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Good Calcium or Bad Calcium – Myth and Reality

“Got Milk,” has been the fun promotion for the dairy industry for years. We have all read that calcium helps build stronger bones and teeth and we know that milk products are the primary source of calcium in American diets. However, the calcium we will be discussing is a different form and it can be deadly.

 

Heart Scans and Calcium Scores

So what is a Calcium Score/CT Heart Scan? A non-invasive imaging that provides clear, 3-dimensional pictures of your heart, showing coronary artery calcification (indicating coronary plaque build-up) and other abnormalities of the heart muscle. It’s a totally noninvasive test, which is performed within five minutes.This test is very precise about detecting and quantifying the calcification of the coronary artery disease. The coronary calcification is a direct measure of atherosclerosis or hardening of the artery. It is almost non-existing to have significant plaque formation within the blood vessels if there is no calcification. Therefore, this test is an excellent tool for early detection, quantification, and possible future of progression coronary artery disease.

 

The problem is how we approach cardiovascular disease in this country. Our healthcare insurance is “sick care” insurance. We are focusing on people coming in with the full-blown heart attack, angina or coronary artery disease. We are not focusing on “prevention.” Thus, we are spending only 3 cents out of every dollar for prevention and 97 cents on chronic disease management. That is why the cost of the healthcare system keeps rising.

 

Why a Heart Scan May Save Your Life

From my experience as a cardiologist, looking at the EKG stress tests will not tell me if this patient has significant coronary artery disease. The only time I see significant coronary artery disease diagnosed by stress test is when the patient already has 70-80% narrowing in one or two vessels. I routinely see people in the hospital coming in after their normal stress test and then having a heart attack or angina. The prime example is President Bill Clinton, who had a normal stress test three months prior to his coronary artery bypass surgery.

 

Guess what? The majority of people who have their first heart attack have only 40-50% blockage. They do not have a 90% blockage, and so we are missing anyone who is prone to have a heart attack by not doing the right test to find out who is going to have this heart attack. So I am calling this “heart attack prevention test.”

 

WebMD argued absence of calcification does not mean there is no coronary artery disease. Yes, that it is true. Some people can have soft plaque even without calcification, but the incidence is less than 1%. This test has such a strong negative predictive value, that if you have 0% calcification, the likelihood of you developing significant coronary artery disease is almost none. If you have any calcification, then it means you are developing atherosclerosis.

 

What We Know

We know the incremental value of coronary event increases by increased calcium score. The likelihood of having a coronary event is 10 times higher with a score between 100 to 200. It is more than 25 times higher when the score goes beyond 400. So we know that if somebody has a score of 400 with a normal stress test, then this patient is going to have a significant risk, and that is the person we need to identify and complete a strong risk factor modification and follow up very closely. We are missing all of these risk factors because insurance does not pay for these new tests.

 

In conclusion, “TO STAY YOUNGER AS YOU GROW OLDER, YOU HAVE TO LIVE SMARTER.” And the smart way to maintain health is through preventive medicine. The first step is information. “YOU” and your physician need to know exactly what’s going on inside you, and what to do about it.