Heart & Cardiology/Heart Calcium Score

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Question
I am a 68 years old male. Recently I had a CT Calcium Score of 1055. I don't have any other symptoms. Subsequently I had an Echo stress test stating:1. No evidence of ischaemia by symptom or echo criteria, but there were ECG changes in late recovery 2. Excellent exercise performance for age (lasted 12 minutes) 3. Normal LV ejection at rest 4. Findings are most consistent with small ischaemic burden.
I am not overweight and generally eat healthy and exercise regularly. In the past, without Lipitor, my Cholesterol level was about 270, but in the past 5 years with Lipitor 20mg total cholesterol is around 190, HDL 85 and LDL 85. Triglyceride 100. My PB is around 130/80. I have a family history of heart disease. (Brother 2 stents at age 59 and Dad died suddenly at age 74 from a heart attack without prior warnings)
I was put on Crestor 20mg and aspirin 100mg, but without any further invasive investigations.
I am concerned that no further investigations are recommended and
I would appreciate your opinion and advise.

Thanks
Max

Answer
Hi Max,
A CT Calcium Score of 1055 is very high, and indicates extensive atherosclerosis, but not necessarily blockages in your coronary arteries that are severe enough to warrant treatment. I find it a useless test. With your history, I'd suggest a CTCA:
http://www.cardiachealth.org/heart-disease-diagnosis/ct-angiography-for-cad/ct-a
Treatment of coronary artery disease depends on whether it has resulted in blockages that are severe enough to limit the blood supply to your heart (which doesn't appear to be the case for you). As far as other treatments are concerned, your cholesterol appears well under control, especially the HDL=85 and your BP are good news.
Hope this helps,
Dr T
http://www.cardiachealth.org/

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