Coronary calcium scoring

[Buffy6956]

Can someone help me out here cause I’m struggling to understand? I have read that the higher the calcium score on CT angiogram the more calcium plaque you have

0 = low chance of developing heart attack

11-100 mild plaque

100-400 moderate plaque

400+ severe plaque

With this being the case then how come my calcium score was eleven (11) yet I had an 80% mixed plaque in my RCA and 60% in my left circumflex tested with fractional flow that isn’t impeding blood flow so is medicated yet a friend of mine had a calcium score of around 738 and CT angiogram said was consistent with severe calcified plaque and buildup was in all four arteries but recently invasive angiogram deemed the plaques as mild 49% in two arteries??? Can anyone help me understand why this is please. From everything I’ve read it seems that even the president of the United States snd astranoughts have to have this calcium score done before they can be considered for these positions as they give a clear idea of your cardiac risk and how much plaque you have but clearly this isn’t the case???? Very confused

[84green]

Hi Buffy

My understanding is that your coronary artery calcium (CAC) score relates to the amount of calcium in your arteries (“harderned arteries”). Although not desirable, such plaque is usually regarded as more stable than non calcified or “soft” plaque. Indeed, one of the ways in which statins stabilise plaques is by calcifying it. This is why CAC scores aren’t as useful for people already on statins and with existing heart disease.

So, it is possible to have a low CAC score but still have blockages that might need stenting. Your case is one that would seem to me to be an example of why people should be cautious in using just the CAC score alone - as this may not identify non calcified plaque.

In your friend’s case, it may be that the plaque they have is mostly calcified but it is not at a level that requires a surgical intervention.

My CAC score was 133 (the same score as Donald Trump when he stood for president) with what was described as “minimal “ blockages throughout my LAD and RCA. My two “mild “ blockages were described as “mixed” or “non calcified” plaques.

Another point that may be relevant to your friend - a cardiologist told me recently that in his experience CT angiograms often overestimate the amount of plaque.

As I say, this is just my understanding but hope it helps.

[Sunnie2day]

Hopefully someone will be along today to give you the benefit of their personal experience - I have absolutely none to share but I wonder two things - if perhaps the best way to get an answer would be to contact your medic and ask for a detailed explanation, and if you might benefit from talking to the BHF Heart Helpline nurses. I'm posting a link to the BHF page on the helpline, it has the current telephone-chat-email details and open hours information:

bhf.org.uk/informationsuppo...

Once you have some answers from your medic (and/or the BHF nurses), please update.