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Questions and Concerns
1. I received the report and I still don't know what
it all means for me.
Advice: If you have a physician who
knows your history and who understands this test, bring the report to
your doctor to see if you should be on treatment to lower your risks.
If you do not have a doctor or would like to visit with one of our experts,
call our center and ask for a physician consultation. We can also perform
a Healthscan global risk factor assessment which can be very useful
to get a fuller appreciation of your overall risks.
2. The report says I have more plaque
than 75% or 90% of people my age and gender. What should I do now?
Advice: People with scores in the top
25% (above 75%) are at 22 times the risk of those who have less plaque
than 75% of peers. Remember, if you have any symptoms (chest pain, etc.),
see a physician immediately. If you have risk factors for heart disease
(e.g. high cholesterol, hypertension, family history of early heart
problems, etc.) and your score is greater than 80, you should probably
be treated according to "secondary NCEP guidelines". In other
words, your LDL cholesterol (bad cholesterol) should be lowered below
100 by medications. Visit a physician.
3. My coronary calcium score is very high—your report
says it is severe. What do I do now?
Advice: If you have symptoms like chest
pain, see a doctor immediately. If you do not have chest pain or other
symptoms, you will need to be on aggressive risk reduction strategies
under a physician's care to stabilize plaque. Most people will be considered
for placement on a statin drug (cholesterol lowering drug) regardless
of the baseline cholesterol level. We now know that patients on such
medications will have their risks lowered substantially. In addition,
future heartscans should show that the rate of progression (worsening)
has been decreased. Many patients with severe scores (over 400) should
also be considered for ACE inhibitor drugs like Altace. In addition,
most people will need to get a stress imaging test by a cardiologist
to verify that there is no significant blockage. About 20-35% of people
with scores over 400 will have such hidden narrowing.
4. I sometimes have shortness of breath,
chest pain or discomfort. However, my heartscan results did not show
much plaque. What should I do?
Advice: Any recent onset of chest symptoms need
to be taken seriously regardless of a favorable calcium score. You should
visit a knowledgeable physician who will try to determine whether your
symptoms are indeed, cardiac in origin. He/she may perform other tests
(stress) to look for hidden coronary blockage. Patients with symptoms
can indeed have blockage with soft plaque, even with a zero or low calcium
score.
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