Question in coronary artery disease (kidney stones, blood, heart, symptom)

[Adriank7]

My relative who is dear to me is 47. He had a cardiac scoring test for plaque and this was his results:


SCORE SUMMARY
The total calcium score is 2.

RANKING GUIDE
The total calcium score of 2 is between the 25th and 50th percentile for
males between the ages of 45 to 49. This means that 25 percent of people
this age and gender had less calcium than was detected in this study.

Left Main Artery (LMA) - zero
Right Coronary Artery (RCA) - 2
Left Anterior Descending (LAD) - zero
Left Circumflex (LCX) - zero
Posterior Descending Artery (PDA) - zero

The best is 0 of course, and the worst over 400. They told him he had minimum plaque and low risk. Then today, a year and a half later he goes for a physical and this posted on his chart:

coronary artery disease involving native coronary artery of native heart without angina pectoris i25.10

Posted within a half hour after his appt. The dr didn’t say anything about it and said everything was good and EKG was normal. I’m assuming it’s based on his cardiac scoring from last year even though it was a low score and dr said minimal risk. If he had coronary artery disease wouldn’t he need more testing to be diagnosed? Like a stress test? His echo last year was normal.

[Aredhel]

Originally Posted by Adriank7

If he had coronary artery disease wouldn’t he need more testing to be diagnosed?

He HAS been diagnosed with (mild) coronary artery disease; that's what the cardiac scoring test did. Since he's currently asymptomatic and the coronary artery disease is mild, he doesn't need any additional testing right now.

[Adriank7]

Thanks. I wonder why they never told him this and it wasn’t stated last year when he received the test. What are his chances of a heart attack? Last year the dr advised he get a a stress test. He didn’t , this year she didn’t mention it. She is a thorough Dr do not sure why nothing else was said.

[Aredhel]

Originally Posted by Adriank7

Thanks. I wonder why they never told him this and it wasn’t stated last year when he received the test. What are his chances of a heart attack?

No one can say with certainty, but since he doesn't have much coronary artery disease the odds of him having a problem right now are fairly low.

Last year the dr advised he get a a stress test. He didn’t , this year she didn’t mention it. She is a thorough Dr do not sure why nothing else was said.

Right now a stress test is not indicated, as there's absolutely no reason to think it would be anything other than normal. She advised it last year, prior to having the results of the coronary artery score testing, because the extent of any coronary artery disease was unknown (so a stress test might have indicated a hidden underlying problem).

[goodgal]

I am pretty freaked out. Uncle has Cac (calcium)score of over 800 He tends to get kidney stones too. He has a 70-99% blockage in medial LAD and is diagnosed with severe coronary disease. Crazy thing is he is a health nut exercising 1+ hours every day, non smoker maybe 5 pounds heavier than he should be. Age 63. Worrisome and I think Dr just wants to do statins for now which he isn't crazy about but this sounds very scary!

[guidoLaMoto]

Originally Posted by Adriank7

Then today, a year and a half later he goes for a physical and this posted on his chart:

coronary artery disease involving native coronary artery of native heart without angina pectoris i25.10

.

This has to do with the stupidity of the med billing system & mandatory computerized med record system. They gotta put something in every blank, even if it's wrong. Govt involvement = paper work.

An obvious example: they can't order a test without a diagnosis, but some diagnoses, like DM or anemia, are defined by the blood test, so how can they order a BS or CBC without being clairvoyant about the results? They don't allow a diagnosis of "Rule out anemia" to justify the blood count. Once "Anemia" is recorded in the computer, it becomes a permanent part of the record, even if the blood test turns out normal.


BTW--never trust your care providers to be familiar with your history. Once someone (usually an in-take nurse) puts it in the computer there's no guarantee the doc will even read it let alone remember it.


In regards Coronary Calcium scoring: too many false negatives & false positives to have confidence in it. https://www.medscape.com/viewarticle/899231 USPSTF: Insufficient Data for Coronary Calcium, hsCRP, Brachial Index in Asymptomatic CVD Risk Assessment