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PSA: CT HEART CALCIUM SCORING


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Monday got a stent in the LAD (widowmaker).  Very "busy" procedure (lots of nurses/busy "operating room" - camaras and computers buzzing and you can hear and see everything).  Got crotch shaved just in case but ended up going through the wrist.

Feel good - doctor told me since I was asymptomatic to begin with I wouldn't necessarily feel better -- I guess I do but mostly from a anxiety standpoint since its over and now I have work to do and veggie recipes to learn.

 

 

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1 hour ago, The Original Greaser Bob said:

Feel good - doctor told me since I was asymptomatic to begin with I wouldn't necessarily feel better -- I guess I do but mostly from a anxiety standpoint since its over and now I have work to do and veggie recipes to learn.

 

 

Don't be surprised if you have chest pain due to anxiety.  For an entire year after getting stents, I had chest pain while trying to fall asleep at night.  It was 100% caused by anxiety.

Also, make sure sure you get an ultrasound annually to get an idea your heart health.  I got stents 7 years ago and have generally been good with diet and exercise and until a recent ultrasound I was fine. While I don't have any additional blockage, my heart ejection refraction is at 51% which is barely above the 50% threshold before failing into  heart failure category. So that's nice.  While stents are a 2nd lease on life, make sure your affairs are in order. 

 

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On 4/21/2023 at 4:08 PM, 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.

I have to ask, was there ever a medical diagnoses from a psychiatrist or psychologist (I know not a real doctor) about how this procedure/situation led to depression, much less 20 years of it? One would think that they were alive would feel like a gift?

22 hours ago, CooterBrown said:

Don't be surprised if you have chest pain due to anxiety.  For an entire year after getting stents, I had chest pain while trying to fall asleep at night.  It was 100% caused by anxiety.

Also, make sure sure you get an ultrasound annually to get an idea your heart health.  I got stents 7 years ago and have generally been good with diet and exercise and until a recent ultrasound I was fine. While I don't have any additional blockage, my heart ejection refraction is at 51% which is barely above the 50% threshold before failing into  heart failure category. So that's nice.  While stents are a 2nd lease on life, make sure your affairs are in order. 

 

Not to pry, but help me understand the heart failure aspect. There's literally nothing to be done, your kicker is just slowly going to quit working? Is a transplant a viable option?

20 hours ago, South Austin said:

So when you get stents you're allowed to have some?

Are you implying that your ex had stents? /ducks. Sorry man, couldn't help myself. 

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23 hours ago, CooterBrown said:

"Don't be surprised if you have chest pain due to anxiety.  For an entire year after getting stents, I had chest pain while trying to fall asleep at night.  It was 100% caused by anxiety."

 .

 

Well now you've done it!!! Have my Calcium Scoring appointment this afternoon and have already been having to try to calm myself....

Edited by Chico_SA
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35 minutes ago, SydneyCarton said:

Not to pry, but help me understand the heart failure aspect. There's literally nothing to be done, your kicker is just slowly going to quit working? Is a transplant a viable option?

Basically, the normal range is 50-70%. Your heart won't fail instantly when your fall below 50%, but if you get down to 40%, your life expectancy is around 3-7 years.  You can improve it via better diet and exercise.  I haven't had a real discussion about options with my cardiologist yet since that'll happen at my next appointment.  As of now, I am back on my routine from when I initially got stents...an insanely strict diet and exercise twice per day. 

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16 minutes ago, CooterBrown said:

Basically, the normal range is 50-70%. Your heart won't fail instantly when your fall below 50%, but if you get down to 40%, your life expectancy is around 3-7 years.  You can improve it via better diet and exercise.  I haven't had a real discussion about options with my cardiologist yet since that'll happen at my next appointment.  As of now, I am back on my routine from when I initially got stents...an insanely strict diet and exercise twice per day. 

Good luck dude. 

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1 hour ago, SydneyCarton said:

I have to ask, was there ever a medical diagnoses from a psychiatrist or psychologist (I know not a real doctor) about how this procedure/situation led to depression, much less 20 years of it? One would think that they were alive would feel like a gift?

Yes, he was diagnosed clincally with depression.  I don't think he entered therapy, but I suppose he might have had to have some quick annual (?) wellness checkups with the prescribing doctor.  Honestly, he seemed to feel like the meds worked and he didn't see any reason to go off of them and tempt fate.  I don't blame him.

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I got my calcium score about a year ago after a good friend died of a massive heart attack at age 60.  He was a former college basketball player and still seemingly very fit.  My score was zero.  I also do the stress test every year at my annual physical.  All good so far. 

I know several older guys who were friends with Dr. Denton Cooley and he would tell everyone that would listen that, except for cigarettes, it’s all about genetics.  
 

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Test was Thursday and got results today.  Score of 2 so great news and much better than I was expecting given the results both my brothers got within the past few months.  I'm wondering if scores can get worse exponentially based on age. 

I'm 53.  My 61 year old brother scored around 400 and got a stent put in(he's the reason we all decided to get the test), and my 64 year old brother scored much worse and is going through the steps to figure out what they will need to do.

I'll certainly be talking to my doctor about what I need to do to try to stay where I'm at given our genetics and family history. Of course, I know a few things I can start doing differently.

I'm going to be recommending this to many more of my friends. 

 

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2 hours ago, Chico_SA said:

Test was Thursday and got results today.  Score of 2 so great news and much better than I was expecting given the results both my brothers got within the past few months.  I'm wondering if scores can get worse exponentially based on age. 

I'm 53.  My 61 year old brother scored around 400 and got a stent put in(he's the reason we all decided to get the test), and my 64 year old brother scored much worse and is going through the steps to figure out what they will need to do.

I'll certainly be talking to my doctor about what I need to do to try to stay where I'm at given our genetics and family history. Of course, I know a few things I can start doing differently.

I'm going to be recommending this to many more of my friends. 

 

Good that you are on top of it.  God’s speed.

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Fwiw if you have severe cardiac stenosis such that your heart valve needs replacement, there's now a minimally invasive option to open heart surgery, Transcatheter aortic valve replacement (TAVR). Apparently they do a lot of it at the Medical Center for the Rockies near Fort Collins, which also serves as a training center for other cardiologists, but I'm certain they also do it at Austin Heart and Houston Methodist.

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Just got back from a 1/2 day physical at Austin Heart Hospital that included the CT scan.  

28.4 Agatson score with 2.84 in LAD.  Mild but not great.  No blockages though and everything else in the body running solid based on stress test and ultrasounds   

My cholesterol has always been fine and TriGs see saw.  I was up over 280 at one point a few years back, but at 175 today.  When I am working out regularly, TriGs are generally under 125 when I look at past results   

LDL was at 124 which is normally fine, but given calcium score, they want it under 70 which seems but so but I’ll give it a go.  Doc gave me a statin prescription but I am hesitant to start that and thinking diet and exercise for 90 days, retest, and see if LDL and TriG goes down.  But curious others’ thoughts presuming I don’t get the side effect if I might as well do both?  

Anyway, I am 47 so glad I found this thread as it got me to do the scan.  

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8 minutes ago, A-Tex Devil said:

Just got back from a 1/2 day physical at Austin Heart Hospital that included the CT scan.  

28.4 Agatson score with 2.84 in LAD.  Mild but not great.  No blockages though and everything else in the body running solid based on stress test and ultrasounds   

My cholesterol has always been fine and TriGs see saw.  I was up over 280 at one point a few years back, but at 175 today.  When I am working out regularly, TriGs are generally under 125 when I look at past results   

LDL was at 124 which is normally fine, but given calcium score, they want it under 70 which seems but so but I’ll give it a go.  Doc gave me a statin prescription but I am hesitant to start that and thinking diet and exercise for 90 days, retest, and see if LDL and TriG goes down.  But curious others’ thoughts presuming I don’t get the side effect if I might as well do both?  

Anyway, I am 47 so glad I found this thread as it got me to do the scan.  

Did you request a half day physical or some underlying condition forced it on you?   Haven’t heard of one of these but I would be interested in it from sheer curious it’s…also 47.

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16 minutes ago, Hornbeliever said:

Did you request a half day physical or some underlying condition forced it on you?   Haven’t heard of one of these but I would be interested in it from sheer curious it’s…also 47.

It is the Exec Wellness Program at Austin heart hospital.  It’s $3500 flat but my company subsidizes about 75% of it. Was worth it I think.  
 
Basically a full typical primary care, physical, plus stress test on treadmill, CT scan, ultrasound of carotids and internal organs plus checking blood flow in limbs (cuffs just above ankles and wrists), the 45 minute massage followed by immediate consultation on results with internal medicine Dr and nutritionist.  

My wife had DCIS breast cancer (did not spread) and now has potential MAC infection in lungs, so when she found out our company does this she insisted I do it to flush things out.  I never go to Dr and never get sick so if something was brewing inside of me I wouldn’t know. 
 

 

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On 8/13/2023 at 11:17 AM, Chopper said:

Fwiw if you have severe cardiac stenosis such that your heart valve needs replacement, there's now a minimally invasive option to open heart surgery, Transcatheter aortic valve replacement (TAVR). Apparently they do a lot of it at the Medical Center for the Rockies near Fort Collins, which also serves as a training center for other cardiologists, but I'm certain they also do it at Austin Heart and Houston Methodist.

My 84 year old Dad just had his TAVR done Tuesday morn by Rajesh Ramineni at Memorial Hermann in The Woodlands.  Ramineni has been a great doc, the cath lab at MH is awesome, and the overall facility is fantastic.  Easy-peasy...

Now he has a nice, long healthy life of dementia ahead of him.  Fucking modern healthcare.....

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14 hours ago, A-Tex Devil said:

Just got back from a 1/2 day physical at Austin Heart Hospital that included the CT scan.  

28.4 Agatson score with 2.84 in LAD.  Mild but not great.  No blockages though and everything else in the body running solid based on stress test and ultrasounds   

My cholesterol has always been fine and TriGs see saw.  I was up over 280 at one point a few years back, but at 175 today.  When I am working out regularly, TriGs are generally under 125 when I look at past results   

LDL was at 124 which is normally fine, but given calcium score, they want it under 70 which seems but so but I’ll give it a go.  Doc gave me a statin prescription but I am hesitant to start that and thinking diet and exercise for 90 days, retest, and see if LDL and TriG goes down.  But curious others’ thoughts presuming I don’t get the side effect if I might as well do both?  

Anyway, I am 47 so glad I found this thread as it got me to do the scan.  

Pretty unlikely you can get your LDL under 70 from diet and exercise.   Statins have for some reason gotten a bad rap but I'm on a max statin given high genetic risk and CAC and I've have had zero side effects after 6.5 years.  Also, if you dive in to lipids, LDL-C isn't the best test.  Should have your Dr. test apo(b) which is more precise because sometimes (rarely) LDL-(c) and apo(b) can be discordant (although they typically track - mine always has).  Should probably find a preventative cardiologist (preferably one that is also a lipidologist) rather than just utilizing a GP to check in with once per year.

I learned a lot about all of this stuff via Peter Attia who brought on top cardiologist/lipidologist for his podcasts after I figured out my risk.  Those are all available and good listens as well (some are very technical and somewhat geared towards medical professionals), but he just released a book earlier this year (Outlive) which synthesizes a lot of the current info/guidance on lipids/heart disease but also dives into all the other important stuff (diet, exercise, sleep, cancer risk, etc.).   

I just started getting through it a couple of weeks ago and kind of gave me a renewed focus after I've let my diet/drinking habits slip over the summer.  I'm actually doing a Dexa Scan later today and bloodwork tomorrow to see how far I've slipped (probably got a bit lazy starting with the Stars playoff run last spring) and plan to lose 5-7 LB's over the next couple of months and reset.

 

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Also, LDL isn't a good indicator by itself.  Mine was like 40. Also, my HDL was even lower and barely measurable (which was bad).  I still had 90% blockage on two vessels. 

There's an excellent bloodwork panel by Boston Diagnostics that you can get done at Any Lab Test Now.  They'll send you a 20 page booklet on your results.  It showed that  while I had minimal LDL, my liver was still creating a ton of bad cholesterol from carbs and that was causing the blockage. 

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2 hours ago, CooterBrown said:

  It showed that  while I had minimal LDL, my liver was still creating a ton of bad cholesterol from carbs and that was causing the blockage. 

Not following this.  What was the specific measurement in the labwork you are referencing?

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12 minutes ago, CooterBrown said:

It was a genetic marker that made me more likely to convert excess carbs to cholesterol.

Just curious because at the end of the day, lipids are lipids.  Was curious if you had LDL-P or APO(b) measurement that was discordant with LDL-C.  Clearly your low LDL is now treated but maybe that marker made it higher in the past before treatment?  Also, everyone should check LP(a) once (which was my genetic marker/gift).  No drug lowers it currently but one is in phase 3 trials and if successful will be out in 2025 (and at that point, everyone will know about it as it will become a standard test once pharma marketing picks up).  If my GP would have ever heard of it/tested it, I would have been on statins to treat LDL maximally years earlier.

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On 4/14/2023 at 1:33 PM, The Original Greaser Bob said:

Since this is a board about living the good life and also eating lots of red meat, you guys need to go get your calcium scoring test done.  Quick little CT scan, not covered by insurance (but only $100 bucks).  Gives you an idea of the calcium in your heart, and thus the plaque buildup.  I got my first one today and I'm on ArmyBrat's side of the temporal fence, and I'm pissed that I didn't take this earlier.  The numbers aren't pleasing.  My LDLs were only recently just a tad over normal but I've got some ugly numbers.  It would have been nice to get a scare in my 30s or 40s so I could have gotten the scare a bit earlier.

Anyway, Peter Attia is all about the early testing so this is an inexpensive test.  Go get it. 


my test is scheduled for the end of the month. Thanks for the heads up

 

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Got mine done a few weeks ago. Score was 1568. That’s not a typo. GP called me at 8am two days later to tell me score and say “might want to start taking a baby aspirin and call x cardiologist ASAP.”

Anxiety was through the roof.

I had/have zero symptoms and GP recommended this CT scan after a recent physical.

Been on statins for years. Never been one to workout regularly and pretty much eat (ate) ribeyes like tacos.

Found out my paw paw’s (moms dad) body basically manufactured cholesterol.

Just finished my cardio stress test and the cardiologist came in for the last five minutes while I was on treadmill getting heart rate to 175. He watched as tech was doing ultrasound on heart. He said heart looked good with no blockage and strong pump/flow. “See you in a year.”

Major lifestyle changes incoming. Very glad I got this test done. 

Stay healthy Surly.

 

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