Ultrafast CT Scan with 2 very different diagnosis

[jerry78]

When I was 36 years old(male), Ihad an Ultrafast CT Scan done at a University, top-rated heart hospital in Pennsylvania.

The results were:  a 1mm focus of calcification in the Left coronary artery, and a smaller, 1mm focus of calcification in the Right coronary artery, for a total calcification score of 2.  The report also said these results placed me in the 95th percentile for my age/sex group.

Now, The confusing part:

A Cardiologist at the hospital told me that it was indeed, a very good report, that although there is some calcification, it is almost non-existent, and the 95th percentile means that only 5 % of my age/sex population has a score better than me.

Then,at a subsuquent visit to he same center, a certified nurse practitioner in Cardiology, read the report and told me that most 36 year old men have NO calcification findings, and even though my score is only 2, the 95th percentile ranking means it is a poor report, meaning that I was placed in the HIGH risk; meaning that 95% of my age/sex population have scores BETTER than me.

So, who is reading this report correctly?  The Cardiologist, who says it is a good report, or the Nurse practitioner, who gives me a grim report?   Thanks

[HAMMERHEAD]

JERRY
I'M 41 AND JUST HAD THE ULTRAFAST HEART SCAN MY SCORE WAS 3.8 THEY SAID YHAT PUT ME IN THE 50TH RANGE.ALSO JUST HAD CARIDOLITE STRESS DON'T HAVE THE LOWDOWN BACK ON THAT YET.MY ANXITEY HAS BEEN AS BAD AS IT'S EVER BEEN FOR ABOUT THE LAST 2 MONTHS.I HOPE WHEN I GET ALL MY TEST BACK MAYBE THIS WILL HELP WITH THE ANXIETY.BUT FEEL ASURED YOUR NOT ALONE .

       BEST WISHES
      HAMMERHEAD

[jerry78]

Raildown:
   Yes, you are  correct.  Thank you for your concern.  In fact, I am in psychiatric treatment for my anxiety/panic and obsessions, doing somewhat better than before, but sill have a ways to go.

     Yep, you did hit the nail on the head with saying I have a hard time accepting "yes" for an answer.  It seems for every positive, reassuring test or report I receive, I can search and seek out  corresponding counter-report that is negative in nature.......and which one do I choose to believe?.....The negative one, of course.

     Hey, thanks my friend, for the reassuring words....I hope to God I can get my anxiety/panic under control in the near future, and I feel for everyone out there going thru similar emotional states. Jerry

[raildown]

Jerry you need to learn to accept Yes for an answer...you've had a multitutde of tests and IIRC they show little evidence of CAD and yet you keep obsessing over it even while admitting that you have a lot of anxiety;

at the risk of being a skunk at the party, you might get more relief if you pursue the underlying anxiety that causes this enless testing;

serioulsy look into 'mindfullness training' and meditation practices;

be well my friend;

//

[pandora9049]

hi,
jus to add, i would go to another cardiologist and get a second opinion. just as an example, and I know this has nothing to do with hearts, but when I take my daughter to the pediatricians (shes very big for her age) and the doc charts her growth, she'll say to me that shes in the 95 percentile for children her age, meaning that 95 percent of children r smaller than her, and only 5 percent r bigger.  i dont know if it's the same way with that test, but i would get a second opinion, just for ur own peace of mind.
good luck,
pan

[jerry78]

Paulus:
    I do appreciate your comments and opnion; however, I must agree with Hankstar and the Cleveland Clinic doctor that the Nurse is very wrong in her interpretation of the report.

     I say this with certainty after receiving a response on my report from Dr. Kenneth Cooper of the famed Cooper Aerobic Clinic, Dallas, Tx.
     He states-"Your score of 2 on the coronary calcium scoring is indeed,an indication that your coronary calcfication is almost non-existent.  You should be reassured with this finding, and continued lifestyle efforts in your diet and exercise program should result in no further progression."

[paulus]

I've had this test myself and am familiar with the scoreing.

The nurse is quite correct in what she says. The ranking of 95% is saying that you have more calcium in your arteries than 95% of the population (at your age the vast majority of persons would register a 0 score - which is reflected in the fact that this test is generally recommended for the over 40's).  

However if I were you I would not panic over it as your score is still very low - see it as a very early warning that if you don't take action now your risking real problems further down the track.

The team that did this test should also be conducting other checks to determine why you have a fat build up at an early age (ie lifestyle, wieght, insulin, cholesterol, blood pressure, lp(a), homocystien, CRP etc) and giving you appropriate advice.

Your lucky to have such an early warning - my score at 44yo was 300.  Hopefully I've made the approriate changes to lifestyle and diet and cholestorel to now have things under control.

Good luck to you - and get a good preventative cardiologist who's able to explain things to you properly - yours does'nt sound so hot if he's left you so uncertain!

Best wishes - Paulus

[CCF-M.D.-RCJ]

Jerry78,

From what you have told me, I believe that the nurse practitioner is in error.

Most 36 yo Americans do indeed have some calcium in their arteries.  We know this from autopsy studies done on fallen Vietnam soldiers, who were usually in their early 20's.

But make sure you find out for sure (fer sure!).  Contact your cardiologist and make sure you get the right info.  And let him know the name of the NP so that he/she can receive proper training.

Happy Holidays.