HomeAnswersCardiologycardiac calcificationIs minor calcification in proximal LAD reversible?

Can minor calcification in proximal LAD be managed by lifestyle modifications?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Vinodhini J.

Published At July 12, 2020
Reviewed AtJuly 4, 2023

Patient's Query

Hi doctor,

I am 36 years old. 18 months ago, I experienced some mild chest pain and went to the ER. I had all the blood tests done, and it was determined that there was no heart attack and no blood clots. I have followed up with a local cardiologist in my place. He had me undergo a CT angiogram. He called later and stated it was no big deal. Everything was fine, just a little minor plaque. I was relieved. I have since lost about 105 lbs, from 327 to 222 currently. I have ate relatively well and quit drinking alcohol two years ago, not that I was ever a heavy drinker. Only slight family history of CAD with my grandmother on my dad's side who was a hefty drinker, smoker, and severely overweight. And she survived a heart attack, had a bypass, and lived another twenty years. I recently decided to look at the report from the angiogram, and I was worried because it states minor calcification in the proximal LAD with no flow-limiting stenosis. The doctor did not seem worried at all. Again, now more than ever, I continue to lose weight and eat extremely healthy. At the time of my angiogram, I had an entire lipid panel run, and my overall cholesterol was well within normal limits. However, my good cholesterol was a little low at 32 mg/dL, and my bad cholesterol was within normal limits. Triglycerides were normal, right at the limit, before I started losing weight. I also exercised six to seven times weekly, usually with a strenuous cardio routine. I have two young children and am very worried. Can someone help put this in perspective for me? I am currently on 10 mg Escitalopram for anxiety, not that it works. I take a daily multivitamin, probiotic, fish oil 2400 mg, CoQ10 20mg, and Niacinamide 500 mg.

Thanks.

Hello,

Welcome to icliniq.com.

I understand your concern.

Firstly, this disease will not cause any symptoms, so none of your symptoms are related to this. However, there is a definite minimal plaquing with calcification (although they did not quantify its calcium score or percentage stenosis), which needs to be addressed. So there is a disease but in earlier stages. Sometimes this plaque may even rupture and become ACS (acute coronary syndrome). So, you will benefit from a low dose of Aspirin and Statin combination in the long term and get CT coronary angiography repeated after five years. Your vitamin D was down, so it was supplemented. There is only a minimal disease, which means early disease needs preventive treatment, for which a healthy lifestyle and medications should be continued.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thank you for the reply.

Suppose I take low-dose Aspirin and Statin and live a clean and healthy lifestyle. Is the outlook generally good?

Thanks.

Hello,

Welcome back to icliniq.com.

I understand your concern.

Yes, the prognosis is good with a healthy lifestyle along with medications. We can slow the progression significantly, so do not worry about it but take all the possible precautions.

I hope this information will help.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

That is what my doctor also said. Besides a great diet, exercise, and low doses of Aspirin, what other precautions can I take? And I have read conflicting reports in medical literature. Can this be reversed?

Thanks.

Hello,

Welcome back to icliniq.com.

I understand your concern.

Precautions are general, like avoiding oily fatty and high-calorie food, plenty of green vegetables. Avoid weight gain and achieve BMI (body mass index) in the ideal range—regular exercises at 30 minutes a day. Try to minimize stress and normal adequate sleep. Avoid excessive alcohol. You may perform yoga. Plaquing sometimes may be reversed with Rosuvastatin, but not always, so not reliable. Our target is to prevent the progression or development of heart attack. Statins slow down the progression and Aspirin prevents the development of heart attack. But in most individuals, even on medication, it progresses slowly over years or decades, so regular testing should also be done to keep checks on it.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

Are you permitted to prescribe me the Statin?

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

There is no option, but it is better to get it from a doctor as it would be easy to undergo follow lipid testing after eight weeks, sugar, and CPK (creatine phosphokinase) levels if you develop any side effects. It is not an emergency so you may wait until your next visit.

I hope this information will help you.

Thanks.

Patient's Query

Hi doctor,

Thanks for the reply.

I got my lipids testing redone and wanted to share it with you. The new cardiologist is not prescribing statin because the numbers are good. BP is a bit high at the doctor’s than normal or near normal at home. I was still losing weight, eating a no-cholesterol diet of fruits, veggies, and fish, and exercising one hour of cardio daily. I had a stress echocardiogram that I was told looked good, and I passed. Is there anything else I can or should be doing?

Thanks.

Hello,

Welcome back to icliniq.com.

I understand your concern.The rest of the lipid parameters are excellent except for HDL (high-density lipoprotein), which is marginally lower than the target of 40 mg/dL. So other than a healthy lifestyle, they do not need other medications. I suggest you continue with your healthy lifestyle. Normal stress echo rules out the possibility of significant blockages.

I hope this information will help you.

Thank you.

Patient's Query

Hi doctor,

Thanks for the reply.

Yes, HDL is still low, but it climbed by two points and gradually improved daily with exercise. I know you said before that even with diet and exercise and medications, CAD can get worse as time goes on, but because we caught it early and doing everything possible to treat it and good testing, am I relatively low risk for any trouble until later in life if I do all I am supposed to do? I need something good to hang onto.

Thanks.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Since you have achieved good levels with lifestyle alone and in the early stages, the prognosis is good, and you fall into the low-risk category. Your focus should be on maintaining it, which is more challenging. You should periodically check your lipid profile every six months to one year (if it remains normal). Also, check blood pressure, and avoid addictions, especially smoking. So, the prognosis is good, and continue preventive measures like a healthy lifestyle.

I hope this information will help you.

Thanks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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