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Is Calcium Score Test Value Of 4000+ A Cause For Concern?
Question: Can a person have a calcium score test with a result of 4000+ and have no symptoms while exercising. Also on a treadmill and getting the heart rate regularly at 125 to 130 bpm. Then finishing the exercise at 150-155 bpm. The person is 70 years old.
Brief Answer:
Yes a person can have have high calcium in spite of good exercise tolerance
Detailed Answer:
I do underatnad your dilemma , but Yes it is very common to have very high calcium score and no symptoms ,
One have to understand that calcium is due to degenerative process in your patient because of his age and generalised atherosclerosis. This calcium is deposited in the walls of the artery and not in the lumen . It's only when lumen becomes narrow there will be decrease blood supply to the heart resulting in angina pain .
So even though there is some Co relation between high calcium and luminal narrowing ( stenois) it doesn't mean the same thing .
I have many patients in my practice who has high calcium score but with normal coronary angiogram particularly more than 70 years , diabetic and chronic kidney disease patients .
So a 'nuclear stress perfusion scan ' would be good for the patient , considering it will check the functional status of the heart arteries and whether the heart muscle is receiving enough blood when it is subjected to physical stress .
If that is normal , no further test is required . If it has perfusion defects next step would be conventional coronary angio gram .
Lastly the heart rate you reach on treadmill is optimum for your age (220- Age ,for you more than 150) , which you have been able to achieve.
However that suggests only that it's a well trained heart and chances of stenosis are less , but doesn't rule out cardiac disease 100%.
However you may also undergo a treadmill stress echocardiography as a more non invasive means to nuclear scan if there are no risk factors for cardiac disease .
Let me know if any clarification is needed .
I would be happy to help.
Regards Dr Priyank Mody, Cardiologist, XXXXXXX
Yes a person can have have high calcium in spite of good exercise tolerance
Detailed Answer:
I do underatnad your dilemma , but Yes it is very common to have very high calcium score and no symptoms ,
One have to understand that calcium is due to degenerative process in your patient because of his age and generalised atherosclerosis. This calcium is deposited in the walls of the artery and not in the lumen . It's only when lumen becomes narrow there will be decrease blood supply to the heart resulting in angina pain .
So even though there is some Co relation between high calcium and luminal narrowing ( stenois) it doesn't mean the same thing .
I have many patients in my practice who has high calcium score but with normal coronary angiogram particularly more than 70 years , diabetic and chronic kidney disease patients .
So a 'nuclear stress perfusion scan ' would be good for the patient , considering it will check the functional status of the heart arteries and whether the heart muscle is receiving enough blood when it is subjected to physical stress .
If that is normal , no further test is required . If it has perfusion defects next step would be conventional coronary angio gram .
Lastly the heart rate you reach on treadmill is optimum for your age (220- Age ,for you more than 150) , which you have been able to achieve.
However that suggests only that it's a well trained heart and chances of stenosis are less , but doesn't rule out cardiac disease 100%.
However you may also undergo a treadmill stress echocardiography as a more non invasive means to nuclear scan if there are no risk factors for cardiac disease .
Let me know if any clarification is needed .
I would be happy to help.
Regards Dr Priyank Mody, Cardiologist, XXXXXXX
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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