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My Heart Was the Case Study: Why a CAC Score of Zero Didn't Tell the Whole Story

Written by
Irma Jennings, INHC
Uploaded
October 23

Heart disease is the number one killer of women in the United States, responsible for about one in five female deaths. Yet many women still believe breast cancer is the bigger threat. I was one of them for longer than I'd like to admit.

So when my integrative cardiologist, Dr. Sanul Corrielus, and I sat down to talk about women's heart health, I offered him the most honest example I had: my own heart.

Why I Take Heart Health Personally

My father died at 54. My mother at 66. My sister at 60. Add 25 years of smoking and a high-stress Wall Street career, and you can see why I don't leave my heart to chance.

But here's the first surprise. When I told a lipidologist I had a family history of heart disease, she asked how I knew. Without medical records or autopsy reports, family history is a story, not data. That question sent me looking for real numbers.

Women's Heart Symptoms Are Easy to Miss

Two in three women who die suddenly of heart disease had no prior symptoms. And when women do have symptoms, they rarely look like the movie version. Watch for:

  • Unusual fatigue
  • Nausea or upper abdominal pain
  • Back, neck, or jaw pain
  • Shortness of breath

These are easy to dismiss, by us and by our doctors. That's exactly why testing matters.

My Test Results Disagreed With Each Other

My advanced blood work looked alarming:

  • ApoB: 118 (target under 80)
  • LDL particle number: 2,105 (high risk)
  • hsCRP: 7, a marker of inflammation (target under 1)
  • Lp-PLA2: 131 (elevated vascular inflammation)

On paper, I was a statin prescription waiting to happen.

But my imaging told a different story. My coronary artery calcium (CAC) score was zero. Twice. My carotid ultrasound, echocardiogram, stress test, and heart monitor were all normal.
So which was right?

Why a CAC Score of Zero Isn't the Whole Story

A CAC scan only sees calcified plaque. It can't see soft plaque, the kind that's more likely to rupture and cause a heart attack.

To settle the question, Dr. Corrielus ordered a coronary CT angiography (CCTA), a scan with contrast dye that can detect soft plaque. Mine was read with HeartFlow AI, which the technician said was faster and more accurate than the older off-site readings.

The result: no soft plaque. My blood work showed potential risk, not actual disease.

The Outcome: No Statin, For Now

With that complete picture, Dr. Corrielus decided I didn't need a statin. We'll recheck in a year.
This is what integrative cardiology means to me. Not one number. Not one test. The whole picture, so you're neither under-treated nor over-treated.

Root-cause thinking showed up in another way too. I'd had an allergic reaction to red yeast rice, a natural cholesterol option that works much like a mild statin. Dr. Corrielus traced the reaction not to the red yeast rice itself but to a binder in that particular brand. Different brand, different story. We'll revisit it when the timing is right.

What You Can Do Now

  • Check your blood pressure at home weekly. The target is under 120/80. If it runs high, check daily at the same time, such as before breakfast.
  • Know your vitamin D. Above 30 ng/mL is the minimum; around 50 is ideal.
  • Ask about advanced markers like ApoB and hsCRP. Panels such as Cleveland HeartLab and Cardio IQ give similar information. Getting the data matters more than which lab you use.
  • Ask whether a CAC scan makes sense for you. It often costs around $150 and usually isn't covered by insurance. It isn't a universal screening tool, which is why the conversation with your cardiologist matters.
  • If your results conflict, ask what would resolve them. For me, that was a CCTA.

Watch the Full Conversation

Dr. Corrielus walks through every one of my results in our video interview, including the questions women most often ask him.

Your heart deserves more than one number. So do you.

This post shares my personal experience and is for education only, not medical advice. Please talk with your own doctor about the testing and treatment that's right for you.

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From my bones to yours,

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Irma Jennings, INHC - Osteoporosis Patient Navigator

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