Plaque buildup in arteries

[Unregistered]

First, I am 59 years ole, male. I've never had a cardiac ST scan done, and was just curious about my arteries. I looked up CT scans on the internet for my city and I found where a particular hospital would do a cardiac CT and bloodwork for $150.

So I had it done. The bloodwork was all 'normal'. Cholesterol 171, and others where they were supposed to be. Well the CT scan showed me actually somewhat above the range they use to judge from 'no' to 'severe' plaque build up. I was actually above the 0-401 range they use. I didn't see a doctor, just the lab technician doing up the score by looking at the scan. I did get a letter from a doctor who reviews these where they give you all the details of bloodwork and CT scan score. But there has been no 'official' diagnosis by a doctor nor have I seen one.

My question is, what are my responsibilities here as far as my medical? I know what I need to do personally, but I haven't seen a doctor yet. Not having actually seen a doctor, when I get my next medical, should I report this? Is plaque buildup something that is required to report, etc? Is plaque buildup disqualifying?

Just wondering how to handle this to my advantage where my medical is concerned.

 

[Jimmy cooper]

First, I am 59 years ole, male. I've never had a cardiac ST scan done, and was just curious about my arteries. I looked up CT scans on the internet for my city and I found where a particular hospital would do a cardiac CT and bloodwork for $150.

So I had it done. The bloodwork was all 'normal'. Cholesterol 171, and others where they were supposed to be. Well the CT scan showed me actually somewhat above the range they use to judge from 'no' to 'severe' plaque build up. I was actually above the 0-401 range they use. I didn't see a doctor, just the lab technician doing up the score by looking at the scan. I did get a letter from a doctor who reviews these where they give you all the details of bloodwork and CT scan score. But there has been no 'official' diagnosis by a doctor nor have I seen one.

My question is, what are my responsibilities here as far as my medical? I know what I need to do personally, but I haven't seen a doctor yet. Not having actually seen a doctor, when I get my next medical, should I report this? Is plaque buildup something that is required to report, etc? Is plaque buildup disqualifying?

Just wondering how to handle this to my advantage where my medical is concerned.

Your responsibility is to pass the applicable medical. Plaque is not something you have to report as most pilots have no idea what their plaque count even is. You can however , go to Johns Hopkins cardio site, look up dr. Blumenthal and watch his video on how to avoid plaque buildup and how to have a healthy diet, weight etc. His specialty is heart attack prevention and heart health at johns Hopkins.

 

[NoHeat]

Why would anyone want to get an unnecessary CT scan? The radiation dose is quite high, vastly higher than a dental xray for example.

You sure it wasn't ultrasound?

 

[poadeleted20]

My question is, what are my responsibilities here as far as my medical?

To answer all the questions on the application completely and accurately.

I know what I need to do personally, but I haven't seen a doctor yet.

Perhaps, but you have seen a "health practitioner".

Not having actually seen a doctor, when I get my next medical, should I report this?

Yes, that visit (including the nature of the visit) does have to be reported in Block 19.

Is plaque buildup something that is required to report, etc? Is plaque buildup disqualifying?

I know of no question on the application which asks about "plaque buildup". However, your visit to the health practitioner for those tests will probably trigger the AME reviewing you application to ask about the visit including why you went and what was discovered.

Beyond that, you should ask an aviation medical expert like Dr. Bruce Chien. You can reach him either via his web site or on the AOPA Forums -- he doesn't visit here anymore.

 

[Checkout_my_Six]

ya I'd report it......preventive Cardio checkup..xx/xx/2015....everything reported normal.

Been there, done that, not a big deal.....

Now, having said that, you are at risk for anterior interventricular branch (LAD) blockage if some of that plaque decides to let loose, i.e. widow maker. Do what you need to do to reduce the buildup and restore your artery health. If not dealt with that plaque will turn into arteriosclerosis.....

 

[Unregistered]

Why would anyone want to get an unnecessary CT scan? The radiation dose is quite high, vastly higher than a dental xray for example.

You sure it wasn't ultrasound?

No, it was a cardiac CT scan. I as just curious being 59, if I had any buildup and the CT scan is the most unobtrusive way to find out. I'm overweight, but pretty decent shape for being overweight. Been working out with cardio and weights regularly for years. Never had a problem. But my score was over 4 times higher than where the 'severe' numbers start. Yet my cholesterol numbers, etc were normal. Cholesterol 171, LDL and HDL about where it should be. I've probably screwed myself as far as the medical. But I needed to know for my personal benefit where I can start to do something about it.

 

[Checkout_my_Six]

talk with your primary care doc and ask about having a Nuclear stress test (nuke imaging cardio scan) from a cardio center. I had this done earlier this year and it did not interfere with my medical. Obviously if there are issues it might affect your medial exam.

There were two procedures. The first involved having an MRI of the heart at rest....an injection of radioactive dye....tread mill activity to get the heart rate up....then a post MRI. This will indicate flow or lack there of throughout the heart. The dye marks where the blood is flowing and not....and the imaging can tell if the valves are functioning properly.

The second was an echo cardio gram....and this was more like a sonogram. The tech took measurements and video of the heart operation.

The two of these should be enough for a cardiologist to determine blockage and heart health.

 

[Henning]

You just answer the questions on your medical app. For Medical practitioner question you report "routine physical and tests", When the AME asks, you can say, "I didn't get diagnosed with anything." as that is all you have at this point.

BTW, I would be somewhat suspicious of that result. Things may not be as they appear.

 

[pilot1956]

I would be very skeptical of the medical recommendations made here. I am not aware of any evidence that any CT cardiac testing, nuclear stress testing, or any other cardiac test (including an ECG) has any known benefit in reducing mortality or morbidity among persons with no symptomatic evidence of heart disease (no chest pain on exertion, no shortness of breath, no heart rhythm disturbance).

Yes, heart disease is common, but regardless of what the test shows, if you want to minimize your chances of being impaired by heart disease, you will manage your weight, physical activity, and other risk factors (mostly tobacco use). Unless you are ill (chest pain, shortness of breath, etc), the test results change nothing that would not already be in your best interest.

What the tests can do is (1) be false positive (leading to many bad outcomes, including possible loss of medical certification), (2) be true positive that would not have affected your morbidity or mortality, (3) be a true positive that would not change any treatment or lifestyle choices (if you are living in a reasonably healthy way).

Bottom line, doctors will almost never treat positive heart test results in the absence of evidence of clinical illness. In reality, it is very hard to know what such test imply, in terms of intervention, when the patient is without symptoms.

 

[Henning]

I would be very skeptical of the medical recommendations made here. I am not aware of any evidence that any CT cardiac testing, nuclear stress testing, or any other cardiac test (including an ECG) has any known benefit in reducing mortality or morbidity among persons with no symptomatic evidence of heart disease (no chest pain on exertion, no shortness of breath, no heart rhythm disturbance).

Yes, heart disease is common, but regardless of what the test shows, if you want to minimize your chances of being impaired by heart disease, you will manage your weight, physical activity, and other risk factors (mostly tobacco use). Unless you are ill (chest pain, shortness of breath, etc), the test results change nothing that would not already be in your best interest.

What the tests can do is (1) be false positive (leading to many bad outcomes, including possible loss of medical certification), (2) be true positive that would not have affected your morbidity or mortality, (3) be a true positive that would not change any treatment or lifestyle choices (if you are living in a reasonably healthy way).

Bottom line, doctors will almost never treat positive heart test results in the absence of evidence of clinical illness. In reality, it is very hard to know what such test imply, in terms of intervention, when the patient is without symptoms.

Well, there are exceptions. In general, the results of the test used as an indicator of the efficacy of your diet or exercise regime on the plaque risk factor can be determined. I used the Calcium Heart Scan to help me determine if I should use a cholesterol altering medication. I have for decades recorded high numbers that have always brought comment from doctors, and dietary efforts to regulate on my part that brought little effect. So last time the doc wanted to put me on a script for it I asked, "Why, what will it prevent?" "Plaque formation in the arteries." "What's the test to see if it's there?" "Calcium Heart Scan, $100" so I agreed to the heart scan; scored "0". Doc agreed he wasn't seeing where it was doing me damage.

 

[poadeleted20]

You just answer the questions on your medical app.

Agreed.

For Medical practitioner question you report "routine physical and tests",

Strongly disagree -- there's nothing "routine" about the tests described. Fill out the application completely and honestly, and hold nothing back.

When the AME asks, you can say, "I didn't get diagnosed with anything." as that is all you have at this point.

Again, really bad advice. The FAA would consider that answer deceptive, and withholding information. Again, answer fully and honestly, with no evasion.

Finally, please contact Bruce Chien or another AME with his level of experience before you go further in order to obtain complete, accurate, and reliable advice.

 

[pilot1956]

Henning, practicing medicine by exception rather than by evidence is poor practice.

How do you know the Calcium Heart Scan test was correct? If it was correct for your heart, how do you know you have no plaque anywhere else (like in your head, about to cause a stroke, or in your groin, about to cause ED)?

Based on your Calcium Heart Scan results, is there reason to believe you are now immune to the lifelong effects of your "high numbers"? Will you never treat your cholesterol? When do you get the next calcium heart scan? What is the best interval?

 

[Henning]

Henning, practicing medicine by exception rather than by evidence is poor practice.

How do you know the test was correct? If it was correct for your heart, how do you know you have no plaque anywhere else (like in your head, about to cause a stroke, or in your groin, about to cause ED)?

Based on your "Calcium Heart Scan" results, is there reason to believe you are now immune to the lifelong effects of your "high numbers"? Will you never treat your cholesterol? When do you get the next calcium heart scan? What is the best interval?

I don't, I don't know anything about when I'm going to die or of what. I am avoiding taking a medication regime that has increased alongside Alzheimer's and affects the chemistry that keeps your nervous system, 'lubricated'.

Since there are no studies on correlation between cholesterol control meds and Alzheimer's, and my dad has been on these meds, and in the mean time developed Alzheimer's, I figured I'd try avoiding them since I have nothing to lose. It's more to satisfy curiosity than any medical belief. I have no problem with dying.

 

[pilot1956]

Henning, I am sorry to hear about your father.

Statins don't cause dementia. Atherosclerosis of the arteries in the head, on the other hand, are a known risk factor for vascular dementia, which is just as debilitating as Alzheimer's. Self medication is a risky business.

 

[Henning]

Henning, I am sorry to hear about your father.

Statins don't cause dementia. Atherosclerosis of the arteries in the head, on the other hand, are a known risk factor for vascular dementia, which is just as debilitating as Alzheimer's. Self medication is a risky business.

Cholesterol is one of the factors in the process. There is no risk when you have nothing to lose. Answering curiosity is what life is for.