What Your Coronary Artery Calcium Score Means

After graduating from a Caribbean medical school, finishing my internal medicine residency, and my cardiology fellowship I will be starting my day in the life as a non-invasive cardiologist shortly. Follow along for medical education content covering cholesterol management, echocardiography, invasive cardiology procedures, and much more.

In this video I review the basics of cholesterol management, atherosclerosis, and how it relates to coronary artery calcium scores. Coronary artery calcium scores (CACS) help cardiologists better risk stratify their patients. It can help doctors make more informed decisions with their patients on cholesterol lowering therapy like statin medications and evaluate a patient's risk of future ASCVD (atherosclerotic cardiovascular disease), or their future risk of heart attack or stroke. I review the pathophysiology of atherosclerosis, the basics of our ASCVD risk calculator, images of a few coronary artery calcium scores (CACS), explain in detail how that information can change our medical management, who does and does not benefit from this imaging study, and how much the test costs (typically ~$100 out of pocket.

*This video is purely for educational purposes and is not meant to replace medical care. So if you have follow up questions about this video drop them in the comments but I cannot provide personalized medical advise.

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[MAgaSUXX]

I am a male 67 265 pound male, non smoker retired airline pilot who had six month check ups for most of his life. 10 years ago I had a stress test and they told me I had the heart of an 18-year-old. But recently I had some chest palpitations and I did a calcium score of 214.. I’m scheduled to do the stress test in a couple days. Personally hoping that this is a wake up call to change my diet, lose weight, exercise, and increase my chances of having a normal life without stroke or heart attack. Your video is absolutely flawless and it helps me to understand. I wish I had seen it 20 years ago. 🙏

[higuysrealtalkwithtracy]

My husband had a zero calcium score but a 90 percent blockage!!!! Now he has a stent. ❤❤❤❤❤

[bugsy]

My calcium score at 70 yo is 450. Vigorous exercise 3 to 5 times per week for 45 years, gave up smoking 35 years ago, good diet. High cholesterol all my life same as my parents. They lived into their 90’s in perfect health. Had a cardiac stress test every year for the last 5 years. All good. No pain, no discomfort, quick recovery. Refuse statins due to terrible side effects. There’s more to it than what doctors currently know.

[higuysrealtalkwithtracy]

I appreciated the way you explain this. Genetically I got it. Build up in 6 arteries. My score was 370. I am 61 and going for an updated c t next week. I love the way you are explaining this. Thank you❤❤❤❤❤❤

[jeffj]

Thanks, Doc, for a clear understanding of the CAC.

[acer]

I was seeing this ordered at my clinic by some providers and couldn't figure out when they chose to order it...until i stumbled on your video. keep it up up up upppp my dude!! <3

[kevinsandridge]

Thanks for this video - I have struggled understanding my test score - this is by far the best explanation I have found - Thank You!

[kathiparshall]

Thank you. That was very informative and clear. I just had this test done and was very confused.

[greysonmuotka]

Such a well rounded video on the subject !

[lucyb]

This was very easy to
Understand. Thank you.

[alanjones]

Clear explanations. A great service. Thank you.

[russbrown]

Boy, it seems like the"risk" changes depending on the risk calculator you take. Example, I took the calculator test mentioned in this video, and my 10 year risk was 3.3% I have high LDL, my Dr imputed the same numbers including my LDL into another test that required the LDL number ( probably designed by big PHARMA), and I have a 50% 10 year risk! As far as cac score... I have a cac score of 24. They recommended high intensity statins with aspirin. I asked them what was the highest score they have seen? In the thousands... One man had a cac score of almost 6000. He was in his 80s! They said usually people with diabetes in their 80's have a high score! I don't understand? As far as statins? Research relative vs absolute risk reduction. Wow, relative risk reduction says you have a 29% reduction in heart attack wow! Well, not really. Absolute risk means you have a 1.3% risk of heart attack prevention. Simply put; 70 people will be treated with a statin to prevent 1 heart attack. Talk about deceptive marketing for a 30 some BILLION dollar per year profit... Hmmmm I think we're making a mistake thinking that stains, and cholesterol is going to do anything to stop heart disease. Just sayin...

[joses]

Great video. I just took a CAC scan because my dad's cardiologist recommended it to all siblings. He died last year at 90 yrs old. Im 59 yrs old working out with weights since 1993. Take lots of supplements. I check my blood every 6 months. I have always had elevated triglycerides average between 200 and 400 and low HDL 32. My Vldl 48. My CAC was zero. I would've thought there would be some calcium due to my triglycerides. Fasting insulin 7.1. Fasting glucose 92. A1c 5.4. Also had a PAD scan on carotid and legs which showed normal. Not taking my health for granted .

[MoMagnets]

Thanks Dr. Katz for the extremely informative video.

[cknzbnt]

This is a great explanation. Thank you!

[rorydoremus]

Excellent information, will be put into practice as a cardio PA.

[debbiea]

Thank you, Dr Katz for the best explanation of this topic I've witnessed. What is out there to address someone who has discordant biomarkers as follows: total chol 218, ldl 128, hdl 78, triglycerides 41, but LDL-P of 1509 (high), low large HDL-P, APoB 88 and Lipo 10. CAC reading 6 years ago was 1 and recent carotid scan shows no evidence of hemodynamically significant carotid stenosis. I'm 102 lbs with a 18% body fat and physically fit. My diet not so good but genetically my total cholesterol has never been below 218 from my 20s. currently 61. I searched web on the discordant readings on my tests but nothing explains it. Thank you!

[brenharris]

I sure do need all of the information . Exactly where I am now with doc giving me a risk score and asking me yo go get the calcium scan.

[deanP]

Your explanation of this topic was well presented.

[LK-bzsk]

Excellent video Doc. Here in Texas, November 2022, the CAC test cost $75.