CT with calcium/angiogram

[Frootbat]

I wonder if anyone else has my concern or can shed any light. I had angina in 2017 followed by a CT with calcium score (my choice as less invasive than angio). The result was bad over 600 and showed RCA "obscured " by calcium. Then had angio and stent put in LAD which was badly blocked. Been ok since but problems recently with high BP and palpitations. Being looked at but not even the cardiologist has explained the discrepancy between the two tests. Am now aware that I will have to wait until Covid over before any further investigations can be done unless I have a heart attack.

[MichaelJH Heart Star]

Unfortunately calcium score is widely misunderstood. Like cholesterol it is a predictor but not a measure of any narrowing. Hence the high reading in your RCA despite your LAD needing treatment. You really need an angiogram to see if there are any further narrowing which could include restenosis of the LAD. Mine was such that a peer-to-peer review decided a bypass was the better treatment option. If offered an angiogram I would suggest you take it.

As regards palpitations these may improve by eliminating alcohol, caffeine, chocolate and spicy foods from your diet.

[Frootbat in reply to MichaelJH]

Thanks that’s very useful. I have reduced alcohol greatly and any other triggers also. I have found that now am on amlodipine for BP the arrhythmia and palpitations seem to have lessened. I’m hoping it’s the drug helping. Have been on Carvedilol since stent but doesn’t seem to be helping now with the palpitations. I won’t be offered a angiogram unless angina worsens or until COVID gone away. Thanks

[Zindolo]

I live in Austin Texas, so with our broken healthcare-for-profit system, one always has to wonder if they really NEED the recommended treatment, or if the doctor just wants to pay off his yacht! Anyhow, I purchased cheap insurance with a large deductible in case I got in a car crash, but it included one free physical. At that, my BP was 200/120! That doctor sent me for the CT, and my calcium score was 504. Then I went to a cardiologist who did an angiogram (for $24,000 - fortunately my insurance paid most of that and turned out to be better than I thought it was) and after telling me that that was the "gold standard" and last test I would need, said I needed an echocardiogram. After all these tests he said I had a bicuspid heart valve that was calcified and would require open heart surgery to replace it. This came as a great shock to me as I've known I had a heart murmur since my teens but was always told it was harmless. Also had an echocardiogram about 15 years ago and was told everything looked great and my heart was "very strong". So I certainly wasn't expecting any of this! I had noticed in the past few years that I get out of breath very easily and don't have nearly the stamina I used to, but I figured it was just old age and weight gain. But the cardiologist told me I would be lucky to see 60 if I did NOT have the operation and I'm 57 now. He said I should regain my stamina also once the valve got replaced, so I agreed to do it. Also, the surgeon said he could do it by only cutting my sternum half way down, not all the way like my dad when he had his surgery in the 1980s. I wasn't going to do it at first and just figured, "Oh well, I guess my ticket's up in a couple more years". But after a few weeks I decided since my insurance covered it maybe I had better get it done while I can. So I did it on November 3rd, which was also Election Day in the USA. (I voted early, of course!) It wasn't as bad as I thought, but the 10 night stay in the hospital was hellacious. I was hungry and thirsty the entire time as they put me on strict calorie and liquid restrictions. I'm back on my bicycle already and plan to start lap swimming again in less than a month. Anyhow, I just thought I would tell you this since your calcium score was even higher than mine was, so don't be too shocked if they eventually tell you that you need open heart surgery. But also, if they do, they have less invasive techniques nowadays so be sure to look into those, and it probably won't be as terrible as you might think it will be. I will forever wonder if I really needed it, or was just duped into it to make more money for them, especially if my stamina never improves to better than it was before the operation. But as you probably saw on the news, yesterday was a BIG day here in the USA, and now that the Democrats control everything maybe they will finally have the balls to tear down our broken and corrupt health care system and rebuild it into something more like you have in the UK, fingers crossed! My deductible was about $8,000, but I could see what they billed my insurance for, and it came to a total of around half a million dollars! So you can see why things need to change here, starting with the outrageous rates that hospitals are billing for nowadays.