My CCTA Score = CAD-RADS 1% Stenosis

[jetman]

I asked my PCP doctor to order a CCTA scan.
Medicare paid 100%.
The diagnosis he used = other specified health status, code ICT-10: Z78.9

My CCTA report states: Minimal stenosis of the proximal left anterior descending coronary artery. CAD-RADS 1% stenosis. Minimal non-obstructive CAD or plaque with no stenosis. Further Cardiac Investigation: Consider preventative therapy and risk factor modification.

In the Coronary Artery Disease – Reporting and Data System (CAD-RADS), my 1% stenosis falls into Category 1 = stenosis = minimal non-obstructive disease

Clinical Interpretation:​

Non-obstructive = No significant luminal narrowing; plaque burden is minimal.
No functional significance: In most cases, such low stenosis is not hemodynamically significant.
Management: medical therapy (e.g., statins, antiplatelets, antianginals, risk factor modification).

Key Point for CAD-RADS category 1 = a 1% stenosis is not obstructive and is considered benign in terms of hemodynamic impact.​

IMO this is not too bad all things considered in my 69 yrs.

Your results may vary
@alarmguy
@Pablo

 

[alarmguy]

Thanks, I’ll bookmark this in case my primary doctor might be looking for some Code. I won’t see him to the fall but maybe I’ll try to move up my cardiologist appointment.
I’m hoping since I have had an invasive angiogram five years ago with 20% plaque all over the place and CAC score 477 this year that my advantage plan will pay for a CT angiogram like you had.
I believe insurance companies are receptive to a follow up after five years, but I don’t know.

I think in my case, it would be very prudent to be able to get one. However, without symptoms, I don’t know and I really don’t wanna make any up.

 

[jetman]

I finally had a visit with my PCP about the CCTA results that he ordered in April, and my ongoing thyroid and uric acid #s.

He thought my CCTA looked good with only mild stenosis in my LAD. I told him about the heart rate #s I see with my heart rate monitor on my HIIT rides. He said theres my stress test, no need to order one. I asked him if I should see a cardiologist. He didn't think so but would recommend some if I wanted. I said no thanks

I mention my thyroid TSH # being high (4.7 uIU/mL) but told him I didn't have any hypothyroidism symptoms. He again said there's nothing to treat then, you don't treat the # you treat the patient, same goes for my high uric acid (7.8 mg/dL) and no symptoms.

I reminded him that I'm a LMHR. I told him my goal for myTC # is 220 mg/dL and my goal for my LDL is 150 mg/dL because these are the sweet spots for all cause motility. I asked him to prescribe Ezetimibe 10 mg once/day to help lower my TC & LDL and for protecting my brain health. He agreed. I started Ezetimibe today. I'll do a follow-up lab and visit with him in September to see how it going toward my TC & LDL goals.

Here is a Nick Norwitz video about Ezetimibe and brain health:


and another video about how Rzetimibe is used for TC & LDL:

 

[alarmguy]

Glad you're doing good. I do question your use of word "mild" in post #3 Mild to me is pretty significant. I think you mean't to say Minimal which is CAD-RADS category 1 according to this chart.If it was him who used the word mild maybe you are in-between the two ... I have no clue.
I know you don't like doctors. For me, I dont like PCP's. I saw mine Tuesday, he can't order a CT Angiogram even though they freaked out when I told them about my Memorial Day weekend event. I much rather see a specialist - cardiologist.

CURIOUS, DID YOU EVER GET A CAC SCAN?

AS its your heart and you have arterial disease. I'll post my 2021 results below. This was the invasive angiogram so frustrating that the terminology is different but seems like my results are much like yours only more of it. I know you know what you are doing, my comments are based on looking in from the outside.

https://www.journalofcardiovascular...a52-a121-d27966dc69b3/main.assets/gr1_lrg.jpg

 

[alarmguy]

So I dug up my 2021 invasive angiogram results. Frustrating cant compare the CT procedure you have but both say minimal.
Ohh.. but re-reading my report it mentions the other "branch" as mild. But both with minimal mentioned.
GO figure. Ok, so Tuesday, my PCP told me he couldnt order the CT Angiogram but he and his nurse were a little freaked out about a Memorial Day thing I had going on, even though my Cholesterol is only 109 taking a 5mg statin, he sent a script for 40mg to CVS. I am not picking it up, I will let the cardiologist who is the one that prescribed 5mg and 10mg max tell me

Anyway I go upstairs to the cardiology. Out of ALL their (a lot)cardiologists, including my own the soonest ANYONE can see me is in two weeks and this is considered "urgent" *LOL* on top of that, the only person available is an NPA or something. SO I set that appointment but going to look to move myself to a new medical center closer to me assuming, this cardiologist I found can see me ASAP. I can also call everyday to see if any cancellations.

 

[alarmguy]

This is my 2021 report.

 

[jetman]

I reminded him that I'm a LMHR. I told him my goal for myTC # is 220 mg/dL and my goal for my LDL is 150 mg/dL because these are the sweet spots for all cause motility.

Meant to say "mortality", not motility

 

[jetman]

CURIOUS, DID YOU EVER GET A CAC SCAN?

As I've stated in various threads a few times, my CAC Agaston score was 33 April of 2025.

 

[alarmguy]

As I've stated in various threads a few times, my CAC Agaston score was 33 April of 2025.

Yeah, I figured you did but the threads are so fragmented ... and way too much to go through ... I did check the CAC thread.
I wish I had your number

 

[alarmguy]

This guy has many great videos, factual to the point, and he doesn’t always agree with what some might be considered the routine thought process.

However, he is affiliated with a very well-known medical network in New York. He is a Mount Sinai Medical Center board certified cardiologist. I checked him out.

Don’t let his age fool you.
This one is on Facebook but one time I’ll try to find some on Instagram and YouTube
https://www.facebook.com/share/r/17owRdwMoj/?mibextid=wwXIfr

 

[alarmguy]

Here is his YouTube account.
This is a really good one about people who say big pharmaceutical companies keep people on statins for profit.
His explanation is fantastic

 

[jetman]

Here is his YouTube account.
This is a really good one about people who say big pharmaceutical companies keep people on statins for profit.
His explanation is fantastic

https://pubmed.ncbi.nlm.nih.gov/11502313/

 

[jetman]

Here is his YouTube account.
This is a really good one about people who say big pharmaceutical companies keep people on statins for profit.
His explanation is fantastic

 

[alarmguy]

Yup, that's correct ^^
Insurance won't pay for health advice and much the stuff people like us and in forums want to do. We need to be honest as well, as a people (not us).
Not sure who I blame most, the public or the doctors. I know the vast majority of the public doesn't listen to their doctors advice and we know doctors dont have the time nor are they paid for anymore more than the few minutes that are offered.

Im only saying this because my past much loved cardiologist (before we moved 3 years ago) was a great doctor. He would spend all the time that you wanted on a subject, was a great aid in getting me into a electrophysiologist to perform an ablation as one example. HE literally walked the halls (the place is huge) to track him down so we could all go over some things while I waited in my Duke associated heart center in Columbia SC.
Im only saying this because at the time I was about 10lbs over my BMI and I commented to him I was annoyed at my self. I could tell by the look on his face when he said " you are fine, god you would not believe some of my patients" I'll never forget it. The look of frustration of them not listening to him. His NP was great as well, I meet with her after a nuclear stress test, it wasn't all bad but agreed the gold standard was to have an invasive angiogram, she made it happen. I saw the notes put in my chart to make sure it cleared ins approval, at the time my company health plan paid for it. (I suspect your primary did too

Rambling again! Anyway, I miss what I had before we moved. Not sure if I know what I do now on the coast I would have moved here. The lack of facilities and frustration dealing with more rural places... who I dont think are at the top of their game.

Anyway, 3 hours (almost to the minute) away is Duke Medical Center (s) They actually have multi cardiology clinic/programs for people who want to be proactive. Both with established heart disease of all types to people without heart disease who want to keep it that way.
.... IM certain insurance wouldn't pay for it but it ironic that with all the medical networks around me less than an hour away no one will see you unless you have heart disease. Here I think there is a slight chance I was having a heart issue (attack) Memorial Day weekend and I have to wait two weeks to see not my regular cardiologist or any of the other 8 other more of them but an appt with an NPA !
Duke guaranteess 24 hours... me the wait down here on the coast 2 weeks without a real doctor. (working on it)
https://www.dukehealth.org/treatmen...on&docsShowing=10&showMiniFAD=1&scrollPos=654

 

[PWMDMD]

Just received my CAC result. I'm 47 and at one point I was 6'5" and 365lbs - currently on a GLP-1. I'm now 265lbs but carry quite a bit of lean mass and workout 4x per week including cardio. I've been hypertensive my entire adult life and current take two meds but have been stable at 125/75 ish for years on my meds. The only other issue is hypothyroidism and I take levothyroxine. My sister passed from a heart attack at 44. Between this and no findings on last weeks colonoscopy, I'm feeling pretty good about my health.

TECHNICAL QUALITY: excellent without artifact

FINDINGS:

Calcium Score

LMA: 0
LAD: 0
LCX: 0
RCA: 0
Total calcium score: 0 using the AJ-130 method.

Other cardiac findings:

Cardiac size
No cardiomegaly.

Valves
No valvular calcifications.

Pericardium
No pericardial effusion, thickening or calcification.

Overall limited visualization of the thorax secondary to limited z-axis collimation.
Within the limited field of view:

Mediastinum and large vessels:

Aorta
No aneurysmal dilatation of partially imaged thoracic aorta.

Pulmonary arteries
Main pulmonary artery is not dilated.

IMPRESSION:
1. CT coronary artery calcium score is 0.

 

[alarmguy]

So this is the week, not sure will it end up. I thought I felt some chest pressure Memorial Day weekend. Didnt go to the ER (yeah, dumb)
Anyway, at my annual physical, I told my primary Dr what was going on, he raised his eyebrows. Wanted to increase my statin dose over 400% ...
However since my cardiologist is the one who prescribed the original dose just reviewed 6 months ago. I am waiting to meet with him. So from that appt with my primary I went up to the 2nd floor to my cardiologist office to schedule appt right away, which of course my primary thought was important too, I wanted my primary to schedule a CCTA but he said he can't do that and get an appt with cardiology. Well, out of the entire office, not just my cardiologist but a whole team of them, no one could see me right away, no openings, best I could do was with their NP and that takes place June 24 7:30AM. Horrible but I made that appt. I hav my doubts that he will get me that CCTA either.

Disgusted with the long wait times to see a doctor, more so for someone who felt chest pressure. There is a major newer network here, closer to my home too. Not new in the sense of the organization but established medical centers who have now moved into this area. Anyway, found a super looking Cardiologist there. Looked up his education. good stuff, amazing amount of patient reviews, and he is a bit younger 40 years old. I managed to get an appt with him on July 8th as a new patient. Moving forward I will move all my medical stuff to this organization, more local, nice newer hospital, buildings of all kinds expanding. I would have sooner but it was all just coming about when we moved here 3 years ago.

I couldn't decide whether to keep the first appt but think I will, just in case. But ultimately location wise I am liking what I see as this organization keeps expanding here. But I guess my health plan can't deny me getting second opinion and talking to another doctor.
I dont have too much against the present organization, though some things substantial, its just their main centers in Willmington is where anything serious would be taken care of and that is just over an hour away. As I get older, the new medical centers are 15 minutes and nice stuff going on there, Main hospital, plus separate medical offices and a cancer building.

Ok, anyway, purpose of this post related to the OP @jetman
I'll have all the answers between these two appts. But I have learned some things. I think the CCTA might be a little "vague" (my words) for someone who has a high CAC score. I hear and I dont know if correct but will most likely be educated in the coming weeks. People with a lot of calcium produce a "blooming" effect of the imaging in some areas of a CCTA making a complete analysis difficult. My CAC is 474
A search on a search engine has much on the subject = blooming effect on a CCTA
Ill know more this week and by July 8th...

 

[jetman]

@alarmguy
I thought my CCTA $cost was gonna be zero$ but I was wrong. Ended up costing $268, paid for with my wifes HSA.