My CCTA Score = CAD-RADS 1% Stenosis

My wife sees it daily
that's why we don't have advantage.
I dont understand :) "sees it daily" ( I think we are misinterpreting our words)
Anyway, if following my story. My cardiologist NP which is the only one who could see me so soon (weeks later) after some chest discomfort Memorial Day weekend. Spent at least 1/2 hour with me, came into the room well informed of my heart procedures (invasive angiogram, cardiac ablation etc) from past medical centers in our old house/state. SO that was impressive, family history too.

However I suspect he was not in a position to order a CT Angiogram. Before he did come in the nurse told me once he see's me, they will determine if this needs to go up to my regular cardiologist or not, I think if needed to that would have been the extra step. I suspect that I was put one stop short, though I did not insist on the angiogram I brought it up, maybe I should have insisted but I listened to him explain his thought process, which also made sense. Long story short, even though I was in a recently new center with a beautiful hospital that I regularly go to for imaging. He wants me to go into the main city (Wilmington) heart center for a combination ECHO/STRESS test. Where I was he explained they can to a stress test and they can do an echo separately but not a combination stress/echo which he explained why he thought it made more sense for me to undergo, I was starting to "zone out" and forgot the explanation. He did take notice of my 2026 CAC 474 score too. I think he thought ST Angiogram would be a certain thing to get IF I was still having chest discomfort and implied that for some reason this other test will tell more of the story for now.

IN the meantime He acknowledged my stupid low lipids for most my life and commented unfortunately even though that helps greatly genetics (family history) is controlling the agenda here and I have done good compared to the males in my family train wreck. My current total is 107 - latest LDL was 59, I wanted it in the 20-30 range, not going to happen. IN the past with my regular cardiologist we discussed going from 5mg statin to 10mg statin. I agreed then backed off. I bought this up, he was good with the 5mg but saw in the notes the back and forth. I said I was worried about my total (107)to be too low, he said that is not a concern here. So I told him let's go to 10mg. See if I can get LDL to the 40's I am positive I can. Might be a stretch. He thought in his mind 55 or under is great. My cardiologist thought 20 wasnt too low but statins are not going to achieve that.

BTW- In my previous notes I mentioned my primary DR two weeks prior when I told him about the heart discomfort, freaked out and said with my family history I have to go up to 40mg rosuvastatin. (which is the equal of 80mg avorstatin cant spell it) I never picked up the prescription, was not going to have a primary DR over rule a cardiologist. I did the right thing, cardiologist ANP thought that was nuts (by the look on his face and deleted it from my file.) However I told him let's go to 10MG, more than safe for my risk group.

Ok, so moving forward, I havent had chest pressure, Playing pickleball, landscaping, working on the boat. IT was just that weekend. I dont know what it was, maybe mental but hopefully this test will reveal something, not expecting much, he even said with the way I "workout" telling him I routinely work my heart rate into and above 150 that is a stress test in itself. But something still makes him uncomfortable and why I will have to drive over an hour into the city for this test.
He also for now prescribed Nitroglycerin 0.4 and told me to carry it around, if any discomfort like what happens or more serious. Sit down and put one under the tongue, wait 5 minutes and then another until it stops then call them right away to come in. I dont see this happening, just a precaution, maybe what I described is concerning and why he ordered the test.
Once they contact me to schedule, I am hoping it is after July 8th below incase I like what this new cardiologist tells me.

I have an appt on July 8th with a new to me cardiologist practice in a new medical center for a new patient interview. So felt less urgent all the above, though I am confident in the above, I plan on moving my health care to this newer MUCH more close medical center and hospital based on my meeting with this doctor. If I like it, I will then finally also get rid of my primary DR and move to one in this new center.
 
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