DearCustomer If you have the full CT report, it would be most helpful. That being said, we can begin to see atherosclerotic changes on CT in some people as early as age 10!
Atherosclerotic changes can be serious. It will depend on the extent, size, and degree of calcification present within the plaques. This is where the actual report comes in handy.
In order to better address your concerns and question, I need to ask you a few additional questions:
Once I hear back from you, I will respond.
Kindest Regards,XXXXX XXXXX, MD
It looks like you went offline, so I will go ahead and provide some additional information about Aortic Atherosclerosis. Atherosclerosis is serious no matter how we look at it. It carries with it risks of rupturing or breakage that can cause pieces of it, or a resulting clot at the site of plaque rupture, to shed off and flow to various parts of the body -- including heart, arms, brain, kidneys, legs, and many other locations. This can result in blockage of blood flow to that particular part of the body. If the particle of plaque or clot flows to the brain, it can cause a stroke ... to the coronary arteries, it can cause a heart attack.
Here is a video prepared by my alma mater at the Mayo Clinic in Rochester:
Here are some resources on the atherosclerosis process, itself:
Now, just how serious your aortic atherosclerosis changes are depends a lot upon your risk factors, as noted above. Also, the process of plaque instability comes into play, and it appears that inflammatory processes and even infections play a role in destabilising plaques of atherosclerosis, increasing their risk of rupture or breakage.
You should discuss with your physician or Cardiovascular Diseases specialist exactly how you can minimise the risk of developing progression of these atherosclerotic changes, and how to best stabilise them to keep them from rupturing. It appears that the drugs called "statins" play a crucial role in plaque stabilisation even if they don't lower cholesterol as much as we sometimes hope. Statin medications work on at least 20 different steps in the cholesterol synthesis and transport pathways, and we are only touching the tip of the iceberg in realising their benefits.
Thank you for visiting JustAnswer.com's Health Information. I hope that all of your concerns have been addressed and that your experience here was positive and helpful. If you have a new or different question, please don't hesitate to come back or submit a new question. It has been a pleasure helping you. Your FEEDBACK is very important to me.
Thank you very much for the additional information. It is helpful and appreciated. I apologise for my delay in responding today, I just got off work very late but wanted to check on any responses here at JustAnswer.com before retiring.
The discomfort under the shoulder blade does not sound typical of cardiac pain, although I am glad they did a CT of the chest because constant pain like that does worry me for aortic problems. I wonder if the CT images reached down to the level of the kidneys at all? The hematuria is difficult to assess over the discussion here, because it requires all the technical terminology, other labs, imaging, and physical examination findings in order to diagnose ... sometimes even more invasive studies such as ultrasound or CT guided biopsy are needed.
The other pain, the one that radiated around and under the rib area, also sounds atypical for cardiac pain, but again is very hard to discern through discussion here. Cardiac pain in women is sometimes very atypical, and causes many physicians to write it off as something else. Although you work out three times weekly, it would be reasonable to have a stress test evaluation to evaluate your exertional tolerance and stress EKG. The same process that causes atherosclerosis in the aorta takes place in the coronary arteries, cerebral arteries, and other major arteries throughout the body.
Some questions to address with your physician:
Could it be pain from chest or abdominal adhesions following your surgery (possible)? Could it be related to the hematuria (quite possible, kidney stones?)? If it was right-sided, could it be gallbladder or gallstones (possible, plus this pain often radiates to the back and/or shoulder ridges)? Did your physician do liver function labs? Did your labs include tests for inflammation of the pancreas (which can radiate toward the back and between the shoulder blades)?
These are just some of the immediate thoughts going through my mind as I read your additional information in the context of your initial information. There is a lot of ground to cover here. I would prioritise things as such to evaluate the hematuria promptly and to make sure your heart is healthy and able to well-withstand a stress EKG study. Along the same timeline, I belive that the other issues raised in the questions above could be evaluated if they have not already been completed.
That would be my work-flow in your scenario. Most of this is just me typing out loud, but I do want you to be aware of what crosses my mind as I think about all of these issues. I am a little overprotective of all of you, my little flock of Internet information seekers, but I am proud of you for having excellent insight and seeking information in order to be an informed patient. While I am not privy to all the information that your physician is, this information may help you to ask the right questions and to address your concerns clearly and concisely to your doc.
In the end, all I hope for is that I have helped you in some way, shape, or form. I wish you well. I would greatly appreciate updates and progress notes on how you are doing and what you are finding out. You can pop in here and drop me a note any time. I am at your service!
Regards,XXXXX XXXXX, MD
Do you have any other questions or concerns? If not, please click the ACCEPT button so that I may get credit for my work. If you have any questions or concerns along this line, we can still continue to discuss things even once you click ACCEPT. I hope the information I provided was useful. I do wish you well, and appreciate your allowing me the opportunity to provide this information.
--XXXXX XXXXX, MD
I am relieved to hear that the CT imaging was continued on down through the abdomen and pelvis. The haematuria (hematuria) remains concerning, and I hope that the physician(s) is/are paying due attention to that issue. If there are red cell casts (packed together instead of just free floating), white cell casts, or hyaline casts the cause of the haematuria is coming from the kidney level glomeruli or tubular level. If there are no red cell casts, then the workup will focus on other causes at lower levels than the kidney tubules.
Adhesions remain a possible cause of the pain, and if you were my patient I would feel obligated to make sure your coronary arteries are capable of keeping up with stress demands during exertion, since the atherosclerotic process isn't particular about which arteries it affects ... it tends to be a ubiquitous, wide-spread process. The specific terminology of the CT report on the plaque changes is important, such as size, extent, locations, calcification, and aortic diametre. I would discuss the pro's and con's of considering a plaque stabilising medication from the "statin" class of medications because of their pleiotropic (having many effects, not just "lowering cholesterol") effects.
I do appreciate progress updates, but you don't have to feel obligated to do so ... and, I welcome follow-up questions or concerns should they arise along this same topic. I am at your service. Be well. /Daniel