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What Do The Following Test Results Indicate?
Question: 53 year old male- 5 9 165 pounds- active-does vigorous cardio 6 days per week- strong family history of CAD on fathers side- been on statins for 20 years(Lipitor 40mg) plus Altace 10mg-has had numerous stress tests-nuclear and regular- had EKG and stress test 3 weeks ago and passed with flying colors-labs are usually very solid- went for EBCT test since they were being offered for free- shockingly my calcium score was 1148- sent test to my doc and he is increasing Lipitor to 80mg. very compliant other than diet is not always the best. any thoughts?
Brief Answer:
You need new preventive and therapeutic medical strategies.
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that coronary calcium score is a helpful marker of atherosclerosis, and in patients with known coronary risk factors it may predict the future probability of coronary events, as well as indicate the need for modulating our life style, avoiding potential coronary risk factors or even switch to a new treatment.
Returning to your clinical scenario; your overall coronary calcium score of 1148 is considered as a severe scale of atherosclerosis (>400) and facing your present coronary risk factors (strong family history of CAD, dyslipidemia, hypertension, it may be concluded that there is a high likelihood of at least one significant coronary narrowing.
At that point, a more aggressive strategy regarding your coronary risk factors management is necessary. So, your doctor's decision to increase Lipitor to 80 mg is justified. Nevertheless, there isn't a standard approach when facing such a result in a physically active, clinically normal individual.
What is important to consider, additional confirmatory diagnostic tests are necessary. Follow up tests will be indicated to reveal possible progression, as well as beneficial effects of preventive or therapeutic medical strategies.
For the moment, aggressive approach against modifiable coronary risk factors (dyslipidemia, hypertension, avoiding close smoking contacts, glucose intolerance, etc. ), as well as a healthy lifestyle couple with a healthy diet, seem to be a reasonable strategy.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
You need new preventive and therapeutic medical strategies.
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that coronary calcium score is a helpful marker of atherosclerosis, and in patients with known coronary risk factors it may predict the future probability of coronary events, as well as indicate the need for modulating our life style, avoiding potential coronary risk factors or even switch to a new treatment.
Returning to your clinical scenario; your overall coronary calcium score of 1148 is considered as a severe scale of atherosclerosis (>400) and facing your present coronary risk factors (strong family history of CAD, dyslipidemia, hypertension, it may be concluded that there is a high likelihood of at least one significant coronary narrowing.
At that point, a more aggressive strategy regarding your coronary risk factors management is necessary. So, your doctor's decision to increase Lipitor to 80 mg is justified. Nevertheless, there isn't a standard approach when facing such a result in a physically active, clinically normal individual.
What is important to consider, additional confirmatory diagnostic tests are necessary. Follow up tests will be indicated to reveal possible progression, as well as beneficial effects of preventive or therapeutic medical strategies.
For the moment, aggressive approach against modifiable coronary risk factors (dyslipidemia, hypertension, avoiding close smoking contacts, glucose intolerance, etc. ), as well as a healthy lifestyle couple with a healthy diet, seem to be a reasonable strategy.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr.Sharka, so why not get a catherization(I understand it is invasive but the gold standard) and see what is going on? I realize I am asymptomatic but the goal is to prevent an event.
Thank You
Thank You
Brief Answer:
You need to discuss with your attending cardiologist about this option.
Detailed Answer:
Hi again!
As I explained you above, there isn't a standard approach when facing with and asymptomatic individual showing a high coronary calcium score, such as your.
Not rarely, in our daily clinical practice, high calcium scores on such settings have resulted false alarms.
Nevertheless, an elective scheduled coronary angiography could be an option.
You just need to discuss with your attending cardiologist to build a strategy.
Better prevention would be yielded by properly facing your coronary risk factors (as I mentioned above).
Best regards,
Dr. Iliri
You need to discuss with your attending cardiologist about this option.
Detailed Answer:
Hi again!
As I explained you above, there isn't a standard approach when facing with and asymptomatic individual showing a high coronary calcium score, such as your.
Not rarely, in our daily clinical practice, high calcium scores on such settings have resulted false alarms.
Nevertheless, an elective scheduled coronary angiography could be an option.
You just need to discuss with your attending cardiologist to build a strategy.
Better prevention would be yielded by properly facing your coronary risk factors (as I mentioned above).
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr.Sharka, so there is still some uncertainty regarding the calcium scan? You state that it is more than a rare occassion when there can be false positives. Perhaps I should use this as a good wakeup call?
Brief Answer:
Coronary calcium score is a reasonable predicting tool and alert signal.
Detailed Answer:
Hello!
In fact, in your case an increased coronary calcium score indicates just a wake-up call.
You should be more alert hereinafter for better preventing future coronary events.
Remember EBCT is more reliable than a standard coronary CT scan.
Follow up tests are necessary.
Regards,
Dr. Iliri
Coronary calcium score is a reasonable predicting tool and alert signal.
Detailed Answer:
Hello!
In fact, in your case an increased coronary calcium score indicates just a wake-up call.
You should be more alert hereinafter for better preventing future coronary events.
Remember EBCT is more reliable than a standard coronary CT scan.
Follow up tests are necessary.
Regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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