got to an Iraqi bakery to pick up Samoon bread, so I'm gong to have to figure out if that can play into things a bit.

My GP told me not to worry, that as long as I was feeling healthy, and still losing weight, he didn't think I'd need increased testing or referrel to a cardiologist unless I had issues with getting the LDL down after taking the statin or just developed some other issues. 

I'm thinking with the test results I got, I am going to feel better finding a good young cardiologist who is not going to retire before I win the Cenenarian Decathalon. 

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On 4/15/2023 at 12:53 PM, FirstTimeCaller said:

I did some bloodwork about a year ago and my cholesterol was slightly high. Surprised me because I don't eat a ton of red meat.

Y'all know that cookies/cakes has that shit? I inhale that stuff. 

If you didn't see my reference to Pendulum's Metabolic Daily, you might want to take a look. The sugar cravings you describe are something that can be changed by changing your gut.

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On 4/15/2023 at 4:37 PM, TwiceHorn said:

Carbs are the cholesterol generator, not meat.

 

On 4/15/2023 at 5:14 PM, dcbc said:

Genetics has them both beat. 

Both of these.  I pretty much ate and drank like a garbage disposal for decades with little impact.  But you hit an age, have kids, and realize that there's some shit you were just born with and there's other just lazy decisions you make that have long-term effects, and then there's addiction/dependencies.  I have to accept I can't make sweeping, categorical changes and just go vegan and spend half my day doing cardio.   But I can sub more veggies for carbs, cut out alcohol, swim more, and obviously get off my ass for a simple $150 calcium heart test.

As demented as this site is, many of you are my contemporaries and the advice we give one another with regard to health, wellness, fatherhood, alcohol, stress management, career advice, etc.  We're actually a half decent group of full-on morons.

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Cannot encourage peeps to get one enough. I did my first one back in 2014....scored a 70 and my GP said, work on your diet, etc. fast-forward to last year it was something like 700 or a 1000. Went to a Cardiologist and he ordered a Nuke Strees test which showed a healthy heart but Arterial Occlusion. went to the CATH Lab...LAD was 100% occluded, CRX was 90%, RCA was over 80%. Mind you....I felt great and had no outward signs of heat issues.

 

Want to know what the survivability rate is for a LAD Cardiac Event if you are not in a Cardiac Care center? 12%

 

I had three stents put in, in and out the same day, two sessions. Now its as if they were not occluded. crazy shit

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Anyone with high score should get their LP(a) checked (one time blood test).  It's either going to be high or low and pretty much completely genetics driven.  Found out that was my issue after a CAC test (likely suggested by someone on the old site 5-6 years ago).  No drugs to treat yet (a drug that pretty much obliterates it is in phase 3 trials and, if benefit proven, likely available in 2-4 years) so nothing you can do currently but treat every other risk factor.  If/when a drug is available this likely becomes a "standard" 1 time test from every GP but not even on radar of most currently.  If I had known about that risk factor I probably would have started statins years earlier when LDL was testing low to moderately high and my lazy GP just kept saying "try to eat better" (stuck in the 80's advice).  Peter Attia as mentioned in first post above is a great resource.  He's had podcast with top lipidologist in the country on.

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23 hours ago, next2naus said:

Cannot encourage peeps to get one enough. I did my first one back in 2014....scored a 70 and my GP said, work on your diet, etc. fast-forward to last year it was something like 700 or a 1000. Went to a Cardiologist and he ordered a Nuke Strees test which showed a healthy heart but Arterial Occlusion. went to the CATH Lab...LAD was 100% occluded, CRX was 90%, RCA was over 80%. Mind you....I felt great and had no outward signs of heat issues.

 

Want to know what the survivability rate is for a LAD Cardiac Event if you are not in a Cardiac Care center? 12%

 

I had three stents put in, in and out the same day, two sessions. Now its as if they were not occluded. crazy shit

Sweet Jesus.

How have the stents limited any of your activity?  Although my GP wanted me to just see what the statins and weight loss did, and didn't recommend seeing a cardiologist, he agreed when I told him I was ruminating and surfing the web and freaking out a bit. 

I don't kill myself in the gym, but I enjoy a 15 mile bike ride and a 20K steps walk and a 2000 yard swim without really thinking about it.  If you told me I could continue those activities even with stents/bypass, I probably wouldn't be so anxious. 

 

 

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Sweet Jesus.
How have the stents limited any of your activity?  Although my GP wanted me to just see what the statins and weight loss did, and didn't recommend seeing a cardiologist, he agreed when I told him I was ruminating and surfing the web and freaking out a bit. 
I don't kill myself in the gym, but I enjoy a 15 mile bike ride and a 20K steps walk and a 2000 yard swim without really thinking about it.  If you told me I could continue those activities even with stents/bypass, I probably wouldn't be so anxious. 
 
 

Dude, it’s better. If you have blockage, your heart is working on less blood flow than normal. Opening up that blood flow gets you to normal while minimizing the risk of a heart attack.

When you get the stents put in, it’s a wild sensation because your heart is beat like crazy getting used to all the blood flow it had been missing. For me it lasted for over a full day. It felt like my heart was gonna burst out of my body and go run down the hallway.
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Everyone should get the calcium scoring done but to be sure should get a stress test too if you think you're at risk. 

I had the calcium scoring done and it came back 100% clean. Less than a year later had a heart attack with 90% blockage. The doc did think I was around 10-20% blocked in that artery but a piece broke off and got stuck. Other arteries were around 10-15%.

I was 47 at the time. Doc explained that calcium in the blockages doesn't start appearing till you're 50+ so the test isn't that accurate before you're 50.

The liver converts carbs and sugars to cholesterol, but for some people it's mainly hereditary and nothing but drugs will lower it. 

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My dad went in for a stress test prior to prostate surgery.  Doc came out after additional testing and said "The prostrate surgery is canceled, he needs heart bypass surgery."

4X bypass.  That's not a surgery I'd recommend lightly to anyone.  Recovery was brutal, including additional, significant pain where they harvested the artery from his leg along with depression that lasted the rest of his life, some 20 years more.

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On 4/19/2023 at 5:26 PM, The Original Greaser Bob said:

Sweet Jesus.

How have the stents limited any of your activity?  Although my GP wanted me to just see what the statins and weight loss did, and didn't recommend seeing a cardiologist, he agreed when I told him I was ruminating and surfing the web and freaking out a bit. 

I don't kill myself in the gym, but I enjoy a 15 mile bike ride and a 20K steps walk and a 2000 yard swim without really thinking about it.  If you told me I could continue those activities even with stents/bypass, I probably wouldn't be so anxious. 

 

 

I'm not a Doctor...that being said I walk 3miles a day and hit the dumbbells and kettle bells. Cardiologist has ok'ed this, he said I can do a 5k if I want. I'm not a runner. I did my one marathon back in 2003. I'm about the turn 52 so I'm just working out the stay alive. I can't shovel snow anymore which is a real bummer... no seriously, I like it, I;m weird that way. Your Cardiologist will set the rules.  

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On 4/19/2023 at 10:15 PM, CooterBrown said:


Dude, it’s better. If you have blockage, your heart is working on less blood flow than normal. Opening up that blood flow gets you to normal while minimizing the risk of a heart attack.

When you get the stents put in, it’s a wild sensation because your heart is beat like crazy getting used to all the blood flow it had been missing. For me it lasted for over a full day. It felt like my heart was gonna burst out of my body and go run down the hallway.

there is something to this. my BP went down as the pump doesn't have to work so hard. When I did the stress test and had me on the treadmill....they said the heart was that of man 20 years younger and was strong. Must be all that cocaine from you youth. 

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6 hours ago, jimmyjazz said:

My dad went in for a stress test prior to prostate surgery.  Doc came out after additional testing and said "The prostrate surgery is canceled, he needs heart bypass surgery."

4X bypass.  That's not a surgery I'd recommend lightly to anyone.  Recovery was brutal, including additional, significant pain where they harvested the artery from his leg along with depression that lasted the rest of his life, some 20 years more.

yup....I was slated to have my right shoulder scoped clean out all the arthritis in the A/C joint and some other bullshit from a life well lived. still need to get that done. had the left one done in 2020 the week before the close the hospitals due to Covid. just lucky. 

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Everyone should get the calcium scoring done but to be sure should get a stress test too if you think you're at risk. 
I had the calcium scoring done and it came back 100% clean. Less than a year later had a heart attack with 90% blockage. The doc did think I was around 10-20% blocked in that artery but a piece broke off and got stuck. Other arteries were around 10-15%.
I was 47 at the time. Doc explained that calcium in the blockages doesn't start appearing till you're 50+ so the test isn't that accurate before you're 50.
The liver converts carbs and sugars to cholesterol, but for some people it's mainly hereditary and nothing but drugs will lower it. 

Friend is in his 70s and started going to heart Dr regularly when he turned 50. 20+ years and never did a stress test. Called me after a visit and told me his Dr said he was good for another 10 yrs. Next day he had a major heart attack. Survived it, but was pissed. Other Dr told him if he wasn’t doing stress test nothing else really mattered.

I’m 45 and just got my calcium. Nothing. Going for follow up visit with Dr Monday and I’m going to mention the stress test to see what he says.
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1 hour ago, kmac30 said:


Friend is in his 70s and started going to heart Dr regularly when he turned 50. 20+ years and never did a stress test. Called me after a visit and told me his Dr said he was good for another 10 yrs. Next day he had a major heart attack. Survived it, but was pissed. Other Dr told him if he wasn’t doing stress test nothing else really mattered.

I’m 45 and just got my calcium. Nothing. Going for follow up visit with Dr Monday and I’m going to mention the stress test to see what he says.

basic stress test is crap, needs to be the Nuke Test w/ treadmill too

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An acquaintance I made after moving to Fort Collins was telling me how he had the greatest cardiologist, super knowledgeable, thorough, and who saved his life. Guy (mid 50s) walked into his regular cardiologist appointment for a check-up, told the nurse he wasn't feeling all that well, she went and got the doc, and within minutes the guy was in the back of an ambulance, on his way to the hospital for a bypass. Turned out we have the same cardiologist.

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24 minutes ago, The Original Greaser Bob said:

Did nuke stress test with treadmill.  Profusion great, electrocardiogram iffy.

Wants to do a cardiac CT angiogram.

Really wanted it to stop at the stress test.  Furk.

Relax....While scary...this whole process can be really easy and it means not croaking unexpectedly on your family and friends. I went in at 6:00 AM for the LAD stent and was home within 24 hours, a week later the other two stents and a junction ballon, same thing, arrived in the AM and went home after dinner. I can barley see the scar on my wrist. 

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Had a CT Calcium score a couple of years back at Methodist in Houston. Came back with good results. Wish I had taken advantage of their combo heart scan plus to also get some vascular screening too. I like combo deals at fast food restaurants, why not with medical orders too.  I will look at that within in a few years. 

Even if you're healthy, it seems to me to be a good idea to benchmark where you are at certain ages so if it eventually trends bad, docs can understand how fast you're deteriorating.

https://www.houstonmethodist.org/heart-vascular/prevention/heart-scan-packages/

Now that I'm moving up in age, and lucky to have a bit of excess cash, I have interest in tests like this to hopefully identify any problem before it becomes a real problem. 

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I haven't had to cross that bridge (yet) but I know there is a lot of debate as to value of a stent in a non-emergency (i.e., active heart attack) and if asymptomatic (angina).  I think there is data out there that no real difference in outcomes (and thus important to treat all risk factors aggressively and not assume a stent solved the problem), but again, haven't taken a deep dive on the topic as only stress test i've done was fine.  Might take one later this year though.

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On 4/25/2023 at 10:18 AM, next2naus said:

basic stress test is crap, needs to be the Nuke Test w/ treadmill too

When I had to get stents, I had nothing show up on the regular stress test. Cardiologist still had me go to ER because I said it felt weird.  Did the nuke test on the treadmill and that showed the 90% blockage on the widowmaker and circa. 

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2 hours ago, CooterBrown said:

When I had to get stents, I had nothing show up on the regular stress test. Cardiologist still had me go to ER because I said it felt weird.  Did the nuke test on the treadmill and that showed the 90% blockage on the widowmaker and circa. 

yeah, plain jane stress test is somewhat useless.

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  • 3 weeks later...

Bump.  I was having a beer at Hills and Dales and one of the guys (56 years old)  I see there regularly came up to give me a message he now feels he is meant to share.

Get the test. 

About a month ago he went home after a beer and told his wife he was feeling "off". He had been feeling tired a lot the previous month but docs kept saying "we will test you later this summer, your labs are good" . He went out for dinner with his wife but couldn't sleep that night.  Blood pressure was elevated so they went to the local Helotes urgent care.  Luckily there was a veteran nurse there who pushed tests.  He was in the midst of a heart attack. 90% blockage of LAD.  He had stents put in that night and is feeling so much better.  He has changed his diet and is now drinking Topo Chico at Hills. 

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  • 2 months later...

Remember Thou Art Mortal bump.

Started this thread with my bad calcium score.  Then the stress test, which kinda was okay - cardiologist thought it was a coin flip to take a CT angiogram.  Just got the results.  Bad.  Now I'm scheduled for the actual angiogram (catheterization).

Wish me luck you boys.  

If we aren't essentially training as if we were preparing for the Tour De France, we are doing it wrong.

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I try to remember this, and the fact that I had calcium buildup in the widow maker artery every time I don't want to do my cardio, when I feel like I'm dying on the elliptical, or when I see some totally unhealthy food I want to heat. I'm successful most of the time. 

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