High Calcium Score: What Next?

Allow me to share my story and journey that started about 4 months ago with a 209 calcium score (59yo). I have a family history of heart disease, this is what led me to take this test. After the 209 score which fell into the "moderate" level, I wasn't convinced that I has not in danger, so the next step my cardiologist and I agreed on was a simple stress test, which I "passed" with flying colors (surprisingly). At this point the cardiologist was satisfied, but I wasn't, I knew I had plaque and wanted to know how much. So I suggested to my cardio that I should get a CT Angiogram, he was fine with that and it was done. The test results were overwhelming, severe stenosis and soft plaque found in LAD and other major arteries. This test listed my CT Cal Score at 197 (lowered), however because of all the soft plaque found that is NOT detected by CT Calcium scores, this test raised my CT Cal Score level/score to 1000+. The cardiologist was puzzled and I asked him why, he said because he is not seeing this from the stress test images. So I then insisted a full CT Cath, I wanted them up there at this point to give me some percentages, he agreed and said he would be surprised if a stent was needed, I was hoping he was right. Full Cath day arrived and up they went, it didn't take long for the Cath doctor to ask me one question and then the words I will never forget. "Do you have a family history" then..."I am sorry but you have major blockages all over (80 to 90% in the LAD) and you are in need of bypass surgery asap. So, from a simple "moderate" 209 calcium score to life saving bypass surgery within 4 months. I am NOT trying to scare anyone who comes back with a calcium score, but it is up to YOU to find out what is really going on before its too late. Skip the Stress Test PLEASE because in my opinion its just a waste of time, how could I have "passed" a Stress Test with 80/90% blockage in the LAD??? Go right to the CT Angiogram and see what is really going on and then take it from there. BTW, I am now two weeks out of double bypass and doing well. Just want to also point out that I had absolutely no symptoms during this whole ordeal, it truly was going to silently kill me.

I had a calcium score of 1188 twelve years ago, mostly in the LAD, at age 68 and was terrified. Now I’m 80 and so far no heart attack or stroke, but it’s still early in the day. So it raised my risk, but wasn’t a death sentence.

Excellent perspective, I'm feeling better about this. My number was 1500. Totally asymptomatic, all numbers at annual physical within acceptability. Not over weight, non-smoker , 85% or so Mediterranean diet. Total shock. Statin therapy and Zetia teamed up brought the LDL from 85 down to 53, with 70 being the prescribed target number. Nuclear results were excellent with a high level of exercise endurance, so I was told. I'm 64 years old. Don't let this ruin your joy and happiness. Life is short. Stress shortens it and increases inflammation. Make the changes and live. God bless.

Thank you for this. I am 44 years old. Diagnosed 3 years ago with CAD. CT calcium score 4100. 90% blocked on the right. 80% on the left. Diseased widow maker. Had to have 5 stents placed. Family history I was unaware of. Relatively healthy person. I obsessively think about my CAD everyday of my life. I constantly think I may be having a heart attack or stroke. I take my BP 4-5 times a day. This video helped me a lot and I appreciate it.

I am a 74 yr old male. In May 2020 I suffered a stroke which luckily produced a two day black out but no lasting effects. I have a history of blood clots from work travel in 2010 which caused me to have a pulmonary embolism in my left lung. I also had a TIA that attacked my eyes and left me with double vision for six months. After the clots, I was on Coumadin for several years then put on baby aspirin until the stroke. We spent two months searching for what exactly caused my stroke. I had no FAST indicators but total confusion and headaches. After scores of Echo’s and MRI’s and CT scans I finally had a CT Scan with a calcium scoring. My score was 1800. My doctor and I then decided to do an angiography and discovered my left anterior artery (The Widow Maker) was over 90% blocked so they put in 4 stents to open the flow. My doctor and I both feel the stroke was a blessing in disguise in my case. The calcium score was a good indicator that pushed us to go the invasive route. I have a filters in my vein to catch clots as well as a full time monitor in my chest that monitors my heart every day and take Eliquis daily. So far things are going well for me. I count my blessings every day.

Thank you, thank you!! I got a CAC and it came back just over 2000. I had been on statins for 3 years and had recently discontinued them due to side effects and drilling down about the absolute effectiveness of statins. I made a personal choice not to take statin any longer. My cardiologist about went ballistic. So, he said I want you to do a nuclear stress test and a carotid US. I did and passed both tests. No restrictions in the carotids. By the way I am 72, asymptomatic. I paid out of pocket for the advanced lipoprotein panel. Triglycerides: 46, Apo(a): <10, ApoB: 98, LDL pattern: A, LDL size: 225, CHOL/HDLC RATIO: 3.3. Those results don't seem to alarm me and I wanted to share them with my cardiologist. He would not even look at them stating: "your LDL is 130 that's all I need to know----you need a statin." I disagreed and we parted ways.

The finest intro to this topic I've seen, after combing through so many that purport to "clear the artieries" and "lower your calcium score." Professor Barlis "re-perspectivizes" the focus from trying to "change the score" (or "treat the symptom") to leveraging the score, in combination with complementary findings, to take steps / investigations that shift the focus to lowering risk based upon qualitative findings and lifestyle changes. There are, after all, other tools that can be combined with the score that reveal not only the true state of risk, but that offer a roadmap to arresting situations that might be dangerous to ignore or overlook. WELL DONE. Professor Barlis!

I had a high calcium. The next test my pcp ran was PTH. I spent 6 months repeating these tests and continued with elevated test results. I was sent for a sistimebi, which showed a 2 cm parathyroid adenoma. High calcium has many causes, but once it reaches over 10.3, the adult patients will feel very ill. Mine peaked at 11.2, and PTH was 123. I still have osteoporosis. I am taking infusions for treatment. Great information for other elevated calcium causes.

Here’s my story. I have been on statins for the last 18 years, initiating them in my late 30s, due to a strong family history of coronary disease. My dad, as healthy as I am, had a heart attack in his early 50s. I am a long-distance cyclist, do not smoke, and I’m generally extremely healthy. After contracting Covid, two years ago, I was experiencing post Covid chest pain, atypical in nature, but sometimes exertional, leading me down the cardiac work up pathway. This included an EKG, echocardiogram, and a stress test, all of which were normal. My cholesterol is under excellent control, and HDL levels run high. However, because of going pain, my cardiologist suggested, in order to allay my concerns, that we do a coronary calcium score. This returned at nearly 900. Severely high. Imagine my great surprise. This, then led to a formal, cardiac catheterization. All of my vessels are wide open, without any stenosis, without any plaque. I think that my case demonstrates the pitfalls of coronary calcium scoring. I have since learned that statins lead to arterial calcification. This in turn is likely related to interference with calcium transport, which is reliant on CoQ10, depleted by statins, as well as vitamin K2, each of which I have now been on for the last year. I do plan to get another coronary calcium score performed with another year or two to see if there’s any difference.

My daughter told me to watch this and I'm so glad I did. You calmed me down a lot! Thank you!

I have an extremely high CAC score and your video helped shed some of the terror I was feeling and gives me some hope. I am asymptomatic. I found a metabolic cardiologist near me and will be seeing him soon. Thank you for making this video.

An excellent explanation! I wish that my cardiologist had explained my calcium score in such a reassuring manner, some years ago. I feel so much more confident now. Many thanks!

Did a CAC test which showed 0. Did a LipoA test which showed 14. Did a PAD and carotid test that showed no obstructions. Im 60 yrs old. My dad had issues but lived until 89 and my mom 92. I still don't take life or health for granted. GOD is good.

Great video. As someone who has a score of 3100, this come as a relief to know that something can be done to stabalise. Thanks Professor Barlis

Excellent video. This is the most informative presentation of the definitions for high calcium scores that I've ever heard. My score is 3200 so this has always been a major concern since I was tested 8 years ago. Thank you Professor Barlis.

Thank you. 1500 following modern med. over 5 yrs it went up to 4100 even thought I lost 80lbs. I am asymptomatic

My score was 2400 in 2016 and at the end 2016 an angiogram showed that I had significant blockages. in 2019 I had some chest pain and another angiogram indicated that the blockages had progressed so the cardiologist recommended I get quadruple bypass surgery. Instead I opted to fly to Mt. Sinai in NYC where they performed atherectomies on the major blockages and added stents. An atherectomy is like a roto rooter on the arteries. It removes the plaque and calcification while the medicine coated stents keep the arteries open and prevent restenosis. My point is although the calcium score is a strong indication of future blockages, it's not the end of the world. Technology has advanced to the point where there are many treatments available. Diet and exercise are obviously the best medicine but sometimes those can't offset heredity.

Professor Barlis Is the most honest professional smartest cardiologist in the whole world. He doesn't try to scare people to become his patients like all other drs do. He just gives the facts and options may he live at least forever!

Thanks Professor - the best explanation I have heard

Thank you. Your video was useful. My problem is finding a medical professional that will take the time to talk with me and help me understand what my risks really are. In my world, finding medical professionals is very difficult. I will keep looking, but I am very grateful that you care enough to talk and explain this subject.