A 38-year-old gets a coronary calcium scan and finds calcified plaque in his arteries (score 42), unusually high for his age. The scan catches early disease before symptoms appear, letting him start prevention now. Doctors recommend a follow-up angiogram in a few years to check for soft plaque.
Questions this video answers
38 years old.
42.
Above the 95th percentile (reported as >95%).
It only detects calcified (hard) plaque, not soft plaque.
About three years from now (approximately 3 years).
Chapters
All right, now it's time for the cool stuff. We got a somatome calcium scan here, and this is actually going to scan my arteries for any amount of calcification or calcium buildup, which in and of itself can be a cardiovascular risk factor. If you ever read the work of folks like Dr. William Davis, who's been on my podcast, we actually talk about this test on that show. And it can be a really good indicator of a cardiovascular risk potential. So we're going to find out if I've got too much calcium in my arteries, which could be a result of everything from inflammation to atherosclerosis to shockingly, even excess vitamin D intake or excess calcium intake. So it's going to be interesting to see what results look like.
Someone who is.
Just 44.
All the white.
So the large white, that's all calcium deposits.
That's a huge score. This person has a score in the thousands.
Wow.
And the stent. I mean, 44. Okay. So they're not doing so well. You have calcium also in an artery over here. This is the left anterior descending artery territory.
Calcium. The left descending artery right here.
There'S small calcifications there, and then on the right side, there's calcification here.
The score is 42.
Now, that score isn't particularly high when we compare it with people who have obstructions in their coronary arteries.
Right.
Usually they have quite high calcium scores in the hundreds or the thousands. On the other hand, at your age, 38, we typically don't see many people with calcium at all.
Interesting.
So the takeaway here is, is it's not a huge amount of calcium, but it's showing up early.
And, you know, a lot of people would consider that bad news.
It depends on how you look at it.
If you say, gee, I don't like it being there early, I guess you could say that's bad. On the other hand, if you don't have a test like this, you don't know that it's there. And so then you kind of go along and you get to be 45, 50, maybe 55, 60, and then all of a sudden, you got a lot of heart disease. Whereas by spotting this when you're 38 and saying, hey, this is starting early, then you work with your doctor to slow this down considerably.
And it depends upon what's causing it. And in most cases, we don't know every reason why it happens.
We know if you have high cholesterol, it contributes to this, but inflammation usually kicks it off.
You aren't obese so you probably don't have insulin resistance and a little bit of glucose. That's the most common reason.
Yeah, yeah.
But heredity has a great deal to do with this.
Interesting as well.
So we can't explain everything. What we do know is there is some component of inflammation that.
Causes the endothelium, the inner lining of the blood vessel.
To get inflamed. And then in conjunction with cholesterol in your body, there gets to be plaque. And that plaque, as it heals, becomes plaque.
Yep. Okay. Interesting.
Oh, you're looking good.
And. Yeah, a few little spots.
Yeah, well, you know, this is like the pregnancy rule.
Yeah.
Pregnancy rule is you have plaque.
Yep. Yep.
So this is like the deal. This is like knowing what the dealer's holding. You ever play blackjack?
I'm a little bit plaqued.
Yeah. How old are you?
38.
Yeah. This is young. This is very young.
So it's early.
It's early, yeah. And you have a family history of heart disease?
No. I would hazard a guess. It's possible that some inflammation might be contributory due to about 20 years of competing in some pretty masochistic adventure sports and ultra endurance sports, lots of Ironman triathlons.
And, you know, your cholesterol is okay along those lines.
Yeah, quite well. HDL is somewhat high. LDL is fine. HDL to triglyceride ratio is good. LPA is low. CRP is low.
So this tells you it's not low enough. So with every, you know, there's no such thing as one number fits all. So if you had no plaque, I would say that I don't know your numbers, but this says that whatever your cholesterol is, it's too high because you shouldn't have. You should really. 38, you shouldn't have any plaque. This is a finding. What's the percentile for his age?
It's over the 90. 50.
Yeah. So you have actually more plaque than 95% of people.
Wow. Wow. This is good to know.
Yeah. This is why they intervene now. Because probably if you intervene now with cholesterol lowering, what will happen? It probably will save you a lot of years of life.
Good.
So I was surprised to see this, actually. It's very unusual to see 38 year.
Olds with calcium score. I'm going to be headed off to do some research on calcium scan score lowering for sure.
I told him that it's actually good news to find this out when you're young.
Oh, yeah.
Dr. William Davis is the guy I first learned about this scan from. And I Might pick his brain a little bit, too, about some recommendations he may have.
These are very underutilized. If everyone had the scan done, they would. You would be running a lot of.
Hard, simple and quick, too. Now, do you guys send me the results or do you release these to the dock or.
Well, if you leave your docs, we can release it to both.
So, okay, what's the best way to do that?
Just make sure you fill that. Give the name of your doctor and then your contact information out at the front desk.
Yeah, okay. Perfect.
Perfect. Interesting. So, you know, this is. This is. It is what it is. So, you know, the devil you know, they say it's better than the devil.
You don't know. Oh, yeah, absolutely. No, I'm glad to have to have found this. This is actually surprising to me, but at the same time, I like to find. This is why I'm doing these tests to find this information out.
This is really important for heart health and for. And it's a really important prevention.
Exam that you took. So this is what we do. We take this information, and you integrate it into your treatment, and you mitigate risk. So this actually allows us to personalize your risk. So saying that a particular number is normal or good is actually not the way to look at it. What you have to do is you have to take the number your goal, which is related to your risk. So in your case, you know, a lot of doctors will say, oh, your cholesterol is okay, but, you know, it may be okay for some, but, you know, it's not okay for you. So, you know, so this doesn't save lives. It's the action you take.
Yep.
With this that actually saves lives.
All right, cool. Thank you very much. All right. All right. And so how often does one typically retest for a protocol like that?
You may want to do what you may want to do at some point, maybe three, four, five down years down the line, you may want to get what they call a coronary ct, which is where they get contrast, because this particular test only looks at calcified plaque. So in a guy like you, this may be the tip of the iceberg. So what you may want to do is actually get the full coronary ct, where we can look at not only the hard plaque, but we can actually look at the soft plaque, and then we can look along the entire arterial supply, and we can tell you if there's any soft plaque, which is actually the more dangerous plaque. If it's located in the area.
Fantastic. That'd be like, three, four, five, years down the road.
Yeah, I'd say in about three years down the road, you should do a full coronary ct. That's where we get the contrast. And it's a much more comprehensive exam. But this exam, I think, will provide a lot of benefit to you because it really represents, you know, knowing what's.
And then I got a boomerang knowing.
Exactly what the status of atherosclerosis. All right, that's something I would do, but a coronary CT angiogram is about three years.
Noted. All right, good luck. Cool. All right, thanks, Doug.
