Coronary Calcium Score Chart


0

No plaque is present. You have less than a 5% chance of having heart disease. Your risk of a heart attack is very low.


110

A small amount of plaque is present. You have less than a 10% chance of having heart disease. Your risk of a heart attack is low. However, you may want to quit smoking, eat better, and exercise more.


11100

Plaque is present. You have mild heart disease. Your chance of having a heart attack is moderate. Talk with your doctor about quitting smoking, eating better, beginning an exercise program, and any other treatment you may need.


101400

A moderate amount of plaque is present. You have heart disease, and plaque may be blocking an artery. Your chance of having a heart attack is moderate to high. Your health professional may want more tests and may start treatment.


Over 400

A large amount of plaque is present. You have more than a 90% chance that plaque is blocking one of your arteries. Your chance of having a heart attack is high. Your health professional will want more tests and will start treatment.

http://umm.edu/programs/diagnosticrad/services/technology/ct/cardiac-calcium-scoring

They talk about percentile scores at various ages. Virtually all males my age (66 this month) have some calcium. I scored 12. That is around the 20% percentile, so, combined with my "no family history of heart disease/not smoking/good stress tests of both types/gene expression test/ ability to exercise and do sports/etc., my risk of heart attack is low. All of these tests work together. Because I have a good health plan, I pushed for all these tests. I paid for the genetic expression test myself. I figured " What the heck, I might as well do every test while I'm obsessing". Plus I have afib, so...

@pacyetep - very nice explanation regarding the sensitivity of the myocardial perfusion study (MPS). Thank you.

Most of my currently-ongoing self-research has focused on the physiologic aspects of atrial fibrillation and flutter.

Evidently my cardiologist deemed my MPS's "normal result" as being sufficiently sensitive to determine that it was safe for me to continue taking the Flecainide low-dose as an antiarrhythmic. It seems to be their standard protocol. So far the Flec has kept me in NSR through the 5 months since I started on it.

I also had an echocardiogram but that was primarily to gauge the condition of the mitral and tricuspid valves. I do have a mild-to-moderate regurgitation of the mitral valve and a mild regurgitation of the tricuspid valve.

Table 4 in the article shows calcium scores by age and gender. For age 65-69 (male), virtually no-one has a score of zero. A score of 32 gets you in the 25th percentile, 180 in the 50th, 566 in the 75th, and 1299 in the 90th percentile (a bad place to be).

Your CRP score for inflammation is another test (it kind of rose up quickly, then fell out of favor), and of course, HDL, LDL VLDL, Triglycerides, and overall Cholesterol tests are done to assess risk (and treat).

Even though I had NO risk factors, a coronary calcium score of 12, cholesterol of 142 and HDLs of 60, I was still prescribed a statin (pravastatin 10mg 3 times a week) because of my age. The new scoring system is very controversial because no males my age can escape being prescribed statins if the doctor follows the new guidelines to a tee.

The reason I went through this whole thing is that we are all vulnerable and need to lead healthy active lives if we want to reduce risk- not to the extent of giving up on living- but enough modification to live longer and with a good quality of life... but it is a losing battle in the end. I guess that's why they call it the end. :-)

buddy: That was smart of your doctor to do that if you were going on flec. You should feel good about that.

Gotta go. It's time for my Bystolic, Pradaxa, and Pravastatin.

Ok Petey, I'll be more specific, the card said normal heart function no structural issues after both types of stress tests. Please don't ban me.

BTW, mild regurgitation is so common that doctors generally don't tell patients as it causes undue worry. Here is an example:

"Mild Tricuspid regurgitation may be detected in over 90% of the normal population... "

http://mykentuckyheart.com/information/TricuspidRegurgitation.htm

petey

@pacyetep - thank you, petey

yeah that makes sense. I don't think my cardiologist would mentioned it but I mentioned it only because a nurse listened to me briefly when I was in the hospital with my very first afib and told me, "did you know you have a murmur?" No one had told me prior so I have no idea how long it's been there. When I told the cardiologist about this, he shrugged and said, it's mild, nothing to worry about - only when it is severe would it trigger afib. I pressed him asking if a mild-moderate regurg would, as an outlier, still trigger afib and he said, "highly unlikely".

I'm still researching papers on afib electrophysiology. I have read about ectopic foci and reentrant wavelet circuit loops and believe I understand them. What I a seeking to know is what leads to the genesis of ectopic foci.

buddy- regarding your search for information regarding genesis of ectopic foci, I believe that is precisely the mystery that still surrounds AF. From what I learned, many sites in the atria are capable of firing an electrical impulse. I was taught that many cardiac cells have automaticity (meaning they can create electrical impulses) and sometimes, these cells become irritable/excitable. As more cells in the atria fire ectopic signals, it literally spreads from cell to cell (conductivity) and more cells get irritable/excitable. In a healthy heart, with a healthy electrical system, the impulse comes from the SA node only, but when too many areas are firing off due to irritablity/excitability, it overrides the SA node. I guess the biggest question is what makes those cells irritable/excitable? It is my belief that there is no one explanation especially when you look at how different we all are in terms of triggers and varying degrees of health status. My cardiologist said whoever figures out what definitely causes AF is going to be a millionaire one day :)

keepumping: Wow, it sure was good that your docs decided to do a heart cath. Isnt it the heart amazing how it builds collaterals to compensate? I actually was on the other side of this situation. I had a physical done right after my father died of heart disease. He was only 53 when he died. I was 30 at the time and was experiencing some shortness of breath and chest tightness (at the time, I was not diagnosed with AF, though suspect that I had it then). My EKG showed junctional rhythm and my nuclear stress test showed ischemia of the heart. In order for them to definitely diagnose what was going on, the cardio advised me to agree to a heart cath. The heart cath showed no blockages or damage. Perfectly healthy heart. The junctional rhythm was determined to be my normal heart rhythm. It was the predominent rhythm since it was pacing faster than my SA node. Fast forward 12 years. I was diagnosed with Afib. I have to wonder if the Afib was what caused the false positive on my nuclear stress test. While they were taking pictures, my heart flipped out briefly..I felt alot of fluttering. I believe this may have shown on the images as ischemia/lack of blood flow. So I believe that stress testing can show both false positives and false negatives. When it comes down to it, the docs have to weigh how the patients symptoms and proceed from there. A heart cath definitely will either diagnose or rule out blockages. Good luck with your decision whether to have an ablation or not. Wow, the atria pressing against your esophagus is definitely something to consider. When I had my ablations, I never had a CT scan prior to either procedure so it was a great unknown. I did have a TEE an hour prior to each ablation and most likely this was observed prior to the procedure, or at least I hope it was. :) Take care, Carrie