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Test results Interpretation

Where does preventive diagnostics for heart stop? My Echo test says mild LVH, Stress tests are normal, blood markers are *very* mildly elevated. My BP varies between 125/80 to 150/90, primarly because of stress.
Cholestorol, HDL, LDL, Triglycerides, liop-proteins etc. are mildly out of place. BMI is 28, and am a smoker (unfortunately), and a regular runner (fortunately). I also do a lot of outdoor activities like mountain climbing, and am constantly worried that on one of these climbs, I may get a call from my Heart.
The calcium score came in today at (01.1). I had asked my doctor that what test could I do, except angiography to ascertain that my chest pain is non-cardiac.
As I understand, plaque is hard and soft. My calcium score indicates low hard plaques, and slightly out of line blood work (triglycerides, cholestorol, apolipo-proteins etc) indicate low soft plaque.
Low hard and Low soft plaque == Low CAD, right?
Request insights! Thanks
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976897 tn?1379167602
"But is there a general agreement on when it should be done"

Well this is basically the decision of the Cardiologist. If the cardiologist is sure there are blockages causing problems, maybe through a failed stress test, then he will likely want to do an angiogram sooner. Some cardiologists would still rather just put you on medication.

"The hazards of smoking, and its addictive nature are well known. I am trying my best! "

That's good, I know it's hard, I've been there.

" is it not a good idea to get on the angiograph in the first place?"

Well not really, none invasive tests may not always reveal a problem, but we must remember they can also eliminate possible problems. For example, an echo will allow all the dimensions of your heart to be checked, wall thickness and of course the functionality of your valves. So an echo scan is a valuable exam. You could look at it the other way. If you had an angiogram which revealed clear arteries, would you be asking "shouldn't they do the other tests first".
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Avatar universal
The gold standard is still the angiogram, and I agree. But is there a general agreement on when it should be done, and should it be done as a part of routine, or preventive?
The Echo-Stress test is a good idea, and will take it up with my doc in few months. The hazards of smoking, and its addictive nature are well known. I am trying my best!
In hindsight, if lipids and echo and stress and calcium cannot reliably answer a yes or a no, is it not a good idea to get on the angiograph in the first place? At least that saves time, and is peace of mind.
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976897 tn?1379167602
No. Your lipid levels in the blood do not reflect the level of soft plaque, these are actual working lipids doing their job in the body. With a calcium test, the Doctor should take your age/sex/race into account because they roughly know the balance with soft/hard plaques. Of course, there are always individuals who get through the filter net. I assume your stress test was on a treadmill? You could have a stress echo which will see any abnormal wall motion when the heart is working hard. However, the gold standard is still the angiogram. You do know that smoking is continually damaging your arteries? You've probably been told this a million times, but if you are concerned about your heart, you would stop.
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