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Coronary artery calcium testing can reveal plaque in arteries, but is underused

nytimes.com

111–120 of 197 posts

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#111

Earlier quoted context omitted.

I'm sure your doc already told you this but chest pain while playing tennis that goes away quickly sounds more like angina than a heart attack. IOW your episode was not a heart attack but rather a strong indicator that a future heart attack was likely and that further tests were warranted. A real heart attack (MI) -- the kind that can kill you quickly -- is usually not exercise related and the pain continues for many…

Since you mentioned take asprin, just curious , how does that help ?

Blood thining characteristics

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#112
post #78

Earlier quoted context omitted.

Unfortunately there is no approved oral medicine to lower Lp(a) that I am aware of. (I mean given a normal LDL.) Statins don't lower it afaik. An oral medicine named muvalaplin is being tested for it.

Oddly enough, there's evidence that saturated fat intake inversely affects Lp(a) levels: https://pmc.ncbi.nlm.nih.gov/articles/PMC10447465/

It doesn't help if LDL gets raised due to the SFAs, as LDL is an independent risk factor.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#113

CAC is pretty common, but I prefer Coronary CT Angiography, which is much more detailed CT of the heart and coronary arteries using IV contrast. It's a bit more radiation, but it shows soft plaque and arterial narrowing, which CAC does not.

How do you get one and what is the cost?

I got one a couple of years ago when I was 41 due to a recurring palpitation and non-standard EKG reading. They are more commonly used to really get a good view of things before heart surgery, but it really depends upon your doctor. The cost usually ranges from $300 to $1,000.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#114
I recently requested this test from my doctor. The lab technician asked if I had requested it or my doctor, and gave a very judgmental "that's what I thought" type response. Ends up I was 95%-tile and put on an aggressive statin therapy, from a risk profile that otherwise didn't determine statin use. The test was easy and (relatively speaking) inexpensive. It helped me in risk stratification in a determinative way.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#115

Earlier quoted context omitted.

I'm sure your doc already told you this but chest pain while playing tennis that goes away quickly sounds more like angina than a heart attack. IOW your episode was not a heart attack but rather a strong indicator that a future heart attack was likely and that further tests were warranted. A real heart attack (MI) -- the kind that can kill you quickly -- is usually not exercise related and the pain continues for many…

Since you mentioned take asprin, just curious , how does that help ?

It prevents platelets from clotting further[1].

[1]: https://www.fda.gov/drugs/safe-use-aspirin/aspirin-questions...

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#116
post #109

One thing I’ve wondered is why getting a diagnostic test done out of pocket in the US of your own volition (without a doc prescription) isn’t possible. Why does it need to be controlled by a doc and insurance? In India this is common. They probably use the same expensive machines for x rays and MRIs but anyone can walk in, and pay for a diagnostic test and get numbers (well, not everyone can afford it, but generally…

Its not impossible to get diagnostic tests done outside the scope of a GP. It's generally very expensive.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#117

The first sign of trouble was chest pains while playing tennis. The pain subsided after a couple of minutes and I was fine. EKG showed no sign of heart attack or major blockage. Prior to that I had no symptoms whatsoever, exercised regularly, never smoked, 57yo male, 6 ft, 175lbs. A CAC scan revealed a calcium score of 411 and a stress test indicated a major lack blood flow to the front of the heart. A cardiac cathet…

>when I had absolutely no symptoms Chest pain during excretion is a symptom in my book. >Recommend everyone to get it A calcium scan is a ECG gated CT scan(a heart CT). It takes time from the CT machine schedule and it requires radiologists to describe it, meaning it's not infinitely accessible.

> excretion

Heh, I think you mean exertion

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#118
post #109

One thing I’ve wondered is why getting a diagnostic test done out of pocket in the US of your own volition (without a doc prescription) isn’t possible. Why does it need to be controlled by a doc and insurance? In India this is common. They probably use the same expensive machines for x rays and MRIs but anyone can walk in, and pay for a diagnostic test and get numbers (well, not everyone can afford it, but generally…

Its not impossible to get diagnostic tests done outside the scope of a GP. It's generally very expensive.

I get a 6 monthly KUB ultrasound and xray for around 1k inr which is around us$10. If I go to a government hospital and ask the emergency doctor for a test when there is a lean time for them, they prescribe the test and its done for a hundred bucks or $1.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#119

Earlier quoted context omitted.

I don’t understand why some prople claim that diet does not impact cholesterol. I did ‘keto’ with bacon/steak/chicken/etc for 3 months, got bloodwork done before and after and my LDL went through the roof.

Years ago I also experienced very high LDL after a few months of low carb. A doctor was convinced it was genetic (familial hypercholesterolemia) even though multiple earlier tests over the years had been in the normal range. He had never heard of low carb cholesterol hyper responders and dismissed that diet could have to do with it. Nowadays I am convinced that what happened was completely explainable by the Lipid En…

no surprise that your reference is from Nicholas Norwitz. It's good he self-owned with the KETO-CTA trial and showed everyone that isn't already bought into the low card dogma that it's clearly a disaster for CVD risk

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#120

Earlier quoted context omitted.

Do you have side effects from the statin?

I initially had an LDL of 152 and was prescribed Atorvastatin which gave me dizziness. So I switched to Pravachol with no side effects. But I needed to increase my dosage to get under 100 LDL and Pravachol is limited to 80mg. So I switched again to 10mg of Rosuvastatin which took me from 114 down to 83 also without side effects.

I got dizziness from lipitor (only in the hours after taking it) and I determined it seemed to be due to dehydration so now I just make sure to drink enough water and no more dizziness. Cut my LDL in half in 3 months and now I take every 2 days
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