Had an echocardiogram last january which found slightly impaired diastolic performance. Was told nothing to worry about. Had a NT-proBNP blood test with a score of 17. Due another echocardiogram this January.
Had a CT corocary angiogram in November 2021. Just got a letter from cardiology after a lot of chasing saying I have moderate coronary artery disease calcification and no significant stenosis. Nothing else said. No action, no prognosis, nothing.
Moderate means a score of 100 - 300. I don't know where I am on that scale.
I am extremely concerned. Is this a definite death sentence. Is it imminent.
Moderate says risk of a heart attack in 3 -5 years. Is that whether I make changes or not. Or if I carry on as I have been without changes.
Can I prevent a heart attack or is it inevitable now.
I am extremely worried
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Your NT-ProBNP number of 17 is well into the normal range. A slightly impaired DD is also a common finding as people age (>50 yo). Did they grade your DD as stage I, II, III, or IV?
The calcification issue you'll have to check with others but it appears manageable at a moderate level with lifestyle and lipid/BP control. I believe they would have talked stenting if blockages were that far along.
Thanks so much BobsBeat. No they didn't grade the DD. Regarding the calcification, they did say no significasnt stenosis. So no significant blockage. Other than that, the cardiologists letter just said, he's happy to see me in his clinic in the future if the need arises. All sounds as if he is not paerticularly worried, but I would like him to tell me that. I would also like to know my calcium score. Am I at the high or low end of moderate. So just above mild or just below severe. I understand there is a lot I can do to reduce the chances of the calcification getting worse. Diet, fitness, exercise, etc. The moderate score for calcium says 'on Google' that the chances are I could have a heart attack in the next 3 - 5 years. What I would like to know is, is that whether or not I make these changes or just if I don't. Is it inevitable or by making these changes, does the risk reduce and by how much. Can I keep the level of clacification as it is forever or will it get worse anyway.
I don't know much on the calcium scoring but I believe with the things mentioned before (lifestyle, lipid/bp control, etc.) you can pretty much control it from getting worse. If the doctor is not overly concerned with CAD at the present time, I would control what you can going forward. Mortality stats and such on many conditions including heart need to be taken with a grain of salt. It sounds like your overall report is quite decent. Consult your doctor for answers to your specific questions and further reassurance as needed.
No! Don’t leave it!I had an ECG in 2010 following the birth of my child following what was termed an eclamptic fit. The cardiologist who checked me out at that point said he thought I had a leaky valve and ordered an ECG…. I never received results, my doctors surgery never knew I had the ECG so had no results and didn’t help me get any. Life seemed ok so just carried on!
Last year I thought I’d had something that felt like a heart attack… well according to the nhs website! A&E said we have your 2010 ECG nothing to worry about but we will refer you to Cardio in case ……that was July 2021.
I met a Cardio nurse in Septembers a heart clinic who said my first ECG showed a left bundle branch blockage which was nothing usual and not a worry but would do a thyroid test, CT scan, ECG and 72 hour monitor. CT in October and thyroid clear, ECG in November was followed by a 4 line letter just before Christmas saying my mild heart failure from my 2010 scan was now moderate and my doctor should prescribe me three drugs!!
I don’t have high blood pressure apart from actually after giving birth I never have! My CT scan is clear, I don’t smoke, l don’t drink much at all and I’m a little over weight and 52 years old and reasonably active but not like I was in my 30s.
My doctor has not been given any more info than the same 4 line letter I received…. I’ve not started on the drugs. I’m waiting for the 72 hour monitor… the heart institute didn’t realise I hadn’t had it! I’m also now waiting for an MRI scan and a full meeting with a Cardiologist.
I wish I’d had my results in 2010!!
The only info I had was on the appointment letter and on arriving at the clinic, I only met the person doing the scan and the letter was taken from me… it was like it never happened! But clearly it did at the hospital have access to it but my doctors do not… I’ve seen my record with them!
These days I’d have taken a photo on my phone of the letter before I let it go!! But these days they don’t take your letter from you and they text/call to remind you of your appointment!
Please ask fir the results and don’t stop until until you have them! Apparently most doctors are too busy to respond to every patient with test results but accept that you can call and ask for results. You’ll never know if they lost your test results, you are problem free or you have an issue otherwise.
I always joked that I wouldn’t have been allowed to walk out of the hospital after the test if there was a problem. Clearly that’s not the case….. I’m still wondering how the last 11 years might have been different if I’d known then what I know now!
Good luck with getting an answer and even more good luck with your results!
Thanks for your suggestion I should have said I had a heart attack just before 1st lockdown and had a stent fitted the echocardiogram was a follow up but will try and get intouch with my consultant
Hi take it from me if there was anything to worry about they'd have kept you on the list follow ups etc keep an eye on your cholesterol ask your doctor if you can have a cholesterol test for hyper cholesterol something or other it's the test to see if you've got the gene that makes you more susceptible to ha s even if your cholesterol is low I've got it and I now have an injection every 2 weeks. I've had 3 ha s and 5 stents.id give my right arm to have had your results.dont goole it it's not always right and in accurate.good luck pam
Mild diastolic dysfunction is present in most people over 60 so don’t let that stress you.
Atherosclerosis (plaque in the coronary arteries causing narrowing) is also common with age. This plaque can be calcified, non-calcified (soft), or a mixture of both.
I had a CT angiogram that provided details of the type of plaque, whereabouts in the artery it was, and an estimate of the amount of narrowing (minimal <25%, mild < 50%, moderate < 80%). Generally, anything below 80% is unlikely to cause symptoms such as angina and will be treated with medication (eg statin and aspirin). It also gave the calcification (Agaston) score.
Most (but not all) heart attacks occur when some unstable plaque breaks off and causes a total blockage of the artery thus stopping blood reaching the heart.
Whilst calcification is certainly not a good thing, it does mean that the plaque is more stable and less likely to rupture. My understanding, is that this is one of the ways statins work.
In terms of risk, I’ve never seen the figure you mention. There are some ten year risk calculators on line. My advice is to try and avoid anything from Google unless it’s from a reputable source such as the BHF or NHS and not to get too hung up on these calculators. There are just too many variables and, as I say, just under 10% of heart attacks occur in people with no pre existing arterial blockages
As has been said, if it was anything serious you would have a follow up appointment and probably an angiogram to check you out.
If I were you, I would ask for a consultation with either a GP or cardiologist to talk through the findings and go from there.
Whilst the diagnosis is always a shock, it’s better to find out now and take the measures you need to stop things getting worse. For many, the first warning is a heart attack
Thank you so much to all those who have taken the time to reply thus far. BobsBeat, Pam and 84Green. I must admit the score charts I found stating that moderate meant the chance of a heart attack in 3 - 5 years were on sites other then NHS and BHF. I don't usually look at sites that are not uk and specific to my search but I think I got distracted as I couldn't find exactly what moderate meant.
I may be being a bit over the top but when cardiology give you a sentance in a letter and that is it, it does cause some anxiety. The heart being pretty important to life. I have emailed the cardiologist with my concerns and questions and asked for a call at least. I was told by his secretatry he would call. Nothing so far in 6 weeks.
A week before Christmas 2020, my wife and I came down stairs to find our eldest daughter (42 years old) passed away on the hall floor. No previous illness, nothing. The coroners report said she had a massive bleed on the brain like a bolt out of the blue. It would have been instant and she would have been gone before she even started to fall. This seems very likely as she was face down with her arms by her side. She hadn't tried to break her fall at all. I did CPR until the ambulance arrived althoug I knew it was too late as she was already cold and blue. It has been an awful year with every new special occassion bit without Laura here. One thing it has done is made my wife and I acutely aware of our own mortality and that things can change in an instant. We have another daughter and 2 grandchildren we would like to be here for, for some time yet. This is why I am so anxious for answers on my status and advice regarding how if possible I can be here for a long time yet.
Thank you again to everyone.
Suzyh, apologies for not replying to you. I would chase the medics up. I look for any number, email or whatever on letters and contact anyone I think is relevant. Or call the switchboard and get put through to the relevant department and see where that gets you. Be a pain in their rear.
Good luck Suzyh. My best wishes to you Pam and thank you again 84green. I don't know your actual position but I wish you all the best.
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