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calcium scoring versus ct angiogram

Im 35/male I've been having shortness of breath with exertion,  and I had an episode of bad chest pain following a 30 minute workout...I am theoretically in decent shape even though I'm 40 pounds overweight I still workout regularly, I guess I just eat too many calories... Anyway, I don't have any insurance and have to "take what they give me" so I was given a resting echocradiogram, labs, chest x-ray, and a regular stress test.  

I was wondering thought,  what do you think about my coming up with $400 to get one of those calcium score scans...would that be revealing perhaps to my over all situation?    I know these don't detect "fresh" plaque,  but my cholesterol is normal,   so with normal cholesterol does that mean it would be just as good as the CT angio with contrest?     Help me understand the difference, and which one I would benefit from most?
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Avatar universal
I had a 64 slice corornary angiogram ct.  It revealed a 100% blockage of my RCA with good collaterols - so my cardio is doing nothing.  All the other arteries were clear.  If I am not mistaken, the 64 slice ct also shows soft plaque, and a regular angiogram does NOT show that.  Most heart attacks are caused by soft plaque.  My calcium score in my LAD was 3 - all the rest were 0 - so I guess that gave me some piece of mind.  It is much less invasive that a regluar angiogram.
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242508 tn?1287423646
MEDICAL PROFESSIONAL
You should have a chest xray and pulmonary function test.  If you have your mind made up on going further with the CAD workup, I think a CT angio would be a good alternative to a catheterization given your young age and low rate of false positive results.  At the same time, having a normal stress test would be good  enough reassurance if I were in your shoes.
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242508 tn?1287423646
MEDICAL PROFESSIONAL
I think that the stress test and how you do on it has the best diagnostic and prognostic value.  the calcium score, unless, highly abnormal, would not be of any value here.  the likelihood that it would be highly abnormal is very low.  It does not say anything about blockages at all.  The CT angio would reveal blockages if they were truely there in someone of your age with good predictive value, however, I am not sure that I would go that far.  I would have the stress test first.  If the stress test is normal I would reconsider cardiac etiology for your chest pain and start looking for alternative explanations such as lung or stomach problems.  
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Avatar universal
PS  any other suggestions are valued   thanx
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Avatar universal
Well, they did say they would give me a heart cath to try to figure it out, but I dont want to do that,  I think a CT angio is just as good and less risky ,    am I being smart or should I get the diagnostic heart cath?
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