Asked & Answered Podcast
The Texas Heart Institute Center for Cardiovascular Care's general and interventional cardiologist, Dr. Alexander Postalian, answers patients' questions about cardiovascular health.
Submit your questions in the comment section to be featured in the next episode of
Asked and Answered.
Read more about our specialties: www.texasheartmedical.org/edu
Asked & Answered Podcast
I had a calcium score of 732, and my nuclear stress test was apparently “normal”. I feel nothing. What’s going on?
On this episode of Asked and Answered, Dr. Alexander Postalian answers a question from a patient, regarding their calcium score and whether or not 732 is considered too "high".
Read More: https://www.texasheartmedical.org/our-specialties/calcium-score-test/
Watch On Demand Videos on Texas Heart TV
Visit Our Website: texasheart.org
00:00:00:07 - 00:00:04:18
Unknown
I had a calcium score of 732, which is high,
00:00:04:17 - 00:00:09:28
Unknown
and my nuclear stress test was apparently normal. I feel nothing. What's going on?
00:00:09:28 - 00:00:20:24
Unknown
first of all, calcium score is a low dose and usually low cost CT scan of your chest that tells us how much calcium buildup there is in the arteries that feed your heart muscle.
00:00:21:01 - 00:00:23:25
Unknown
More calcium usually means more cholesterol plaque,
00:00:23:25 - 00:00:30:16
Unknown
more risk of heart attacks and strokes. And it tells us how aggressive we need to be with lifestyle changes and medication.
00:00:30:16 - 00:00:33:27
Unknown
A score of zero is the best you're gonna get.
00:00:33:27 - 00:00:40:18
Unknown
1 to 100 is mild, 100 to 300 is moderate, and anything above 300 is considered significant.
00:00:40:17 - 00:00:43:19
Unknown
So 732 is in the high range.
00:00:43:21 - 00:00:52:00
Unknown
But it has to be interpreted within your age and gender. So if you're young this is more striking than if you were a little bit older.
00:00:52:01 - 00:01:03:15
Unknown
the custom score tells us there is calcium in the artery, but it doesn't tell us if that calcium is obstructing blood flow inside the vessel. Let's say it can be mostly on the outside and not inside the vessel.
00:01:03:15 - 00:01:07:02
Unknown
So blood flow can be normal even if you have a high calcium score.
00:01:07:01 - 00:01:23:04
Unknown
One way to assess blood flow is doing a nuclear perfusion study, which shows us how the blood is going to different areas of your heart. So in this case, even though the calcium score was high, it seems like the blood flow to the heart muscle is normal.
00:01:23:06 - 00:01:36:02
Unknown
This means that we need to be aggressive with risk factor modification. Maybe medication is to lower risk, but there's no need for a stent, which is a metal scaffold, to open up a blockage or bypass to fix the obstruction.
00:01:36:03 - 00:01:44:04
Unknown
again, custom scoring gives us an idea of your risk, but a nuclear stress test tells us if there is obstruction to blood flow.
00:01:44:06 - 00:01:46:11
Unknown
They are complimentary tests.
