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How Often Should Cardiac Calcium Be Checked In An Elderly Person?
Question: I am male, 67 years old and in very good general health. I had a cardiac calcium score done 7 years back and it was zero. Since then, I continued cardio exercise 4 times a week, 30 minutes each. My stress is very low. LDL has been around 130 and HDL around 45. My oxidized LDL has been around 50. My weight has stayed constant. with a BMI of 24.5. Blood pressure is 120/80. My questions are:
1) When should I repeat cardiac calcium scoring
2)What are the best machines for lowest radiation and accuracy
3)Are any machines coming in next couple of years with much lower radiation.
Thanks.
1) When should I repeat cardiac calcium scoring
2)What are the best machines for lowest radiation and accuracy
3)Are any machines coming in next couple of years with much lower radiation.
Thanks.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
I passed carefully through your question and would explain that your blood lipid profile is normal (LDL/HDL ratio is within the normal limits).
This means that you have no cardio-vascular risk factors, considering your healthy lifestyle.
Coming to this point, I would conclude your overall ten-year risk for future coronary events is almost 0, considering your normal cardiac calcium score.
For this reason, there is no reason to repeat the cardiac calcium scoring in the next 10 years, especially considering its risk of radiation.
Unfortunately all the cardiac tests for coronary artery disease (Coronary angio CT scan, Nuclear perfusion cardiac stress test, angiogram) impose the patient to a high risk of radiation.
Only the exercise cardiac stress test, dobutamine stress echo and the cardiac MRI have no risk of radiation.
Anyway the tests are performed usually in patients with high risk or with a clear cardiac chest pain symptomatology.
Otherwise, there is no need to perform these tests, considering their cumulative risk of radiation.
I would just encourage you to follow your healthy lifestyle and closely monitor your blood pressure values.
Periodic check up is recommendable every 6 months, including a cardiac ultrasound, resting ECG, blood lipid profile, fasting glucose, complete blood count, kidney and liver function tests and blood electrolytes.
Hope you will find this answer helpful !
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
I passed carefully through your question and would explain that your blood lipid profile is normal (LDL/HDL ratio is within the normal limits).
This means that you have no cardio-vascular risk factors, considering your healthy lifestyle.
Coming to this point, I would conclude your overall ten-year risk for future coronary events is almost 0, considering your normal cardiac calcium score.
For this reason, there is no reason to repeat the cardiac calcium scoring in the next 10 years, especially considering its risk of radiation.
Unfortunately all the cardiac tests for coronary artery disease (Coronary angio CT scan, Nuclear perfusion cardiac stress test, angiogram) impose the patient to a high risk of radiation.
Only the exercise cardiac stress test, dobutamine stress echo and the cardiac MRI have no risk of radiation.
Anyway the tests are performed usually in patients with high risk or with a clear cardiac chest pain symptomatology.
Otherwise, there is no need to perform these tests, considering their cumulative risk of radiation.
I would just encourage you to follow your healthy lifestyle and closely monitor your blood pressure values.
Periodic check up is recommendable every 6 months, including a cardiac ultrasound, resting ECG, blood lipid profile, fasting glucose, complete blood count, kidney and liver function tests and blood electrolytes.
Hope you will find this answer helpful !
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your detailed reply.
1) Did you say wait 10 years from today or from 2011 when I had the last scanning
2) Did you recommend a cardiac ultra sound every six months? Does it give any idea of blockage?
3)Would you recommend stress test or stress echo or cardio MRI? How often?
4)Is oxidized ldl a crucial measure of plaque building in the arteries ?
5) Are there any supplements you can recommend to keep my calcium score close to zero? I am already taking omega3.
Thank you.
1) Did you say wait 10 years from today or from 2011 when I had the last scanning
2) Did you recommend a cardiac ultra sound every six months? Does it give any idea of blockage?
3)Would you recommend stress test or stress echo or cardio MRI? How often?
4)Is oxidized ldl a crucial measure of plaque building in the arteries ?
5) Are there any supplements you can recommend to keep my calcium score close to zero? I am already taking omega3.
Thank you.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Here are my answers to your questions:
1. I would like to explain that the absence of additional coronary risk factors, coupled with a normal coronary angio CT means that the probability for coronary cardiac events in the next ten years appears very low. This holds true considering your actual cardio-vascular conditions as you have been following a healthy lifestyle without the presence of coronary risk factors. To summarize, the most important part of this story, is the absence of coronary risk factors and not only the normal coronary angio CT scan. So, the conclusions could be considered from now and in the future. In other words there is no need to perform a coronary angio CT scan every ten years.
2. Regarding the cardiac ultrasound, it may be part of a normal check up to evaluate your heart function, but it does not give any information on coronary artery disease. It is just part of a routine check up, coupled with blood lipid profile, and the other above mentioned tests, which should be checked at least every year (optimally every 6 months).
3. I would recommend a stress test or MRI only if you have clinical chest pain suggestive of coronary artery disease and your doctor recommends doing it.
4. Oxidized LDL is the most atherogenic part of the LDL. Anyway, dyslipidemia is usually evaluated based on the LDL/HDL ratio or Total cholesterol/HDL ratio, which are better indicators of the cardio-vascular risk.
5. There are no special supplements, that I would recommend. Omega 3 oil is OK.
A healthy diet and an active life is the best thing you can do.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
Here are my answers to your questions:
1. I would like to explain that the absence of additional coronary risk factors, coupled with a normal coronary angio CT means that the probability for coronary cardiac events in the next ten years appears very low. This holds true considering your actual cardio-vascular conditions as you have been following a healthy lifestyle without the presence of coronary risk factors. To summarize, the most important part of this story, is the absence of coronary risk factors and not only the normal coronary angio CT scan. So, the conclusions could be considered from now and in the future. In other words there is no need to perform a coronary angio CT scan every ten years.
2. Regarding the cardiac ultrasound, it may be part of a normal check up to evaluate your heart function, but it does not give any information on coronary artery disease. It is just part of a routine check up, coupled with blood lipid profile, and the other above mentioned tests, which should be checked at least every year (optimally every 6 months).
3. I would recommend a stress test or MRI only if you have clinical chest pain suggestive of coronary artery disease and your doctor recommends doing it.
4. Oxidized LDL is the most atherogenic part of the LDL. Anyway, dyslipidemia is usually evaluated based on the LDL/HDL ratio or Total cholesterol/HDL ratio, which are better indicators of the cardio-vascular risk.
5. There are no special supplements, that I would recommend. Omega 3 oil is OK.
A healthy diet and an active life is the best thing you can do.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your point by point response.
One piece of information I did not include before. My father died of heart attack at 56, my father's father at 52. I have two brothers - 2 and 4 years younger. Their calcium scores are 500 and 1000 and the later had a by pass surgery recently.
My mother's side had no heart problems.
Does this information affect any of your recommendation especially 10 years from today for the next calcium scan.
Thanks a lot.
One piece of information I did not include before. My father died of heart attack at 56, my father's father at 52. I have two brothers - 2 and 4 years younger. Their calcium scores are 500 and 1000 and the later had a by pass surgery recently.
My mother's side had no heart problems.
Does this information affect any of your recommendation especially 10 years from today for the next calcium scan.
Thanks a lot.
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
This information, does not change my opinion.
Anyway, it seems that your brothers may have genetic related increased coronary risk factor.
But, as your calcium score was normal and you are following a healthy lifestyle, have no other cardiovascular risk factors and have no symptoms, there is nothing to worry about!
Hope to have clarified some of your uncertainties!
Wishing good health,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
This information, does not change my opinion.
Anyway, it seems that your brothers may have genetic related increased coronary risk factor.
But, as your calcium score was normal and you are following a healthy lifestyle, have no other cardiovascular risk factors and have no symptoms, there is nothing to worry about!
Hope to have clarified some of your uncertainties!
Wishing good health,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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