50% Stenosis of the LAD

[badrad123]

Hi,

I recently had a CT angio because I was experiencing some mild angina. These are the results:
(Left anterior descending coronary artery- There is a mild to moderate calcified and noncalcified plaque noted involving the proximal left anterior descending coronary artery, resulting in approximately 50% stenosis noted of the proximal left anterior descending coronary artery due to predominantly calcified focal atherosclerotic plaque. No additional stenosis are identified.)

I'm 48 and my LDL is 80 and HDL is 44. I'm stressing out over this thinking I'm going to have a heart attack at any moment. My cardiologist didn't seem too concerned and said we could treat with a 10mg statin, diet and exercise.

He also said the CT angio is not very accurate in measuring the % of blockage and most fo the time over estimates the stenosis. Is this true and can I control this with proper diet and exercise? Oh and stress management.  I also thought it was weird that my calcium score was 33 but i had a 50% blockage.

Any advice or opinions are appreciated.  Thanks!

John

[badrad123]

Thanks for the info. Honestly, the whole thing confuses me but I'm glad I had the CT angio and didn't just rely on the CT calcium scan I had a few months prior to the angio.

[Occupant]

I am writing this to get away from this "obsession" with calcification of the arteries. This is from a research paper published several years ago: "51% of coronary segments that showed 50% to 80% blockage and 36% of segments with blockages >80% did not show calcification confirming that not all plaques become calcified and that the absence of calcification does not exclude significant stenosis." These samples came from autopsies of patients that had died from heart attacks.

[badrad123]

Thanks ed34. I appreciate the feedback.

[ed34]

not really. I believe that calcification occurs quite quickly to prevent the sludge of fat releasing into the blood stream, causing stroke etc. I had no blockage and yet 3 months later I had one which was calcified. I've had others which have taken years so there is no fast/cut rule to the topic.

[badrad123]

Thanks......can I make the assumption since it's mostly calcified then it's been there for some time? Maybe the past 5-10 years?  

[ed34]

Yes, but no blockage is ever completely plaque. In this case, the majority is being reported as plaque though.

[badrad123]

Curious but does this comment mean it's mostly calcified plaque?

"predominantly calcified focal atherosclerotic plaque"

[badrad123]

Thanks! Some positive news is always good!

[ed34]

oh yes it is very possible it may not worsen. In fact it could actually shrink a tiny amount.

[badrad123]

Thanks Ed. Last question - is it possible to live the rest of my life without the 50% blockage getting worse or is it predetermined to get worse?

[ed34]

Your welcome and good luck. If you struggle or have any more question please don't hesitate to return here :)

[badrad123]

Thanks Ed. I'm thinking that is the course I will take. Hopefully no bad side effects. Thanks again.

[badrad123]

Hi Occupant,

Actually, it says there were a total of 3 calcifications all in the LAD with a calcium volume of 27 ( not sure what that means). However, I originally had the calcium score done a few months ago and my Cardiologist said the 33 wasn't bad and we would watch it. Well, after a little pain in the left side of my chest he decided to do the Ct angiogram which returned the same calcium score but also showed a 50% stenosis in the LAD. To say the least, I was surprised based on the the prior calcium score.  

[ed34]

Well, a low dosage of statin will reduce inflammation of your arteries, a major cause of atherosclerosis. So I would say take it for a year until you really have your stress under control, then re-evaluate.

[Occupant]

Did they also how much of that Calcium Score applied to your LAD? Probably only a fraction of that and, therefore, the bulk of your plaque is the soft, gooey kind. And that's what turned me off the CT-Scan, apart from the high X-ray load you get taking it - it doesn't tell you anything.

[badrad123]

Thanks ed34. I appreciate the advice. Just curious about the statin. I haven't started yet and was thinking I could get by with diet, exercise and stress management. Do you that that is reasonable if my cholesterol levels are already in good shape?

[ed34]

Hi. Well first of all your arteries have a lot of reserve built into them. What do I mean by this? well they carry far more blood than required. Imagine your artery is a highway with 10 lanes. You could have 7 of those closed and still be functioning great. So with 5 lanes closed, you are ok. Your Cardiologist has given the best advice and I strongly suggest sticking to it. 48 is quite young, I started atherosclerosis at 46 and now I'm 53. That blockage won't go away so all you can hope to do is stop it from worsening. Take your meds, do your stress management and exercise. Also if you smoke, steer well clear of cigarettes. After one year, re-visit your cardiologist for another test. Stress is a huge risk factor and raises blood pressure as well as other things. I know it isn't easy in this day and age to reduce stress, but you need to change your outlook on life. Nothing is worth your life, no matter how bad it seems.